CMS MACs Publish Coverage Decisions on SIJ Pain Treatments On February 10, 2023, five Medicare Administrative Contractors (MACs)—CGS Administrators, Palmetto, Wisconsin Physician Services, National Government Services, and Noridian Healthcare Solutions—released their final sacroiliac joint (SIJ) injection and procedures policies. The updated policies will be effective March 19, 2023, classifying r...
Portions of No Surprises Act IDR Rule Procedures Set Aside by Federal Court Again On February 8, 2023, for the second time in 12 months, a federal district court has set aside provisions of the No Surprises Act’s Independent Dispute Resolution Final Rule on the grounds that the portions of the rule that provide guidance...
Federal Trade Commission Announces First Penalties for Enforcement Action Against Good Rx On February 1, 2023, the U.S. Federal Trade Commission (FTC) took enforcement action for the first time under its Health Breach Notification Rule against the telehealth and prescription drug discount provider GoodRx Holdings Inc. The settlement announced the fine was for failure to...
Specialty Societies Submit Letter in Support of CMS Prior Authorization Proposals On February 13, 2023, ISASS submitted comments to CMS on proposed changes released on January 30, 2023, regarding Medicare Advantage Prior Authorization rules and regulations, including audit standards, as part of a multi-society joint letter. In the final rule, the agency announced it will...