Podcasts about final rule

*Content Warning: sexual violence, stalking, on-campus violence, intimate partner violence, gender-based violence, stalking, rape, and sexual assault.*Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources   Check out our brand new SWW Sticker Shop!: https://brokencyclemedia.com/sticker-shop *SWW S25 Theme Song & Artwork: The S25 cover art is by the Amazing Sara Stewart instagram.com/okaynotgreat/ The S25 theme song is a cover of Glad Rag's U Think U from their album Wonder Under, performed by the incredible Abayomi instagram.com/Abayomithesinger. The S25 theme song cover was produced by Janice “JP” Pacheco instagram.com/jtooswavy/  Follow Something Was Wrong: Website: somethingwaswrong.com  IG: instagram.com/somethingwaswrongpodcast TikTok: tiktok.com/@somethingwaswrongpodcast  Follow Tiffany Reese: Website: tiffanyreese.me  IG: instagram.com/lookieboo *Sources:Association of American Universities. 2019 AAU Campus Climate Survey on Sexual Assault and Misconduct. Association of American Universities, 2019, www.aau.edu/key-issues/aau-campus-climate-survey-sexual-assault-and-misconduct. “The Story.” The Hunting Ground, 27 Feb. 2015, thehuntinggroundfilm.com/story.html. U.S. Department of Justice, Office on Violence Against Women. A National Protocol for Sexual Assault Medical Forensic Examinations: Adults/Adolescents. U.S. Department of Justice, 2013, updated 2023, www.justice.gov/ovw/sexual-assault-medical-forensic-examinations. U.S. Department of Justice, Bureau of Justice Statistics. Rape and Sexual Assault Victimization Among College-Age Females, 1995–2013. U.S. Department of Justice, Dec. 2014, www.bjs.ojp.gov/content/pub/pdf/rsavcaf9513.pdf. U.S. Department of Education, Office for Civil Rights. Title IX of the Education Amendments of 1972; Final Rule. Federal Register, 6 May 2020, www.federalregister.gov/documents/2020/05/19/2020-10512.

The Centers for Medicare and Medicaid Services has finalized the 2026 Outpatient Perspective Payment System (OPPS) rule, with most policies taking effect on January 1, 2026. Jenna Stern, Vice President of Regulatory Affairs and Public Policy at Vizient, joins host Carolyn Liptak, Pharmacy Executive Director in Vizient's Center for Pharmacy Practice Excellence, to discuss key updates to payment policies, payment rates, and quality provisions affecting Medicare beneficiaries receiving care in hospital outpatient departments and ambulatory surgical centers.   Guest speaker:    Jenna Stern Vice President of Regulatory Affairs and Public Policy Vizient Host:   Carolyn Liptak, MBA, RPh  Pharmacy Executive Director Vizient  Verified Rx Host   Show Notes: 00:05 — Introduction Announcer welcomes listeners to VerifiedRx. Host Carolyn Liptak, Pharmacy Executive Director at Vizient, introduces the episode focus: the 2026 CMS Outpatient Prospective Payment System (OPPS) Final Rule. Guest: Jenna Stern, VP of Regulatory Affairs and Public Policy at Vizient.   01:12 — Overview of the OPPS Final Rule OPPS sets Medicare payment for most hospital outpatient services. Published annually (typically November), effective January 1. Covers payment rates, policies, quality programs, and compliance requirements. Note: CMS delayed enforcement of hospital price transparency requirements until April 1, 2026.   01:34 — Key Takeaways From the 2026 Final Rule Jenna's high-level insights: Hospitals will continue facing financial pressure in 2026. Modest payment rate increase combined with reimbursement-reducing policies. Expansion of site-neutral payment policies will be particularly impactful. Rule reflects emerging administration priorities shaping future policy.   02:21 — OPPS Payment Rate Update for 2026 CMS finalized a 2.6% OPPS schedule increase factor for hospitals meeting quality reporting requirements.   02:40 — What the 2.6% Increase means Based on: 3% market basket update –0.7% productivity adjustment Results in a modest net increase. Slightly better than the proposed 2.4% increase, though still viewed as inadequate. CMS estimates $8 billion increase in total OPPS payments compared to 2025.   03:37 — 340B Remedy Offset: Background From 2018–2022, CMS paid for 340B drugs at ASP –22.5%. Prior Supreme Court decision from 2022 found that CMS lacked authority to vary rates as finalized in prior rulemaking (e.g., without using drug acquisition cost surveys to inform policy).   04:13 — 340B Remedy Offset in the 2026 Final Rule CMS considered increasing the remedy offset from 0.5% to 2%. Stakeholders strongly opposed the increase due to hospital financial strain.   05:10 — Final Outcome CMS retained the 0.5% offset for 2026. CMS signaled that larger offsets may be proposed for 2027. This marks the first year the remedy offset takes effect,   06:00 — Site-Neutral Payment Policy: What It Is Concept: same service = same payment, regardless of site of care. Hospital concern: policy reduces hospital reimbursement without accounting for site of care differences, patient acuity, overhead, or service complexity.   06:15 — Site-Neutral Expansion in the 2026 Rule CMS expanded site-neutral payment to include drug administration services at excepted off-campus provider-based departments.   07:08 — Financial Impact Reimbursement aligns with Physician Fee Schedule rates. CMS estimates $290 million reduction in outpatient spending for 2026. $220 million of savings accrue directly to Medicare. Not implemented in a budget-neutral manner.   08:14 — Non-Opioid Pain Management Payments Temporary additional payments began January 1, 2025. Authorized under the NO PAIN Act (Consolidated Appropriations Act of 2023).   08:28 — What's New for 2026 CMS finalized the renewal of: 5 drugs 13 medical devices eligible for separate payment in HOPD and ASC settings. Per statue, payments available through December 31, 2027.   09:32 — Process Improvements CMS will allow more frequent consideration of new qualifying products (not limited to annual updates). Quality criteria unchanged; timing flexibility added. CMS released guidance on how stakeholders can engage for inclusion.   10:58 — OPPS Drug Acquisition Cost Survey CMS finalized plans to survey hospitals on acquisition costs for separately payable OPPS drugs.   11:21 — Why CMS Is Advancing the Survey Addresses Supreme Court requirements from prior 340B litigation. Aligns with White House Executive Order on lowering drug prices. Positions CMS to use survey data for 2027 rulemaking.   12:47 — OPPS Packaging Thresholds for 2026 Drugs and biologics: Threshold remains at $140. Diagnostic radiopharmaceuticals: Increased to $655 (from $630). Products below thresholds retain Status Indicator “N” (packaged payment).   13:26 — Why Billing Packaged Drugs Still Matters Even though not separately payable, hospitals must bill for packaged drugs. Billing data feeds cost reports used to calculate future bundled payments. Failure to bill can result in inaccurately low reimbursement.   14:14 — Elimination of the Inpatient-Only (IPO) List CMS finalized a three-year transition to eliminate the IPO list by January 1, 2029.   14:32 — Why This Change Is Significant IPO list historically ensured certain services were provided inpatient only. CMS emphasizes provider judgment in determining site of care. Raises concerns about: Patient safety Payer coverage changes Pressure to move services outpatient   16:28 — ASC Covered Procedure List Expansion CMS expanded the ASC Covered Procedure List. Enables more Medicare covered services to be performed in the ASC settings.   16:48 — Price Transparency: Still a Priority No major overhaul, but continued refinement. CMS exploring new uses of price transparency data beyond patient comparison.   17:46 — Most Critical Policies to Watch Jenna highlights: Modest OPPS payment increase Site-neutral payment expansion 340B remedy offset Drug acquisition cost survey Broader regulatory activity beyond OPPS   18:43 — Available Vizient Resources OPPS Final Rule Summary Government Relations & Public Policy Summaries  Advocacy   19:20 — Closing Carolyn thanks Jenna for her insights. Reminder to subscribe, like, and share feedback. VerifiedRx is produced by the Vizient Center for Pharmacy Practice Excellence.   Links | Resources:  Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots: Click Here CMS fact sheet on the Final Rule: Click Here Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey: Click Here Vizient Office of Public Policy and Government Relations final rule summary:  Click Here Final List of Qualifying Products for Separate Payment for non-opioid pain medications: (Table 136, pgs. 1138-1140)   VerifiedRx Listener Feedback Survey: We would love to hear from you - Please click here   Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed    

Terry kicks off 2026 by clearing up a major misunderstanding in the provider and manufacturer community. Some believed that CMS's last‑minute withdrawal of the LCD for skin substitute products would delay or stop the 2026 reimbursement changes. That's not the case. The LCD withdrawal has no impact on the Final Rule, and the new 2026 reimbursement methodology for skin substitutes will move forward exactly as finalized, using an incident‑to payment structure. In this episode, Terry breaks down the difference between the policy halt and the reimbursement rules, and explains what providers need to know about the updated approach to skin substitutes and skin graft products and services. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Skin Substitutes and Grafts LCD vs Reimbursement 2026 appeared first on Terry Fletcher Consulting, Inc..

As home health agencies prepare for 2026, CMS is turning up the heat on fraud, compliance, and enforcement—and the consequences are more serious than ever.In this episode of Gravity Healthcare Hacks, host Melissa Brown, COO of Gravity Healthcare Consulting, is joined by Devin Kassi, VP of Home Health Operations, for a critical follow-up discussion on the Home Health Final Rule. This time, they dive deep into Medicare's expanded authority around fraud investigations, retroactive payment recoupment, and why even unintentional missteps can put agencies at risk.Melissa and Devin unpack:How CMS is redefining and enforcing fraudWhy documentation errors can trigger massive repayment demandsThe growing importance of homebound status documentationHow weak processes, outdated technology, and lack of education create dangerous blind spotsWhat agencies must do now to protect themselves and remain viableThis conversation is a must-listen for home health leaders—especially smaller and single-location agencies—who want to understand what's coming and how to adapt before it's too late.Because in today's regulatory environment, doing nothing is the biggest risk of all.Support the show

We break down the 2026 home health final rule, from the 1.3 percent cut and sequestration impact to face-to-face, OASIS, HHCAHPS, and value-based purchasing changes. We share concrete steps to shore up documentation, data, and budgets before January 1, 2026.• Why the final rule timing compresses preparation• Payment impact of the 1.3 percent cut plus sequestration• What changes in face-to-face encounter responsibility and proof• Aligning COPs with the all-payer OASIS requirement• How HHCAHPS and OASIS items are being revised• What new and removed VBP measures mean operationally• Anti-fraud signals in enrollment and oversight• Practical actions to update policies, analytics, and training• Resources to read and where to find deeper summariesWe did present and post two very detailed summaries with the highlights of the home health content as well as the DME content on our websiteVisit our websiteConnect with us - LinkedIn, Twitter, YouTube, FacebookMake Lives Better

We unpack the 2026 CMS DME final rule with an eye on what changes first, what it costs, and how suppliers can adapt without disrupting patient care. Annual surveys, stricter accreditation oversight, and targeted incentives reshape strategy, budgets, and daily operations.• Annual surveys begin at next initial or reaccreditation after 1 January 2026• Elimination of temporary accreditation before surveying new service locations• CHOW events may trigger initial surveys and start annual cadence• Prior authorization exemption for suppliers maintaining 90% approval• Added products and remote item delivery in competitive bidding• Increased CMS validation, AO reapproval, and continued sampling• Faster complaint reporting and more granular data submission• Clear rationale required when accepting corrective action plans• Address changes and warehouse functions require survey planning• Practical steps for budgeting, staffing, and strategic footprint decisionsRead the final rule. Listen to industry webinars and review our resources to understand the key elements and direct impact on suppliers.Visit our websiteConnect with us - LinkedIn, Twitter, YouTube, FacebookMake Lives Better

In this episode of the ASC Podcast with John Goehle we discuss the latest news, including the delay in the Pre-authorization pilot and Anthem's new policy on out-of-network providers.   In our focus segment we discuss the final 2026 CMS ASC/HOPD Payment Rule    This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and  Ambulatory Healthcare Strategies.  Notes and Resources from this Episode: Final Rule: https://public-inspection.federalregister.gov/2025-20907.pdf Press Release about Final Rule: https://www.cms.gov/newsroom/press-releases/cms-empowers-patients-boosts-transparency-modernizing-hospital-payments Fact Sheet about Final Rule: https://www.cms.gov/newsroom/fact-sheets/calendar-year-2026-hospital-outpatient-prospective-payment-system-opps-ambulatory-surgical-center Downloads for the Final Rule: https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/regulations-notices/cms-1834-fc ASC Quality Reporting web site: https://www.qualityreportingcenter.com/en/ascqr-program/ ASC Association Web Site (Join to get more information): http://ascassociation.org INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop  ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers.  More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers 

This week in the Breakroom, Deborah Godes and Marla Kugel join Julia Grabo to explore key policies in the recently released CY 2026 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Service Center Payment System final rule.

In this episode, Greg and Rob catch up on some clarifications gained around the upcoming 340B rebate model, including purchasing requirements and developments with select chain retail pharmacies updating their policies. Additionally, they discuss the CMS CY2026 OPPS final rule that was just published, including potential implications for 340B hospitals. CMS Hospital Drug Acquisition Cost Survey Info: https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient-pps/outpatient-prospective-payment-system-opps-drug-acquisition-cost-survey Come see us at booth #1545 at the ASHP Clinical Midyear Meeting December 8-11 in Las Vegas!

The 2026 Home Health Final Rule is late—but the impact is already here. In this episode, Melissa Brown (COO) sits down with Devin Kassi, Gravity's VP of Home Health Operations, to break down what agencies should be doing right now to prepare for payment cuts, VBP changes, and rising operational demands.Together they unpack:What a 3–6% payment reduction really means for agency sustainabilityWhy your EMR might be costing you more than it's saving youHow AI-driven clean claims, documentation support, and automated intake can reduce labor needs and boost marginsThe organizational restructuring every agency should be evaluating before 2026How to prepare for the proposed Value-Based Purchasing changes—especially new OASIS measures for bathing and dressingWhy recurring training, ongoing Oasis auditing, and external quality support are now essentialPractical, actionable steps to future-proof your operations before the Final Rule arrivesThis is Part 1 of a two-part conversation designed to give home health leaders a roadmap for navigating reimbursement cuts without compromising care or burning out their teams.Because in today's environment, survival isn't about what you know—it's about how fast you can adapt.Support the show

Explore the essential updates from the official CMS Fact Sheet on the 2026 Home Health Final Rule in this episode of Home Health Revealed, hosted by Hannah Vale. This episode breaks down what the CMS rule means for home health agencies, covering payment changes, compliance updates, and care quality adjustments. Key highlights include: A 2.4% market payment update, offset by adjustments, resulting in an overall 1.3% reduction in Medicare payments to home health agencies. Recalibrated PDGM case-mix weights and updated LUPA thresholds, changing how agencies need to plan visits and document care. Important changes to the Home Health Quality Reporting Program (QRP), including removal of the COVID-19 vaccination measure, as well as updates to OASIS data elements. The launch of a revised Home Health CAHPS survey, new value-based purchasing measures, and changes in quality measure weightings. New compliance provisions and revised provider enrollment rules designed to ensure program integrity and fight fraud. Whether you're an agency leader, clinician, or RCM professional, this episode provides everything you need to know direct from CMS guidance to keep your agency compliant, competitive, and prepared for 2026. Don't miss Hannah's expert take and practical tips for navigating the year's most important regulatory updates. Like, share, and subscribe for more insights on home health policy, revenue cycle optimization, and industry trends. #HomeHealthRevealed #CMSFinalRule #HomeHealth2026 Chapters (00:00:02) - Home Health Revealed(00:00:36) - CMS Final Rules for Home Health Services (2026)(00:03:28) - CMS Final Rule 1, Home Health Payment Rates(00:05:47) - CMS Rule 6, Home Health Quality Reporting Program (HHQ(00:12:36) - CMS Final Rule 2026 for DME POS

https://curewounds.com/Discover how the CMS Final Rule for 2026 will reshape Medicare coverage for chronic wound care, potentially limiting access to life-saving treatments for millions of seniors and introducing mandatory waiting periods that could dramatically affect healing outcomes. KureCare a division of Veracor Group LLC City: Miami Address: 1150 NW 72ND AVE Website: https://curewounds.com

By early 2026, substance use disorder (SUD) providers, health plans, clinicians, health information exchanges (HIEs), and vendors must meet new federal privacy standards for SUD treatment records or face Health Insurance Portability and Accountability Act (HIPAA)-level enforcement and penalties. On this episode, Epstein Becker Green attorneys Lisa Pierce Reisz, David Shillcutt, and Laura DePonio join Nichole Sweeney, General Counsel and Chief Privacy Officer at CRISP, to break down the 42 CFR Part 2 final rule: what's changing, what's staying the same, and what organizations often miss. The group explains how the final rule aligns with (but does not replace) HIPAA, why patient consent remains central, and what new operational risks are emerging. Key Takeaways: Adoption of HIPAA Penalties: Part 2 now adopts HIPAA's enforcement and penalty structure. Operational Readiness Challenges: Operational readiness, not technology, is the biggest challenge. Expanded Compliance Duties: Payors and HIEs face major shifts in data access and compliance duties. Visit our site for related resources and email contact information: https://www.ebglaw.com/dhc91. Subscribe for email notifications: https://www.ebglaw.com/subscribe. Visit: http://diagnosinghealthcare.com. This podcast is presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.

This week in the Breakroom, Jeffrey Davis and Rachel Hollander join Erin Fuller to break down major payment policies in the CY 2026 Medicare Physician Fee Schedule final rule.

Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Podcast for 5 Years: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://blog.feedspot.com/medical_billing_and_coding_podcasts/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Sonal's 16th Season starts up and Episode 10 features a Newsworthy spotlight on November as Lung Cancer Awareness Month.Sonal's Trusty Tip and compliance recommendations focus on telehealth updates made in the CY 2026 Medicare Physician Fee Schedule Final Rule. Spark inspires us all to reflect on resilience based on the inspirational words of Margaret Thatcher.Lung Cancer Awareness Month:American Lung Association® Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.lung.org/lung-force/about-lung-force/featured-campaigns/lung-cancer-awareness-month⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Paint The Medical Picture Podcast now on:Spotify: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3X⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id153044217⁠7⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Amazon Music: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Find Paint The Medical Picture Podcast on YouTube: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7A⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Find Sonal on LinkedIn:⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/sonapate/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠And checkout the website:⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://paintthemedicalpicturepodcast.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠PaintTheMedicalPicturePodcast@gmail.com⁠⁠⁠⁠⁠⁠⁠⁠

Kathy Roe, Managing Attorney, Health Law Consultancy, speaks with Annie Shieh and Judith Waltz, Partner, Foley & Lardner, about the impact of recent changes to Medicare Advantage (MA) compliance on plans and providers. They discuss what plans and providers are responsible for when it comes to MA compliance, the current MA landscape, MA compliance changes from a plans perspective (including the current Administration and the 2026 Final Rule), MA compliance changes from a provider perspective (including the 60-day refund rule and recent litigation), and administrative enforcement actions. Annie and Judith spoke about this topic at AHLA's 2025 Annual Meeting in San Diego, CA. From AHLA's Payers, Plans, and Managed Care Practice Group.Watch this episode: https://www.youtube.com/watch?v=vjRzb0UiNuYLearn more about the AHLA 2025 Annual Meeting that took place in San Diego, CA: https://www.americanhealthlaw.org/annualmeeting Learn more about AHLA's 2025 Annual Meeting eProgram: https://educate.americanhealthlaw.org/local/catalog/view/product.php?productid=1472 Learn more about AHLA's Payers, Plans, and Managed Care Practice Group: https://www.americanhealthlaw.org/practice-groups/practice-groups/payers-plans-and-managed-careEssential Legal Updates, Now in Audio AHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Premium members. Get all your health law news from the major media outlets on this podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast. Stay At the Forefront of Health Legal Education Learn more about AHLA and the educational resources available to the health law community at https://www.americanhealthlaw.org/.

Welcome solo and group practice owners! We are Liath Dalton and Evan Dumas, your co-hosts of Group Practice Tech. In our latest episode, we have an important update for therapists regarding the reproductive health Final Rule.  We discuss: The Final Rule requirements that would have impacted therapists Why the Final Rule isn't applicable now Being aware of any state laws that are applicable regarding reproductive health information Intentionality and care around sensitive info within PHI Our CE training on Law and Ethics of Clinical Documentation in a Post-Roe World Listen here: https://personcenteredtech.com/group/podcast/ For more, visit our website. PCT Resources Relevant on-demand, legal-ethical CE training: Law & Ethics of Clinical Documentation for a post Roe world Addresses the practical applications of the US Supreme Court's ruling in Dobbs v. Jackson Women's Health Organization, with particular focus on the impacts this decision has on client confidentiality and documentation of clinical services Group Practice Care Premium weekly (live & recorded) direct support & consultation service, Group Practice Office Hours -- including monthly session with therapist attorney Eric Ström, JD PhD LMHC Resources & References HHS OCR Fact Sheet – HIPAA Privacy Rule to Support Reproductive Health Care Privacy (Final Rule Overview) JD SUPRA Article: Federal Court Strikes Down HIPAA Reproductive Health Privacy Rule Lifting Compliance Requirements for Regulated Entities Court Case – Purl v. U.S. Department of Health and Human Services, No. 2:24-cv-228-Z (N.D. Tex. June 18, 2025) (decision vacating most of the Final Rule) Legal Analysis – Holland & Knight: HIPAA's Reproductive Health Rule is Vacated Nationally Law Firm Compliance Guidance – Ropes & Gray: U.S. District Court Ruling Vacates HIPAA Final Rule on Reproductive Health Privacy

Recently, a federal court vacated the Centers for Medicare & Medicaid Services 2023 Risk Adjustment Data Validation (RADV) Final Rule.This action is reshaping the landscape for Medicare Advantage compliance. The rule had authorized contract-level extrapolation and eliminated the longstanding fee-for-service (FFS) adjuster — two changes that dramatically increased the potential scale of overpayment recoveries.Reporting this developing story during the next live edition of Monitor Monday will be senior healthcare analyst Frank Cohen,The weekly broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, senior legislative affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

CMS's FY 2026 hospice final rule introduces significant changes to the face-to-face (F2F) attestation requirements starting October 1, 2025. All in all, the news is positive: while there is a new requirement for the F2F attestation to be signed and dated, the signed and dated F2F clinical note on its own can now serve as the F2F attestation. In this episode, Husch Blackwell attorneys Meg Pekarske and Andrew Brenton share their thoughts on what the updated F2F attestation rules mean for hospice operators and weigh in on other components of the final rule, including CMS's attempt at housekeeping by clarifying the types of hospice physicians who can certify patients.

The Office of Personnel Management is trying to nix the idea that everybody gets an A in the Senior Executive Service agencies will soon have to limit how many executives can earn top marks on their performance evaluations. A new Final Rule has paved the way for using a forced distribution system to review SES members. Here with more details is Federal News Network's Drew Friedman. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The FY2026 Hospice Final Rule brings positive changes with a 2.6% payment increase and significant regulatory clarifications that reduce administrative burden for providers nationwide. Jennifer Kennedy and Kim Skehan discuss critical updates affecting hospice operations, with special focus on the imminent HOPE assessment implementation.• 2.6% national payment increase for hospices with cap amount set at $34,465.34• Regulatory clarification allowing any physician member of the IDG to complete certification of terminal illness• Face-to-face attestation requirements simplified, eliminating need for separate documentation• HOPE implementation confirmed for October 1st with data submission through iQIEs system• 90% compliance threshold remains in effect with potential 4% payment reduction for non-compliance• Final date for HIS corrections is February 5, 2026• CMS holding on decisions regarding interoperability and deregulation requestsProviders should evaluate the financial impact of wage index changes, update policies to align with regulatory modifications, and ensure readiness for HOPE implementation through comprehensive staff training.Visit our websiteConnect with us - LinkedIn, Twitter, YouTube, FacebookMake Lives Better

The Pentagon has published the final acquisition rule implementing the Cybersecurity Maturity Model Certification program. The rule, released in yesterday's Federal Register will allow Defense Department procurements to include CMMC assessment requirements. The assessments are intended to ensure defense contractors are following cybersecurity standards for protecting controlled unclassified information. The Pentagon estimates 80,000 defense contractors may be required to obtain a CMMC assessment. Officials plan to phase in the requirements over a three-year period. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Welcome solo and group practice owners! We are Liath Dalton and Evan Dumas, your co-hosts of Group Practice Tech. In our latest episode, we clarify who is impacted by the Part 2 Final Rule. We discuss: What's included in the Part 2 Final Rule and why it's necessary How to evaluate if you're subject to Part 2 rules  What compliance looks like under the new Part 2 rules Redisclosure under Part 2 Steps to take ahead of the February 2026 deadline for enforcement Listen here: https://personcenteredtech.com/group/podcast/ For more, visit our website.   PCT Resources: Handout resource: A quick-reference tool to determine if you're a Part 2 program, lawful holder, or not subject—and a concise summary of the new redisclosure rules under the 2024 Final Rule. Helps you prep for the Feb 16, 2026 compliance deadline with clarity and confidence. Part 2 Decision Tree Checklist + Redisclosure Rules (docx version) Part 2 Decision Tree Checklist + Redisclosure Rules (PDF version) Group Practice Care Premium weekly (live & recorded) direct support & consultation service, Group Practice Office Hours -- including monthly session with therapist attorney Eric Ström, JD PhD LMHC + assignable staff HIPAA Security Awareness: Bring Your Own Device training + access to Device Security Center with step-by-step device-specific tutorials & registration forms for securing and documenting all personally owned & practice-provided devices (for *all* team members at no per-person cost) + assignable staff HIPAA Security Awareness: Remote Workspaces training for all team members + access to Remote Workspace Center with step-by-step tutorials & registration forms for securing and documenting Remote Workspaces (for *all* team members at no per-person cost) + more Resources: JD Supra article: HHS Signals Enforcement Regarding Patients' Substance Use Disorder Treatment Records

CMS (Centers for Medicare & Medicaid Services) has released the Fiscal Year 2026 Final Rule for hospital and long-term care payments, and it brings important updates for quality reporting, interoperability, and compliance.Learn what's changing, from the end of the low wage index hospital policy to adjustments in reporting programs, and new expectations under the Promoting Interoperability Program. We'll also highlight why the Security Risk Analysis is taking on an even more central role.Whether you're directly affected or just want to understand where policy is headed, this episode offers a clear look at the changes and how hospitals can prepare.Learn more about Medcurity here: https://medcurity.com#Healthcare #Cybersecurity #Compliance #HIPAA #SecurityRiskAnalysis #Medicare #Medicaid #CMS 

In this episode, Bob McDowell, BESLER Sr. Reimbursement Consultant, shares a glimpse into BESLER's free CPE Webinar, FY 2026 IPPS Final Rule Summary, live on Wed., Sept. 10, at 1 PM ET.

The Friday Five for August 29, 2025: Ritter Summits Takeaways & Shoutouts What I'm Watching Right Now Apple “Awe Dropping” Event Announced Spotify Slips Into the DMs Judge Grants Stay on Many 2025 ACA Final Rule Provisions   Get Connected:

Gain access to Everything Senior Insurance: https://eseniorinsurance.com/On this episode of the Seven Figures or Bust podcast, we break down the conclusion of the 2024 Final Rule court case. We discuss what the outcome means for agents, agencies, and the industry as a whole. Tune in to hear key takeaways and insights that could impact your business moving forward!Learn more about getting your own VA with Hire Heroes here: https://app.hireheroes.com/signup?fpr=christian43Join our free private Facebook group for insurance agents: https://www.facebook.com/groups/551409828919739/Learn more about getting your own VA with Hire Heroes here:  https://app.hireheroes.com/signup?fpr=christian43Get access now to 7 Figure Medicare University:Lifetime access:https://sevenfigureu.com/                    Welcome to the Christian Brindle channel brought to you by Christian Brindle & Christian Brindle Insurance Services. This channel is here for the sole purpose of bringing training, tips, success stories, and personal development from Christian Brindle. Christian is a published author, hosts the ever popular Everything Medicare Podcast, and made six figures in the Medicare business by the time he was 25 years old.

Medicare doesn't typically cover stairlifts—but some Medicare Advantage plans may. A recent ConsumerAffairs article echoes Medicare.org guidance. The CMS 2025 Final Rule formally recognizes home safety modifications under SSBCI, a sign benefits like stairlifts could expand by 2026. David Bynon City: Prescott Address: 101 W Goodwin St # 2487 Website: https://davidbynon.com

The MOSAIC final rule, an interview with the founder and CEO of Flying Eyes Optics, FAA guidance on certification of powered lift vehicles, new galleries opening at the National Air and Space Museum, a Delta pilot lands and gets immediately arrested, deer strikes in Alaska, and the NTSB investigation of a fatal flight in that state. Also, thoughts on recent moves to relocate the Space Shuttle Discovery from the Smithsonian's National Air and Space Museum to Space Center Houston. Guest Dean Siracusa Dean Siracusa is the founder and CEO of Flying Eyes Optics. Dean, a pilot, started the company when he realized that existing sunglasses did not perform well with the increased clamping force of modern aviation headsets. Flying Eyes temples are made of a patented material that allows the temples to conform to your head instead of curving around your ears. They're easy to put on and take off while wearing a headset or helmet. The flexibility of the temple material and shatterproof polycarbonate lenses makes these glasses hard to break. Hillel Glazer, our Aviation Innovation and Entrepreneurship Correspondent, interviewed Dean at EAA AirVenture Oshkosh 2025. Aviation News U.S. Transportation Secretary Sean P. Duffy Announces Improvements to Recreational Aviation Safety, Expansion of Light-Sport Sector The Modernization of Special Airworthiness Certification (MOSAIC) final rule was announced by U.S. Transportation Secretary Sean P. Duffy. The new rule makes changes to the Light Sport Aircraft (LSA) category and Sport Pilot privileges by expanding an alternative to experimental amateur-built aircraft. MOSAIC: Removes the weight limit Encompasses aircraft with higher speeds, more seats, and retractable landing gear.  Allows for new types of propulsion and modern avionics. Allows aerial work with LSA, such as infrastructure and forest inspections, photography/filming, and agricultural surveillance. Allows pilots operating under Sport Pilot privileges to fly a broader range of aircraft. Reduces regulatory requirements by expanding the types of aircraft that qualify as LSA and the types of aircraft pilots can fly under Sport Pilot privileges. Changes for sport pilots and light-sport repairmen take effect 90 days after the final rule publishes. Changes for LSA certification take effect 365 days after the final rule publishes. Video: Secretary Sean P. Duffy Holds Press Conference for Important Announcement on General Aviation https://www.youtube.com/live/iRzzTspdjUM?si=gje-ftiRm94Y2eY4 EAA Airventure Oshkosh 2025 Facts and Figures Attendance for the week: approximately 704,000, the highest on record. More than 10,000 aircraft, 2,543 show planes, nearly 6,000 volunteers, and 962 commercial exhibitors. FAA Releases Powered-Lift Certification Guidance Originally, certification of the new advanced air mobility (AAM) aircraft types, such as eVTOLs, had been worked under Part 23 regulations for light aircraft. In 2022, the FAA categorized them as powered-lift under FAR 21.17(b) regulations for special class aircraft. That category had no airworthiness standards and operating rules. The FAA has now released an advisory circular “streamlining the certification process for advanced air mobility aircraft by releasing guidance for how manufacturers can meet the agency's aircraft design and performance safety standards. It establishes a consistent, performance-based framework for manufacturers to follow.  The FAA will carefully evaluate each proposed design to ensure it meets the agency's rigorous standards.” The AC defines powered-lift as heavier-than-air aircraft that use “engine-driven lift devices” or engine thrust for vertical takeoff and landing and low-speed flight. For lift during horizontal flight, they use rigid airfoils such as wings. National Air and Space Museum Opens Five New Galleries July 28 [2025] The Smithsonian's National Air and Space Museum opened five ...

In this episode of The Broker Link, Josh Slattery dives into the 2026 Final Rule and its impact on the health insurance landscape. While this year's changes are more modest compared to previous updates, several important developments were discussed: GLP-1 Coverage & Debit Card Rules: Proposed changes to expand GLP-1 drug coverage for obesity and revise flex debit card use were not included in the final rule. SSA Qualification Process: The process for Medicare Special Enrollment Periods is now more complex, requiring verification from past claims or providers. Part D Risk Adjustment: Updates were made to help stabilize the Part D market amid growing cost pressures. Medicaid Impacts: The “Big Beautiful Bill” introduced major changes, including work requirements and stricter eligibility limits for Medicaid beneficiaries. Medicare Advantage Update: Penetration rates have reached 53%, but 6% of enrollees faced plan terminations this year. Josh also shares insights on the current regulatory climate, market volatility, and what agents should watch for as policy changes continue to evolve. Learn more about partnering with The Brokerage Inc. by visiting our website, www.thebrokerageinc.com. Remember to like, share, and subscribe to our show!  New episodes are available every Tuesday. Join our Community! LinkedIn: https://www.linkedin.com/company/the-brokerage-inc-/   Facebook:  https://www.facebook.com/thebrokerageinc/  Instagram:  https://www.instagram.com/thebrokerageinc/  YouTube:  https://www.youtube.com/@TheBrokerageIncTexas  Website:  https://thebrokerageinc.com/ 

The sky is changing—and so is the role of the flight instructor. In this episode of More Right Rudder, we're joined by Chris Penningroth, former Air Force pilot and leader of NAFI's eVTOL and Powered Lift Special Interest Group. Penningroth brings his unique perspective to a conversation about the emergence of eVTOL and powered-lift aircraft and what they mean for the future of flight training. We explore the growing demand for instructors in this cutting-edge sector, the challenges of developing new training materials and standards, and how AI could play a role in everything from instruction to aircraft operations. Someday, an eVTOL/powered-lift aircraft will arrive at an airport near you. Start getting ready for that day, today. If you aren't already a NAFI member, join us at https://nafimentor.org. NAFI members have access to nearly a dozen Special Interest Groups, on a wide variety of instructional specialties. FAA eVTOL and Powered-lift Final Rule: https://www.federalregister.gov/documents/2024/11/21/2024-24886/integration-of-powered-lift-pilot-certification-and-operations-miscellaneous-amendments-related-to Thank you to Gleim Aviation and Sporty's for sponsoring this episode.

Agencies officially have more leeway to fire federal employees who recently started a new job. That's after the Office of Personnel Management finalized changes to the federal probationary period. OPM says its final rule sets expectations for a high performing Federal workforce, but some say the OPM rule focuses on the wrong reforms for probationary employees. Federal News Network's Drew Friedman, got more from the Partnership for Public Services, Vice President of Government Affairs, Jenny Mattingly.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Join Sarah for a rundown of this week's updates for insurance agents, featuring her deep dive into the CMS 2025 ACA Marketplace Integrity and Affordability Final Rule.   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Connect With Us On Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Resources: 5 Things About the Insurance License Exam, 1 Year Later: https://lnk.to/asgf20250620 Are You Self-Sabotaging Your Insurance Sales Success? https://ritterim.com/blog/are-you-self-sabotaging-your-insurance-sales-success/ Four Reasons Why Ritter Should Be Your FMO Insurance Agency: https://ritterim.com/blog/four-reasons-why-ritter-should-be-your-fmo-insurance-agency/ How to Build Intentional Value ft. Neil Reich: https://lnk.to/reich2025 Leveling Up: From Chill Mode to Growth Mode ft. Christian Brindle: https://lnk.to/brindle2025 Seven Figures or Bust Episode 79 - What Is CMS Doing? w/ Special Guest Sarah Rueppel! https://lnk.to/qzTwIw Summer 2025 Survival Guide: https://lnk.to/asgf20250606   References: “2025 Marketplace Integrity and Affordability Final Rule.” CMS.Gov, CMS, 20 June 2025, www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-final-rule. “2025 Marketplace Integrity and Affordability Proposed Rule.” CMS.Gov, Centers for Medicare and Medicaid Services, 10 Mar. 2025, www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-proposed-rule. “CMS Finalizes Major Rule to Lower Individual Health Insurance Premiums for Americans.” CMS.Gov, Centers for Medicare & Medicaid Services, 20 June 2025, www.cms.gov/newsroom/press-releases/cms-finalizes-major-rule-lower-individual-health-insurance-premiums-americans. Minemyer, Paige. “CMS Finalizes Rule Aimed at ‘improper' Sign-Ups on the ACA Exchanges.” Fiercehealthcare.Com, Fierce Healthcare, 20 June 2025, www.fiercehealthcare.com/regulatory/cms-finalizes-rule-aimed-improper-sign-ups-aca-exchanges. Minemyer, Paige. “Democrats Introduce Bill to Establish a Medicare ‘part E' Public Option.” Fiercehealthcare.Com, Fierce Healthcare, 16 June 2025, www.fiercehealthcare.com/regulatory/democrats-introduce-bill-establish-medicare-part-e-public-option. Mercado, Darla. “Fed Decision Recap: Central Bank Signals Stagflation Fears, Powell Says Fed ‘Well Positioned to Wait' on Rates.” CNBC.Com, CNBC, 18 June 2025, www.cnbc.com/2025/06/18/fed-meeting-live-updates-feds-interest-rate-projections-loom.html. “HHS Secretary Kennedy, CMS Administrator Oz Secure Industry Pledge to Fix Broken Prior Authorization System.” HHS.Gov, Department of Health & Human Services, 23 June 2025, www.hhs.gov/press-room/kennedy-oz-cms-secure-healthcare-industry-pledge-to-fix-prior-authorization-system.html. Minemyer, Paige. “Mehmet Oz: Insurers' Prior Auth Pledge ‘an Opportunity for the Industry to Show Itself.'” Fiercehealthcare.Com, Fierce Healthcare, 23 June 2025, www.fiercehealthcare.com/regulatory/oz-insurers-prior-auth-pledge-opportunity-industry-show-itself. “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability.” Federalregister.Gov, Federal Register, www.federalregister.gov/documents/2025/06/25/2025-11606/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability. Accessed 25 June 2025. Schneider, Howard. “Powell Repeats Rate Cuts Can Wait as Fed Studies Tariff Impacts.” Reuters.Com, Reuters, 24 June 2025, www.reuters.com/business/powell-repeats-rate-cuts-can-wait-fed-studies-tariff-impacts-2025-06-24/. Simmons-Duffin, Selena. “RFK Jr. and Dr. Oz Say Health Insurers Will Cut Red Tape on ‘Prior Authorizations.'” NPR.Org, NPR, 24 June 2025, www.npr.org/sections/shots-health-news/2025/06/24/nx-s1-5442713/rfk-jr-dr-oz-health-insurance-prior-authorization.   Not affiliated with or endorsed by Medicare or any government agency.

In this episode, we break down the CMS Final Rule for the 2025 Marketplace and what it means for agents, insurers, and consumers. Key highlights include: Past-due premium enforcement: Carriers may require payment of prior premiums before activating new coverage, with flexibility for state-specific rules. Standardized Open Enrollment: → 2026: Nov 1 – Jan 15 → 2027 and beyond: Federal deadline of Dec 15 Tighter eligibility verification: 75% of applications will be randomly selected for verification. DACA exclusion: DACA recipients will no longer be eligible for Marketplace coverage. Financial impact: CMS estimates $12 billion in savings and an average 5% premium reduction due to increased oversight and fraud prevention. This final rule is a major step toward greater compliance, reduced fraud, and a more stable Marketplace. Learn more about partnering with The Brokerage Inc. by visiting our website, www.thebrokerageinc.com. Remember to like, share, and subscribe to our show!  New episodes are available every Tuesday. Join our Community! LinkedIn: https://www.linkedin.com/company/the-brokerage-inc-/   Facebook:  https://www.facebook.com/thebrokerageinc/  Instagram:  https://www.instagram.com/thebrokerageinc/  YouTube:  https://www.youtube.com/@TheBrokerageIncTexas  Website:  https://thebrokerageinc.com/ 

We started out with the Medicare Advantage Minute during which we learned that the "Final Rule" for MA and Part D drug plans for 2026 has been published. Learn 14 (or fewer) exciting things about what the future holds for those plans. In the "Your Medicare Benefits 2025" segment we learn exactly how Medicare would cover Kidney Disease Education. This is an awkward way of saying that Medicare will pay to educate people about the ravages of Kidney Disease. Did you know that Massachusetts is one of only three states that is allowed to design their own Medicare supplement plans? Well, they did a really bad job of it and they don't seem to care at all. Finally, when it comes to GLP-1 drugs fight diabetes and also happen to promote weight loss, they may not be as wonderful as hoped. Six out of 10 patients stop taking these drugs before seeing meaningful results and many health insurance companies have stopped covering them.   Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Welcome solo and group practice owners! We are Liath Dalton and Evan Dumas, your co-hosts of Group Practice Tech. In our latest episode, we unpack what mental health providers need to know about the recently announced non-enforcement of the 2024 Final Rule of the Mental Health Parity and Addiction Equity Act. We discuss: The history and purpose of the Parity Act What has not changed with the Parity Act Key provisions of the 2024 Final Rule The implications of the non-enforcement of this rule State laws and states with stronger parity protections What you can do as a provider to advocate for parity Resources on parity we recommend Listen here: https://personcenteredtech.com/group/podcast/ For more, visit our website. Resources U.S. Department of Labor MHPAEA page The Kennedy Forum Parity Resource Guide Parity Track (state-specific info) APA Mental Health Parity Efforts NASW Parity Policy Efforts ACA 2025 Policy Agenda AAMFT Federal Advocacy Efforts PCT Resources Parity Checklist for Providers PDF version of Parity Checklist Docx version of Parity Checklist Group Practice Care Premium weekly (live & recorded) direct support & consultation service, Group Practice Office Hours -- including monthly session with therapist attorney Eric Ström, JD PhD LMHC + assignable staff HIPAA Security Awareness: Bring Your Own Device training + access to Device Security Center with step-by-step device-specific tutorials & registration forms for securing and documenting all personally owned & practice-provided devices (for *all* team members at no per-person cost) + assignable staff HIPAA Security Awareness: Remote Workspaces training for all team members + access to Remote Workspace Center with step-by-step tutorials & registration forms for securing and documenting Remote Workspaces (for *all* team members at no per-person cost) + more HIPAA Risk Analysis & Risk Mitigation Planning service for mental health group practices -- care for your practice using our supportive, shame-free risk analysis and mitigation planning service. You'll have your Risk Analysis done within 2 hours, performed by a PCT consultant, using a tool built specifically for mental health group practice, and a mitigation checklist to help you reduce your risks.

We breakdown the 2025 Marketplace Proposed Rule and highlight what we think agents like you should know!    Read the text version    Contact our Under-65 Sales Team!   Resources: CMS Finalizes Improvements to Marketplace Plan Selection with 2026 Final Rule: https://ritterim.com/blog/cms-finalizes-improvements-to-marketplace-plan-selection-with-2026-final-rule/ Everything Agents Need to Know About Selling in State-Based Marketplaces: https://ritterim.com/blog/everything-agents-need-to-know-about-selling-in-state-based-marketplaces/ Everything You Need to Know About the ACA OEP: https://ritterim.com/blog/everything-you-need-to-know-about-the-aca-oep/ How to Help Clients Navigate ACA Marketplace Subsidies & Taxes: https://lnk.to/qzlRwV Lawsuit Changes DACA Recipients' Affordable Care Act Eligibility: https://ritterim.com/blog/lawsuit-changes-daca-recipients-affordable-care-act-eligibility/ Learn with Knight School: https://ritterim.com/knight-school/ Meet Ritter's Under-65 Sales Team: https://ritterim.com/meet-your-sales-team/ Steps to Get Ready for OEP: Federal Exchange States & State Based Exchanges: https://lnk.to/SyqM9T   References:   “2025 Marketplace Integrity and Affordability Proposed Rule.” CMS.Gov, Centers for Medicare & Medicaid Services, https://www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-proposed-rule Accessed 23 Apr. 2025.   Follow Us on Social!  Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.

In this episode of 1st Talk Compliance, Kevin Chmura is joined by Rachel Rose, JD, MBA, to discuss the HIPAA Privacy Rule to Support Reproductive Healthcare Privacy, passed in 2024. With the reproductive healthcare landscape being very dynamic, this new rule has already passed one compliance date, with a second important date coming in February 2026. Tune in to learn about this new rule, and what it means in terms of reproductive health, patient privacy, and the legality between different states. In addition, learn some best practices for implementing the requirements of this rule into your practice. Kevin Chmura Rachel, thank you for joining us. Appreciate you joining us and looking forward to a timely discussion.   Rachel V. Rose Thank you, Kevin, for having me, as well as to Panacea and First Healthcare Compliance, it's always my pleasure to coordinate and converse with you on our favorite healthcare compliance topics.   Kevin Chmura And it's always great having you helping us with this and your expertise is invaluable. And you helped us and were the contributor, really writer, of an e-book on this particular subject that will be released very soon. Really this podcast is somewhat of a companion piece to that. And so what we're talking about today is the HIPAA privacy rule to support reproductive health care privacy, passed in 2024. Reproductive health is a prominent and evolving topic within the healthcare policy landscape. It really, major changes have come down in recent years, and so there's just a ton. So we thought it would be great to publish a book to get everybody up to speed and, but moreover, this podcast is an opportunity for people to hear directly from the person who helped us develop that. And that is Rachel. So, Rachel, I wonder, can you just start off by giving us a synopsis of the 2024 Final Rule, maybe some key terms we should be thinking about?   Rachel V. Rose Sure. As you mentioned, Kevin, the reproductive healthcare landscape is very dynamic and the rule itself was issued on April 22nd of 2024 with an effective date of June 25th of 2024. And basically what an effective date does is to start the clock running as to when certain requirements need to be implemented. In this particular rule, which I will refer to as the HIPAA Reproductive Rule, has two prongs of compliance dates. The first already passed and that had to be done by December 23rd, 2024. And for your clients who were with First Healthcare Compliance or Panacea at the time, they were able to access FAQs. And the first prong of the requirements really addressed every applicable item that I'll run through, with the exception of the notice of privacy practices. Now, for anyone who's been in the healthcare sector for a long time, and for anyone who goes to the doctor, a dentist or even a pharmacy to pick something up, we all know we have to sign the HIPAA authorization form, and then covered entities are required to post their notice of privacy practices. So the updated privacy practices, which need to include some of the reproductive health requirements among other items, does not need to be done until February 16 of 2026. So this is similar to the staggering of the compliance dates which we saw with the Final OmnibusRrule, which was published in the Federal Register, it's hard to believe, but going on over 12 years ago and that was January 25th of 2013. Now specifically, the HIPAA reproductive rule really prohibits the disclosure of protected health information related to in these terms I need you to focus on: lawful reproductive health care in certain circumstances. And the reason it's important is because legal means that whatever service or good is being sought, it has to be legal within the jurisdiction where the individual is receiving that care or that good, so to speak. And so if we want to take certain types of surgeries or certain types of procedures that in a viable fetus's lif...

Join Sarah as she dives back into CMS regulations! This week, she highlights 5 regulations from the 2026 Medicare Advantage and Part D Final Rule.   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Resources: 5 Things About the 2026 CMS MA and Part D Rate Announcement: https://lnk.to/asgf20250411 CMS 2025 Marketplace Integrity & Affordability Proposed Rule: https://lnk.to/asgf20250314 CMS Updates to MA and Part D for CY 2026: https://lnk.to/asgf20250425 Expanded Medicare Telehealth Benefits Extended Through September 2025: https://ritterim.com/blog/expanded-medicare-telehealth-benefits-extended-through-september-2025/  Recent ACA Coverage Changes Reversed with 2025 Marketplace Proposed Rule: https://ritterim.com/blog/recent-aca-changes-reversed-with-2026-marketplace-proposed-rule/   References: “CMS Finalizes 2026 Payment Policy Updates for Medicare Advantage and Part D Programs.” CMS.Gov, Centers for Medicare and Medicaid Services, 7 Apr. 2025, www.cms.gov/newsroom/press-releases/cms-finalizes-2026-payment-policy-updates-medicare-advantage-and-part-d-programs. “Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F).” CMS.Gov, Centers for Medicare & Medicaid Services, 4 Apr. 2025, www.cms.gov/newsroom/fact-sheets/contract-year-2026-policy-and-technical-changes-medicare-advantage-program-medicare-prescription-final. “Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly.” Federalregister.Gov, Federal Register, 15 Apr. 2025, www.federalregister.gov/documents/2025/04/15/2025-06008/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare.     Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.

Updates, Medicarians Recap & AI in Healthcare | Episode 83Agent Boost is back in the studio after an intense travel schedule! In this episode, Dan and Mike discuss their recent trip to the Medicarians 2025. Key topics include the latest CMS call letter and its implications, exciting updates in funding for Medicare Advantage plans, and the role of artificial intelligence in healthcare. They also delve into the industry's focus on ancillary products, and share their thoughts on the effectiveness of ship counselors based on a recent JAMA survey. Don't miss insights on navigating the complex world of Medicare!

In Episode 3, host Jordan L. Fischer, Esq. interviews Corey Dennis, Chief Privacy Officer & Assistant General Counsel at Legend Biotech, where he leads the global privacy, cybersecurity, and artificial intelligence legal programs. In this episode, Jordan and Corey walk through two recent developments that are impacting data strategies in the healthcare and life sciences industry: the EU NIS2 Directive and the Department of Justice ("DOJ") Final Rule on the bulk transfer of sensitive data to “countries of concern” or “persons of concern.” Corey provides practical insights into the way that both of these new requirements are impacting businesses, as well as considerations for businesses who are required to comply with these changes. For more information on Corey Dennis, visit: https://www.linkedin.com/in/corey-m-dennis-cipp/. To contact our host, Jordan L. Fischer, Esq., regarding this podcast or to inquire into becoming a guest, please contact Ms. Fischer at jordan@jordanfischer.me.

In this case, the court considered this issue: Did the ATF exceed its statutory authority in promulgating its Final Rule purporting to regulate so-called “ghost guns”?The case was decided on March 26, 2025.The Supreme Court held that the Gun Control Act of 1968 authorizes the ATF to regulate weapon parts kits and unfinished frames or receivers that can be readily converted into functional firearms. Justice Neil Gorsuch authored the 7-2 majority opinion of the Court.  Weapon parts kits qualify as “weapons” under the statute when they contain all necessary components to build a gun and their intended function is clear. Everyday language permits describing incomplete objects by their intended use, just as a disassembled rifle remains a “weapon.” The statute reinforces this understanding by treating starter guns as firearms even though they require modification. A kit like Polymer80's “Buy Build Shoot,” which can be assembled in about 20 minutes using common tools, meets the law's definition because it can be “readily converted” into a functioning firearm, just as a blocked-barrel starter gun qualifies when easily modified for live fire. While not all kits may fall under this definition, the statute clearly covers at least some, making a facial challenge to the rule invalid.  The definition of “frame or receiver” also includes partially complete versions that can be finished quickly with standard tools. Ordinary language and the statute's serialization requirements support this reading, as identification numbers are required on unfinished frames and receivers. Law enforcement has long treated such components as regulated firearms, and even the challengers conceded that some unfinished frames fall within the law's scope. While some objects may be too incomplete to qualify, the statute reaches at least those requiring only minimal work, making ATF's rule facially consistent with the law. Concerns about unintended consequences under the National Firearms Act are misplaced, as the government disavowed any authority to classify AR-15 receivers as machine guns, and the doctrines of lenity and constitutional avoidance do not apply where the statute's meaning is clear.Justices Sonia Sotomayor, Brett Kavanaugh, and Ketanji Brown Jackson each joined the majority opinion and also wrote separate concurring opinions.Justices Clarence Thomas and Samuel Alito each authored dissenting opinions.The opinion is presented here in its entirety, but with citations omitted. If you appreciate this episode, please subscribe. Thank you. 

  The Friday Five for March 14, 2025: Design Overhaul Coming to Apple OS? Google, Chrome & uBlock Origin Content Marketing Gamification Ritter Roadshows are Back for 2025! CMS 2025 Marketplace Integrity & Affordability Proposed Rule   Design Overhaul Coming to Apple OS? Clark, Adam. “Apple Plans Major Software Overhaul, Says Report. Why the iPhone Maker Needs a Change.” Barrons.Com, Barron's, 11 Mar. 2025, www.barrons.com/articles/apple-price-stock-iphone-ios-update-10249921. Mehta, Ivan. “Apple's next Major OS Updates Will Bring the Biggest Design Overhaul in Years.” Techcrunch.Com, TechCrunch, 11 Mar. 2025, techcrunch.com/2025/03/11/apples-next-major-os-updates-will-bring-the-biggest-design-overhaul-in-years/. Jackson, Fiona. “iPhone 17 Leaks Show Off Groundbreaking Designs.” Techrepublic.Com, TechRepublic, 10 Mar. 2025, www.techrepublic.com/article/apple-iphone-17-leaks/. Barr, Kyle. “Your iPhone Home Screen Could Look Entirely Different Very Soon.” Gizmodo.Com, Gizmodo, 11 Mar. 2025, gizmodo.com/your-iphone-home-screen-could-look-entirely-different-really-soon-2000574330.   Google, Chrome & uBlock Origin: Weatherbed, Jess. “Google's Chrome Extension Cull Hits More uBlock Origin Users.” Theverge.Com, The Verge, 3 Mar. 2025, www.theverge.com/news/622953/google-chrome-extensions-ublock-origin-disabled-manifest-v3. Maxwell, Thomas. “Google Is Hobbling Popular Ad Blocker uBlock Origin on Chrome.” Gizmodo.Com, Gizmodo, 4 Mar. 2025, gizmodo.com/google-is-hobbling-popular-ad-blocker-ublock-origin-on-chrome-2000570878. Wallen, Jack. “Once uBlock Origin Stops Working on Chrome, You Have 2 Options.” Zdnet.Com, ZDNET, 4 Mar. 2025, www.zdnet.com/article/once-ublock-origin-stops-working-on-chrome-you-have-2-options/. Yee, Alaina. “Ublock Origin Is Officially Dead for Chrome, but Ad Blockers Live On.” Pcworld.Com, PCWorld, 25 Feb. 2025, www.pcworld.com/article/2595287/ublock-origin-is-officially-dead-for-chrome-but-ad-blockers-live-on.html.   Content Marketing Gamification: Sadick, Barbara. “6 Most Expensive Medical Procedures, Ranked.” Health.Usnews.Com, U.S. News & World Report, 3 Mar. 2025, health.usnews.com/health-care/patient-advice/articles/most-expensive-medical-procedures-ranked.   Ritter Roadshows are Back for 2025: Learn More About the 2025 Season of Ritter Roadshows: https://ritterim.com/roadshows/   CMS 2025 Marketplace Integrity & Affordability Proposed Rule: “2025 Marketplace Integrity and Affordability Proposed Rule.” CMS.Gov, Centers for Medicare & Medicaid Services, 10 Mar. 2025, www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-proposed-rule. “CMS Takes Aim to Reduce Improper Enrollments and Promote More Affordable Health Insurance Marketplaces for Millions of Consumers.” CMS.Gov, Centers for Medicare & Medicaid Services, 10 Mar. 2025, www.cms.gov/newsroom/press-releases/cms-takes-aim-reduce-improper-enrollments-and-promote-more-affordable-health-insurance-marketplaces. “Enhanced Premium Tax Credits for ACA Health Plans: Who They Help, and Who Gets Hurt If They're Not Extended.” Commonwealthfund.Org, Commonwealth Fund, 18 Feb. 2025, www.commonwealthfund.org/publications/explainer/2025/feb/enhanced-premium-tax-credits-aca-health-plans. “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability .” Cms.Gov, Centers for Medicare & Medicaid Services, 10 Mar. 2025, www.cms.gov/files/document/MarketplacePIRule2025.pdf.   Resources: Clarification on HHS Proposed Rule Comment Periods: https://lnk.to/asgf20250307 CMS Finalizes Improvements to Marketplace Plan Selection with 2026 Final Rule: https://lnk.to/asg652 Diversify Your Insurance Portfolio & Reap Real Rewards: https://lnk.to/asg651 On the Road with Damon Logan: https://lnk.to/FCJ7Mg On the Road with Jason Meyers: https://lnk.to/j6QzBq   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and Youtube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail. Not affiliated with or endorsed by Medicare or any government agency.

As expected, the new administration is proposing changes to the ACA Marketplace.  CMS, the Centers for Medicare & Medicaid Services, has issued the "2025 Marketplace Integrity and Affordability Proposed Rule," and we are breaking it down. In this episode of The Broker Link, we talk with The Brokerage Inc. Health Director of Operations, Belynda DiCiaccio, about what these proposed changes could mean for the ACA Marketplace. Some of the topics include: Strengthening Income Verification Modifying Eligibility Redetermination Procedures Implementing Pre-Enrollment Verification for SEPs Adjusting the Open Enrollment period And more! Learn more about partnering with The Brokerage Inc. by visiting our website, www.thebrokerageinc.com. Remember to like, share, and subscribe to our show!  New episodes are available every Tuesday. Join our Community! Linkedin: https://www.linkedin.com/company/the-brokerage-inc-/   Facebook:  https://www.facebook.com/thebrokerageinc/  Instagram:  https://www.instagram.com/thebrokerageinc/  YouTube:  https://www.youtube.com/@TheBrokerageIncTexas  Website:  https://thebrokerageinc.com/ 

  Press play to hear the breakdown of the 2026 ACA final rule affects you and your clients!   Read the text version    Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.   Register with Ritter Insurance Marketing: https://app.ritterim.com/public/registration/   Resources: 2025 ACA Open Enrollment Hits All-Time High: https://lnk.to/asgf20250124 Agent Requirements for ACA Sales: https://ritterim.com/blog/agent-requirements-for-aca-sales/ Carriers with Ritter Insurance Marketing: https://ritterim.com/products/by-carrier/ FAQs About Selling On-Exchange & Off-Exchange Under-65 Plans: https://ritterim.com/blog/faqs-about-selling-on-exchange-off-exchange-under-65-plans/   How Agents Can Protect Clients from Unauthorized ACA Plan Switching: https://ritterim.com/blog/how-agents-can-protect-clients-from-unauthorized-aca-plan-switching/ How to Help Clients Navigate ACA Marketplace Subsidies & Taxes: https://lnk.to/Lw5Dmc Meet Your Sales Team: https://ritterim.com/meet-your-sales-team/ Questions to Ask Clients Shopping for an ACA Plan: https://lnk.to/ZmW0rd What ACA Agents Can Expect From the 2026 Proposed Marketplace Rule: https://ritterim.com/blog/what-aca-agents-can-expect-from-the-2026-proposed-marketplace-rule/ Understanding ACA Plan Metal Tiers: https://ritterim.com/documents/understanding-aca-plan-metal-tiers.pdf   Forms: ACA Consumer Authorization Live Call Script: https://ritterim.com/documents/aca-consumer-authorization-live-call-script.pdf ACA Consumer Marketplace Authorization Form: https://ritterim.com/documents/aca-consumer-marketplace-authorization-form.pdf ACA Eligibility Application Attestation Form: https://ritterim.com/documents/aca-eligibility-application-attestation.pdf ACA Eligibility Application Attestation Script: https://ritterim.com/documents/aca-consumer-eligibility-application-attestation-live-call-script.pdf   References: “CMS Model Content Form for Marketplace Agents and Brokers” CMS, Centers for Medicare & Medicaid, https://www.cms.gov/files/document/cms-model-consent-form-marketplace-agents-and-brokers.pdf. Accessed 3 Feb. 2025. “HHS Notice of Benefit and Payment Parameters for 2026 Final Rule.” CMS.Gov, Centers for Medicare & Medicaid, https://www.cms.gov/newsroom/fact-sheets/hhs-notice-benefit-and-payment-parameters-2026-final-rule. Accessed 3 Feb. 2025. “HHS Notice of Benefit and Payment Parameters for 2026 Proposed Rule.” CMS.Gov, Centers for Medicare & Medicaid, https://www.cms.gov/newsroom/fact-sheets/hhs-notice-benefit-and-payment-parameters-2026-proposed-rule. Accessed 3 Feb. 2025. “HHS Notice of Benefit and Payment Parameters for 2024 Final Rule.” CMS.Gov, Centers for Medicare & Medicaid, https://www.cms.gov/newsroom/fact-sheets/hhs-notice-benefit-and-payment-parameters-2024-final-rule. Accessed 3 Feb. 2025.   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X (fka) Twitter, https://twitter.com/RitterIM and Youtube, https://www.youtube.com/user/RitterInsurance    Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency.

Based on AHLA's annual Health Law Connections article, this special series brings together thought leaders from across the health law field to discuss the top ten issues of 2025. In the seventh episode, Christianna Finnern, Shareholder, Winthrop & Weinstine PA, speaks with Noreen Vergara, Partner, Husch Blackwell LLP, about the Mental Health Parity and Addiction Equity Act (MHPAEA) and its requirements. They discuss some of the changes in the final rule, whether the new administration or the Loper Bright Supreme Court case will affect compliance and enforcement of MHPAEA, and how MHPAEA impacts average health care consumers and those who don't work in the benefits and managed care space. From AHLA's Behavioral Health Practice Group.Watch the conversation here.AHLA's Health Law Daily Podcast Is Here! AHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Premium members. Get all your health law news from the major media outlets on this new podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.

The Physician Fee Schedule (PFS) Final Rule for Calendar Year (CY) 2025 introduces several key updates to Medicare payment policies, aiming to enhance care delivery and reduce administrative burdens. In this episode, Daniel Marino is joined by Managing Partner, Lucy Zielinski, as well as Sarah Hartley, to explore the implications of the PFS Final on physicians and other billing professionals. Together, they discuss the key changes and opportunities for physician services furnished in a variety of settings including physician offices, hospitals, ambulatory surgery centers (ASCs), and others. Tune in to stay informed and gain valuable perspectives on navigating these critical regulatory updates.

NASCIO's 2025 federal advocacy priorities are released! Alex gives us the rundown. https://www.nascio.org/government-affairs/federal-advocacy-priorities/Kalea Young-Gibson, NASICO's policy analyst also joins to give us an overview of the DOJ final rule for accessibility for state and local government websites and apps.

Summary In this episode, Sean and Terry discuss the recent CMS final rule and its implications for healthcare practices, focusing on telehealth regulations, direct supervision requirements, and updates in behavioral health services. They also delve into the G2211 add-on complexity code, emphasizing the importance of understanding the nuances of these regulations to ensure compliance and optimal patient care. Takeaways This is the last hashtag Terry Tuesday for 2024. We have spent quite a bit of time taking a look at the CMS final rule. Direct supervision means immediately available. Audio only is not sufficient for direct supervision. Behavioral health has gotten a huge leap in virtual care. You need to know that your commercial plans also update their language. The perfect example when UnitedHealthcare last year said, we're not going to pay for audio only anymore. You have to be careful because it's something you have to say, OK, this is why I did it. It's a gift. It is an add-on gift that says we respect and understand. I would still caution our audience to not use this as a blanket add-on code.