PYA Webinar Recast

Twice each month, PYA experts discuss the latest industry regulatory developments during our popular Healthcare Regulatory Roundup (HCRR) webinar series. In this webinar, we presented a review of the expansion of Medicare reimbursement for certain types of care.

Over the last several years, the Centers for Medicare & Medicaid Services has expanded Medicare reimbursement for virtual care, including care management and remote monitoring services. During this one-hour webinar, PYA Principal Martie Ross discussed:

• Utilization of care management and remote monitoring services
• Medicare billing rules for care management and remote monitoring services
• Navigation of ambiguities in Medicare billing rules
• Lessons learned from launching care management and remote monitoring programs

On September 28, PYA presented a complimentary webinar that closely examined community benefit reporting by tax-exempt hospitals. During the webinar, PYA Principal Debbie Ernsberger and Senior Manager Abigail Campbell discussed the history and trajectory of Schedule H and outlined best practices for compiling community benefit data.

Webinar attendees gained an understanding of four senators' concerns about reporting and learned to more accurately report their hospitals' data. Specifically, Debbie and Abigail discussed these points:

• The history of Schedule H
• Schedule H stakeholders, including hospital associations and state legislative bodies
• The content of the August 2023 senators' letter
• Best practices for compiling community benefit data and what you should be doing now

Twice each month, PYA experts discuss the latest industry regulatory developments during our popular Healthcare Regulatory Roundup (HCRR) webinar series. In this episode, PYA answered your latest questions about healthcare regulatory issues and discussed new developments.

In the weeks prior to this webinar, our audience submitted their most urgent questions regarding healthcare regulatory issues. Then, PYA Principal Martie Ross and Senior Manager Kathy Reep shared the answers.

Martie and Kathy also sprinkled in some new developments related to:

• No Surprises Act
• Price Transparency
• CMMI Initiatives​​​​​​
• MSSP Performance Data
• MIPS Adjustments

The webinar took place September 13, 2023.

Twice each month, PYA experts discuss the latest industry regulatory developments during our popular Healthcare Regulatory Roundup (HCRR) webinar series. On August 30 PYA presented an overview of the Emergency Medical Treatment and Labor Act (EMTALA) and discussed compliance in today's changing legal landscape.

EMTALA was established years ago, but new challenges in providing hospital emergency care are surfacing due to changes in state abortion laws and related lawsuits.

PYA Principal Karin Anderson and Senior Manager Traci Waugh provided an overview of EMTALA requirements and discussed how to ensure compliance in the face of a changing legal landscape:

• Overview of EMTALA requirements
• Impact on provider liability in the face of changing and conflicting state abortion laws
• Compliance checklist
• EMTALA enforcement and response to surveys

The complimentary webinar took place on August 30, 2023. Attendees of the live webinar were able to earn 1 CPE* Credit in Specialized Knowledge.

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 Derek Long addressed a Top 10 survey topic in the 2023 webinar series: "Physician Compensation Benchmarks: Tracking Tricky Terms and Trends." The webinar explored the following:

• Glossary nuances and what is being reported to surveys
• Trends in various specialties and metrics within benchmark data
• The impact of recent, current, and future events on benchmark data

The webinar took place August 29, 2023.

The ever-evolving healthcare landscape can present opportunities for both investors and providers while improving care, but success requires careful navigation.

PYA is pleased to introduce a new complimentary webinar series, Healthcare Dealbreakers: What You Don't Know Can Hurt You.

Healthcare dealbreakers are rarely obvious; they lurk under the surface waiting to expose the uninformed who fail to exercise appropriate caution. Participants may learn hard lessons about the unique requirements of healthcare arrangements through lawsuits, failed deals, lost revenue, or compliance exposure.

Each quarter, PYA executives will share practical insights into some of the most complex issues in healthcare, helping investors and providers recognize the warning signs that signal trouble for a potential deal.

The first in our series covered IT and cybersecurity issues. While information technology (IT) due diligence is needed for any deal, it takes on a new level of importance in healthcare transactions. Failure to identify and understand technical vulnerabilities, lack of technology investment, or regulatory non-compliance can make a good deal go bad quickly.

Principal Barry Mathis shared personal and practical experiences in conducting large IT diligence projects. In the webinar, "Healthcare Dealbreakers – IT Nightmares That Could Kill the Deal", the audience learned how these projects uncovered details that ultimately altered or strengthened deals on behalf of investors. Venture capitalists who understand this risk-laden aspect of a healthcare transaction learned how to better navigate compliance issues and HIPAA requirements to protect and grow their investments.

Specifically, Mathis addressed these areas of IT in the healthcare industry:

• How could cybersecurity influence an investment or acquisition decision?
• What is reviewed during an IT due diligence assessment?
• What are the five biggest risks of IT when closing a deal?
• What are the five steps to a successful IT diligence assessment?

The webinar took place August 23, 2023.

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