As the November elections neared, you might have expected Washington to slow to a crawl amidst campaigning and uncertainty about the future. However, the show must go on, and both the Biden Administration and Congress have had an extremely busy month.
While most associate the month of October with Indigenous Peoples’ Day and Halloween, it is also Cybersecurity Awareness Month. Officially launched in 2004 by the U.S. Department of Homeland Security and the nonprofit National Cybersecurity Alliance, the observance has only grown in importance, as cybersecurity incidents have skyrocketed in number; indeed, 2024 will likely be remembered as a year with some of the most impactful cybersecurity incidents in history.
In light of this, President Biden recently listed off some of his Administration’s achievements in the field, such as the National Cybersecurity Strategy released in 2023. In addition to this, federal legislation was recently introduced to regulate cybersecurity specifically in healthcare. Authored by two Democratic senators, the “Health Infrastructure Security and Accountability Act” would see the U.S. Department of Health and Human Services (HHS) develop minimum cybersecurity standards for plans, providers, clearinghouses, and associated businesses. The bill would allocate monies to assist hospitals in adopting essential cybersecurity standards, and to follow enhanced cybersecurity measures, including annual audits, stress tests, and the creation of recovery plans. It has been referred to the Senate Finance Committee.
While that bill is currently not bipartisan, members of Congress from both sides of the aisle are in alignment on another important issue: telehealth.
Frequent readers have surely noticed me report on the COVID-era flexibilities on telehealth at the federal level, and the arguments over whether they should be extended. With many set to expire on Dec. 31 of this year, members of the Senate and House both sent letters to the Drug Enforcement Administration (DEA) objecting to a proposal that allegedly seeks to limit the prescription of both controlled and non-controlled substances via telemedicine.
The specifics of the proposal were reported by Politico Pro, which attributed them to an unnamed DEA official. After much public outcry – and reportedly, criticism from HHS – the DEA submitted another proposed rule on the issue earlier this month. The DEA’s proposed rule is not yet available to the public, but is titled “Third Temporary Extension of COVID-19 Telemedicine Flexibilities,” and sources have reported that the extension is for another year. This means that the ultimate decision will likely be under a new administration.
Turning to COVID-era flexibilities that were not extended, the Centers for Medicare & Medcaid Services (CMS) released the latest Medicare Advantage star ratings – and the results have already sparked a lawsuit. The agency had relaxed its star rating calculation standards as part of pandemic relief efforts, which naturally resulted in higher numbers of insurers being awarded top scores, and the bonus payments that go along with them. However, post-pandemic CMS raised the bar back up, and then some. In 2022, a total of 74 plans earned five out of five stars, but this time, just seven did. And the percentage of plans earning four stars or more shrunk by 4 percent in just one year.
At an industry conference last week, CMS was clear that the election was not slowing the agency down. CMS Principal Deputy Administrator and COO Jon Blum spoke abouthis agency’s “huge agenda,” and noted that it was “very bipartisan and will continue no matter who is sitting in the (Oval) Office during 2025.”
So, while the nation is focused on the election, the Biden Administration and Congress appear intent on moving forward on healthcare priorities.
Healthcare has been transitioning toward a more digital, interconnected ecosystem for many years, but the pace and magnitude of current changes represent a fundamental shift.
Has anyone asked you to remember a short list of words, in this case certain nouns? Well, recently, my husband and I were reading some
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Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
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