Twice each month, PYA experts discuss the latest industry regulatory developments during our popular Healthcare Regulatory Roundup (HCRR) webinar series. This episode presents the Centers for Medicare & Medicaid Services (CMS) FY2024 final rules. In late July, CMS released the FY2024 final rules for hospital inpatient prospective payment system (PPS), long-term care hospital PPS, skilled nursing facility PPS, hospice payment rate update, inpatient psychiatric facility PPS, and inpatient rehabilitation facility PPS. The FY2024 final rules go into effect on October 1, the start of the federal fiscal year. PYA’s Martie Ross and Kathy Reep discussed key provisions of these rules: Payment rate updates Value-based purchasing program measure and scoring modifications Quality reporting program changes Hospital DSH payment reductions Changes to hospital add-on payment policies New exclusions to SNF consolidated billing The webinar took place August 16, 2023.

The webinar took place August 9, 2023. The Centers for Medicare & Medicaid Services has released the proposed 2024 Medicare Physician Fee Schedule, which includes a number of areas of interest to providers. During this webinar, PYA Principals Valerie Rock, Angie Caldwell, and Lori Foley explained key takeaways from the proposed rule. Webinar participants learned about these important areas: Conversion Factor Reduction Split/Shared Visit Billing Rules E/M Add-on Code for Complex Patients Telehealth Remote Patient Monitoring Medicare Diabetes Prevention Program Medicare Shared Savings Program Modifications Quality Payment Program/Merit-Based Incentive Payment System  

Presented Wednesday, July 26, 2023. On July 13, CMS released the 2024 Hospital OPPS and Medicare Physician Fee Schedule proposed rules. PYA’s Martie Ross and Kathy Reep presented this 90-minute webinar diving deep into proposed payment and policy changes, including the following: 2024 Hospital OPPS Proposed Rule 2.8% payment rate update New benefit category for Intensive Outpatient Program services Changes to and enforcement of hospital price transparency requirements Separate payment for establishing and maintaining buffer stock of essential medicines Quality reporting program changes  2024 Medicare Physician Fee Schedule 3.34% reduction in conversion factor (from $33.89 to is $32.75) E/M add-on code for complex patients Delay in changes to split/shared visit billing rules New payment for caregiver training services, community health integration services, social determinants of health risk assessment, and principal illness navigation services Telehealth policy changes

The webinar took place July 25, 2023. To continue a dialogue on timely but occasionally tough or tricky topics in physician compensation and fair market value, PYA surveyed more than 50 physician compensation experts and other healthcare professionals to understand their collective thoughts on the topics in 2023. These issues include but are not limited to the 2023 Medicare Physician Fee Schedule and its impact on physician compensation; compensating physicians who work collaboratively with advanced practice practitioners (APPs); new trends in physician compensation and productivity benchmark surveys; and better performing practices in hospital-based specialty subsidies, just to name a few. PYA Principals Lyle Oelrich and Angie Caldwell addressed the No. 1 survey topic in the webinar series: “Compensation for Physicians Working Collaboratively with APPs.” The webinar explored the following: The four ways APPs practice with physicians Potential productivity compensation solutions for physicians who work collaboratively with APPs Three key considerations surrounding proposed split/ shared billing regulations on provider compensation plans  

Presented Wednesday, July 12, 2023. CMS released the following proposed payment rules for calendar year 2024. PYA’s Martie Ross and Kathy Reep discussed key provisions and highlighted their impacts. This webinar addressed the following rules:  CY 2024 Hospital Outpatient PPS Proposed Rule Remedy for 340B-Acquired Drug Payment Policy for CYs 2018-2022 Proposed Rule CY 2024 Home Health PPS Proposed Rule CY 2024 ESRD PPS Proposed Rule Request for Information  – Medical Payment Projects The Latest No Surprises Act FAQs (60 minutes, 1 CPE Credit in Specialized Knowledge for those who attended the live webinar and completed required polls and survey)

The webinar took place on June 27, 2023. To continue a dialogue on timely but occasionally tough or tricky topics in physician compensation and fair market value, PYA surveyed more than 50 physician compensation experts and other healthcare professionals to understand their collective thoughts on the topics in 2023. These issues include but are not limited to the 2023 Medicare Physician Fee Schedule and its impact on physician compensation; compensating physicians who work collaboratively with advanced practice practitioners; new trends in physician compensation and productivity benchmark surveys; and better performing practices in hospital-based specialty subsidies, just to name a few. PYA Principal Lyle Oelrich and Senior Manager Zach Doolin continued the 2023 “Timely, Tough, or Tricky” webinar series with “Traversing Tricky Situations in Common Call Coverage Scenarios.” The webinar explored tricky situations in the following call coverage scenarios: Employment Call Coverage Independent Contractor Call Coverage Market Shortage Call Coverage Physician/ Advanced Practice Practitioner Call Coverage Concurrent Call Coverage

PYA was pleased to present the second annual Summer CPE Symposium on June 22 & 23, 2023. During two complimentary half-day virtual sessions, PYA’s team of thought leaders and guest speakers offered in-depth and timely information focused on a variety of trending healthcare financial and compliance topics. The AICPA’s Auditing Standards Board issued Statement on Auditing Standards (SAS) 145, Understanding the Entity and Its Environment and Assessing the Risks of Material Misstatement, in October 2021. The new SAS supersedes previously existing audit guidance on assessing risk. SAS 145 is effective for audits of financial statements for periods ending on or after December 15, 2023. During the webinar, “Not-for-Profit: Risk Assessment – SAS 145 Updates,” PYA Principal Matt Stuart and Manager Connor Fitzgerald discussed the details of the new audit standard and how it will change the way audits will be conducted. The webinar focused on how the new standard will affect the audit process going forward, with an emphasis on what an auditee organization can do now to best prepare for future audits. This session covered: ​​General Introduction to SAS 145 and Changes to the Risk Assessment Process  Risks Arising From the Use of IT: General IT Controls Under SAS 145 Covering What Healthcare Entities Can Do Now To Prepare for the Changes and to Be Ready for Financial Statement Audits Under SAS 145

PYA was pleased to present the second annual Summer CPE Symposium on June 22 & 23, 2023. During two complimentary half-day virtual sessions, PYA’s team of thought leaders and guest speakers offered in-depth and timely information focused on a variety of trending healthcare financial and compliance topics. Healthcare systems, hospitals, & physician groups are continuing to search for strategies to combat both reductions in reimbursements and increased operating costs. The environments in which these healthcare professionals provide care and treatment to their patients have become an increasingly important component in both the quality of services provided and the business models for their operations. In the webinar, “The Financial Effects of Healthcare’s Physical Environment,” Realty Trust Group’s Director of Capital Projects David Paulaskas navigated some of the planning, design, and construction strategies that can be implemented within the healthcare environment and their impact on day-to-day operations. This session covered the following: Patient, Visitor, & Team Safety Improving Patient Satisfaction Scores Patient & Staff Retention Operational Efficiencies

PYA was pleased to present the second annual Summer CPE Symposium, which took place June 22 & 23, 2023. During two complimentary half-day virtual sessions, PYA’s team of thought leaders and guest speakers offered in-depth and timely information focused on a variety of trending healthcare financial and compliance topics. Presenters: PYA Principal Sarah Bowman PYA Manager Katie Garmon The 340B program continues to be integral to covered entities (CEs) across the country. While HRSA maintains oversight of the 340B program, CEs are ultimately responsible for ensuring compliance with program requirements and staying informed of industry activity. This is of particular importance given the number of flexibilities extended to CEs during the Public Health Emergency which ended on May 12, 2023. During this webinar, PYA Principal Sarah Bowman and Manager Katie Garmon discussed the 340B program, including an overview of key eligibility and compliance requirements, recent industry updates, and post-PHE considerations. This session covered: 340B Eligibility Requirements and Program Overview Pre-Covid Compliance Requirements Including Potential Billing Pitfalls COVID-19 PHE Flexibilities Post-PHE Considerations Recent Industry Events and Activity Needed for Continued Program Participation

PYA was pleased to present the second annual Summer CPE Symposium, which took place June 22 & 23, 2023. During two complimentary half-day virtual sessions, PYA’s team of thought leaders and guest speakers offered in-depth and timely information focused on a variety of trending healthcare financial and compliance topics. Panelists: PYA Managing Principal of Consulting Services David McMillan Jones Day Partner Ann Hollenbeck Oklahoma Hospital Association President & CEO Rich Rasmussen AdventHealth Division Corporate Responsibility Officer Matthew Vogelien Our healthcare industry is in a constant state of change. Each year, its providers, administrators, and consumers are challenged with new regulations, new technologies, transforming points of access, and higher costs. The Summer Symposium “State of the Healthcare Industry – Panel Discussion” featured a discussion of many of these challenges from various viewpoints – advisor for the industry, legal counsel for the industry, health system compliance officer, and hospital association leader and advocate for hospitals. Our panel of healthcare experts covered the following topics: End of the PHE – Biggest Pains, Biggest Wins Price Transparency – Boom or Bust? AI Will Overhaul Healthcare – Fact or Fiction? Industry Consolidation Additional information related to our discussion on AI, provided by Matthew Vogelien: Trustworthy Augmented Intelligence in Health Care | SpringerLink