Updates & Analysis

In this update:  Federal Agencies CMS Releases CY 2025 OPPS/ASC Payment System Final RuleOn November 1st, the Centers for Medicare and Medicaid Services (CMS) issued the Calendar Year (CY) 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System Final Rules. Overall, CMS is updating OPPS and ASC payment rates for…

The 2024 election results have immense yet unclear implications for health care policy. While the incoming Trump Administration will be accompanied by a unified Republican 119th Congress, the Republican Party’s 2024 health care platform was notably vague. Given this uncertainty, SPG believes the best approach for health care stakeholders is to understand the implications of the…

In this update:  NYS and NYC Opportunities OMH Issues RFP for Youth and Family Peer Advocate Workforce Expansion GrantsOn October 31st, the New York State (NYS) Office of Mental Health (OMH) issued a Request for Proposals (RFP) to support the expansion of the family and youth peer advocate workforce. Family and youth peer advocates use…

In this update:  Legislative Updates House Lawmakers Introduce Bill to Delay Medicare Physician Fee Cut On October 29th, Congressman Greg Murphy (R-NC) and a bipartisan group of cosponsors introduced the Medicare Patient Access and Practice Stabilization Act, a bill that would eliminate the scheduled 2.8% reduction in Medicare Physician Fee Schedule (PFS) payments for 2025 and…

As of this morning (November 6th), the results of the 2024 general election are as follows:  While the implications of the election for federal health policy will undoubtedly be immense, they remain unclear. This is both due to the unsettled House races and to the vagueness of the 2024 Republican platform. Trump has said that…

In this update:  Federal Opportunities HRSA Releases NOFO for Behavioral Health Workforce Education and Training Program for ProfessionalsOn October 22nd, the Health Resources & Services Administration (HRSA) released a Notice of Funding Opportunity (NOFO) for the Behavioral Health Workforce Education and Training (BHWET) Program for Professionals. This program aims to increase the supply of behavioral…

In this update:  Legislative Update Senate Democrats Release Report on MA DenialsOn October 17th, the Senate Permanent Subcommittee on Investigations (PSI) released a report on Medicare Advantage (MA) plans’ use of prior authorization to reduce beneficiary stays in post-acute care facilities. The PSI surveyed actions by UnitedHealthcare, CVS, and Humana—which cover nearly 60% of MA…

In this update:  Legislative Updates Bipartisan House Letter Seeks to Avert Medicare Physician Payment CutsOn October 10th, a bipartisan group of over 200 members of the House of Representatives sent a letter to House Speaker Mike Johnson and Minority Leader Hakeem Jeffries urging them to pass legislation to avoid cuts in Medicare Physician Fee Schedule…

In this update:  NYS and NYC Opportunities OMH Issues RFP for Forensic Intensive and Sustained Engagement Team (F-INSET)On October 9th, the New York State (NYS) Office of Mental Health (OMH) issued a Request for Proposals (RFP) seeking one peer-run organization to create a Forensic Intensive and Sustained Engagement Team (F-INSET) for justice-involved populations. The traditional…

In this update:  Federal Agencies CMS Releases 2025 Star Ratings for MA and Part D Plans On October 10th, the Centers for Medicare and Medicaid Services (CMS) released the 2025 Star Ratings for Medicare Advantage (MA), Medicare Advantage Prescription Drug (MA-PD), and Medicare Part D (PDP) plans. CMS publishes Star Ratings every year to measure the…

In this update:  NYS and NYC Opportunities DOH Issues RFA for Rural Health Network Development ProgramOn October 1st, the New York State (NYS) Department of Health (DOH) issued a Request for Applications (RFA) for the Rural Health Network Development Program. This program aims to improve the health of New Yorkers living in rural areas by…

In this update:  Federal Agencies CMS Adjusts Medicare IPPS Rates Due to Court DecisionOn September 30th, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment period to modify hospital Inpatient Prospective Payment System (IPPS) rates due to a decision by the D.C. Court of Appeals in Bridgeport v. Becerra. The…