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Policy Snapshot

January 19, 2024

CMS Finalizes Rule to Expand Access to Health Information and Improve the Prior Authorization Process

CMS has finalized its Interoperability and Prior Authorization final rule (CMS-0057-F). The rule sets requirements for Medicare Advantage organizations, Medicaid and the Children’s Health Insurance Program (CHIP) fee-for-service programs, Medicaid managed care plans, CHIP managed care entities, and issuers...

Policy Snapshot

November 8, 2024

CMS Implements New Respiratory Illness Reporting Requirements for Long-Term Care Facilities

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule for the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS), which includes updates to Medicare payment policies and rates for Home Health Agencies (HHAs). Among the key changes, CMS is finalizing a new dat...

Policy Snapshot

June 30, 2023

CMS Increases Nursing Home Ownership Transparency

Last week, the Centers for Medicare &Medicaid Services (CMS) announced increased transparency of additional nursing home ownership data, including names of affiliated owners for the first time on Nursing Home Care Compare

Policy Snapshot

September 8, 2025

CMS Introduces SNF 3-Day Rule Waiver Under New TEAM Model

The Centers for Medicare & Medicaid Services (CMS) has released new details about the Transforming Episode Accountability Model (TEAM), which will run from January 1, 2026, through December 31, 2030. One key feature of this initiative is a waiver of the traditional Skilled Nursing Facility (SNF) Three-...

Policy Snapshot

July 15, 2025

CMS Issues 2026 Physician Fee Schedule Proposed Rule, Suggests Updates to Telehealth Coverage and Payment Rates

This week, the Centers for Medicare & Medicaid Services (CMS) issued its proposed rule for the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS). PALTmed is reviewing this proposed rule in detail.

Policy Snapshot

August 30, 2024

CMS Issues FAQ Addressing Code G2211

The Centers for Medicare & Medicaid Services (CMS) has posted a Frequently Asked Questions (FAQ) document for code G2211, which is an office and outpatient (O/O) evaluation and management (E/M) visit complexity add one code. All medical professionals who can bill O/O E/M visits (CPT codes 99202-99205, ...

Caring for the Ages

March 1, 2017

CMS Issues Guidance FAQs for Wandering and Exit-Seeking Behavior

Policy Snapshot

October 6, 2025

CMS Issues Guidance for State Survey and Certification During a Federal Shutdown

On October 1, 2025, the Centers for Medicare & Medicaid Services (CMS) released QSO-26-01-ALL, a memorandum outlining how state survey and certification (S&C) operations must adapt in the event of a federal government shutdown. In the memo, CMS covers functions that are not affected by the shutdown...

Policy Snapshot

March 31, 2025

CMS Issues Guidance on Improving Payment Accuracy for Physician Services in SNFs

The Centers for Medicare & Medicaid Services (CMS) has released a new MLN Matters aimed at enhancing payment accuracy for physician services provided in skilled nursing facilities (SNFs). Effective July 1, 2025, these measures will address common misclassifications of Place of Service (POS) codes that ...

Policy Snapshot

September 1, 2023

CMS Issues Proposed Minimum Staffing Standards for LTC Rule

On September 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule, which seeks to establish comprehensive nurse staffing requirements.