PYA Webinar Recast

It's spring, and deregulation is in the air! During this one-hour webinar, PYA's Martie Ross and Kathy Reep discussed the impact of the April 9 Presidential Memorandum Directing the Repeal of Unlawful Regulations. The memorandum instructs federal agencies to repeal any regulation "that clearly exceeds the agency's statutory authority or is otherwise unlawful" and to proceed "without notice and comment, where doing so is consistent with the 'good cause' exception in the Administrative Procedure Act."

The webinar also addressed the Request for Information (RFI) included in the 2026 Inpatient Prospective Payment System proposed rule soliciting public feedback on potential changes to Medicare regulations. Examples of questions CMS would like input on include:

• Are there documentation or reporting requirements within the Medicare program that are overly complex or redundant?
• How can Medicare better align its requirements with best practices and industry standards?
• Are there existing regulatory requirements that could be waived, modified, or streamlined to reduce administrative burdens?

Martie and Kathy highlighted regulatory requirements that may meet these criteria and discuss how to respond to the RFI. They also addressed any late-breaking news from DC on the ongoing budget reconciliation process.

This webinar is part of PYA's twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments.

If you would like assistance with legislative or regulatory impacts or any matter involving compliance, valuation, or strategy and transactions, our executives are happy to assist.

On Friday afternoon, April 11, the Centers for Medicare & Medicaid Services (CMS) released the proposed 2026 Medicare payment rules. These proposed rules cover:

• Hospital inpatient services
• Skilled nursing facilities
• Inpatient psychiatric and rehabilitation facilities
• Hospices

During this webinar, PYA's Martie Ross and Kathy Reep discussed:

• Key provisions of the proposed 2026 Medicare payment rules
• The 2026 Medicare Advantage final rule and rate announcement released earlier this month
• The latest developments in Washington, including:
  • President Trump's deregulation directive
  • The ongoing budget reconciliation process

PRESENTATION SLIDES

This webinar is part of PYA's twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments.

If you would like assistance with legislative or regulatory impacts or any matter involving compliance, valuation, or strategy and transactions, our executives are happy to assist.

It's challenging to keep up with everything happening in Washington these days. Given the potential impact on our healthcare system, one cannot afford to fall behind. During this webinar, PYA's Martie Ross and Kathy Reep summarized the latest developments coming from Washington:

• Proposed cuts to federal healthcare programs
• Impact of Executive Orders
• Changes to rulemaking processes

PRESENTATION SLIDES

This webinar is part of PYA's twice-monthly Healthcare Regulatory Roundup, a popular series during which PYA experts provide practical insights on the latest industry regulatory developments.

If you would like assistance with legislative or regulatory impacts or any matter involving compliance, valuation, or strategy and transactions, our executives are happy to assist.

The likelihood Congress will adopt site-neutral payment reforms seems to be increasing daily. Hospitals need to understand the full impact of such reforms and prepare contingency plans in case of significant cuts to reimbursement.

During this webinar, presented on March 5, 2025, PYA's Kathy Reep and Martie Ross addressed key aspects of the potential reforms:

• Location, Location, Location:Variation in Medicare reimbursement based on place of service

• Ugly, Uglier, Ugliest: Proposed payment reforms

• Big, Bigger, Biggest: Quantifying potential lost revenue from site-neutral payment reforms

• Survival of the Fittest: Strategies for minimizing and tactics for dealing with losses

• Telling Your Story: Helping your community understand impacts of payment reforms

In January 2025, the U.S. Department of Health and Human Services proposed pivotal updates to the HIPAA Security Rule aimed at enhancing cybersecurity measures for electronic protected health information (ePHI).

During this webinar, we took a comprehensive look at the proposed HIPAA Security Rule, delving into the specifics of what changes are being suggested and how they could impact various stakeholders. The webinar took place February 26, 2025.

PYA's Barry Mathis and Erin Walker offered a detailed understanding of the rule's implications, the motivations behind its revision, and the potential effects on healthcare providers, insurers, and patients. Participants learned from the following objectives:

• Understanding the Proposed Changes:Identified and explained the key modifications suggested in the HIPAA Security Rule
• Implications for Compliance:Explored how these changes would alter current compliance requirements and how organizations can adhere to the new rule
• Impact Assessment:Assessed the potential consequences of the proposed rule on privacy, security, and data management within the healthcare sector
• Preparation Strategies:Discussed strategies for healthcare organizations to prepare for and implement the proposed changes effectively

Over the last several years, Medicare reimbursement for virtual care, including care management and remote monitoring services, has expanded. PYA Principals Lori Foley and Martie Ross presented a webinar, "Providing and Billing Medicare for Care Management and Remote Monitoring Services," on February 12, 2025.

During this one-hour webinar, Foley and Ross discussed:

• Use of care management and remote monitoring services and impact on total cost of care
• Medicare billing rules for care management and remote monitoring services:
  • Chronic care management
  • Complex chronic care management
  • Principal care management
  • Advanced primary care management
  • Remote physiologic monitoring
  • Remote therapeutic monitoring
• Navigation of ambiguities in Medicare billing rules
• Lessons learned from launching care management and remote monitoring programs

This presentation covered the key antitrust issues that arise in mergers and acquisitions involving healthcare providers, including hot issues in federal and state antitrust enforcement, practical tips for staying compliant in due diligence and integration planning, and major changes to the requirements for reporting transactions under the Hart-Scott-Rodino Act.

Learning objectives for this session included the following:

• Understanding key antitrust requirements and risks that arise in healthcare mergers and acquisitions
• Understanding recent reforms to the federal Merger Guidelines
• Unpacking key changes to the rules for reporting transactions under the Hart-Scott-Rodino Act and what they mean for the healthcare sector
• Addressing state regulatory requirements and their impact on healthcare mergers and acquisitions
• Addressing potential antitrust enforcement trends and priorities for the second Trump administration

On January 23-24, PYA and Foley & Lardner LLP presented the seventh annual Let's Talk Compliance virtual conference. The event was moderated by Foley Health Care Partner Jana Kolarik and PYA Principal Angie Caldwell. Panelists included attorneys from Foley's Health Care & Life Sciences Sector as well as PYA's healthcare consulting, compliance, and cybersecurity experts. Each day featured two sessions that covered relevant and trending topics in healthcare and life sciences compliance.

The end of Chevron deference and President Trump's reelection mean federal agencies like the Centers for Medicare & Medicaid Services, Health Resources and Services Administration, and the Food and Drug Administration will operate under fundamentally different rules than in the past. This presentation explained the changes and identified what organizations need to know.

Learning objectives for this session included the following:

• Provided key background on the Chevron doctrine, which required courts to defer to agencies' interpretations of statutes, and the Supreme Court's overturning of it in Loper Bright
• Identified important changes resulting from Chevron's end and the election of President Trump, including more cautious rulemaking, more frequent challenges to agency actions, and more restrictions on subregulatory guidance
• Identified risks and opportunities for healthcare companies that are subject to agencies' rules, actions, and guidance

On January 23-24, PYA and Foley & Lardner LLP presented the seventh annual Let's Talk Compliance virtual conference. The event was moderated by Foley Health Care Partner Jana Kolarik and PYA Principal Angie Caldwell. Panelists included attorneys from Foley's Health Care & Life Sciences Sector as well as PYA's healthcare consulting, compliance, and cybersecurity experts. Each day featured two sessions that covered relevant and trending topics in healthcare and life sciences compliance.

The Transforming Episode Accountability Model (TEAM) is less than a year away. Beginning Jan. 1, 2026, selected hospitals will be subject to this new Medicare mandatory episodic payment model for specified surgical episodes of care.

On January 30, PYA's Martie Ross, Kathy Reep, Jason Hardin, Lee Ann Odom, and Angie Caldwell introduced PYA's TEAM playbook, highlighting what your organization can do now to ensure future success:

• Understand TEAM rules
• Educate leadership, management, and medical staff
• Use currently available data to identify opportunities
• Pursue performance transformation to reduce episodic costs
• Enter into TEAM-compliant collaborator sharing arrangements with physicians and post-acute providers

For providers not directly participating in TEAM, the PYA experts discussed broader market impacts of this new program, including changing referral patterns, patient preferences, and commercial payer opportunities.

This presentation covered updates and strategies for healthcare cybersecurity defenses and incident response, Health and Human Services' (HHS) continued enforcement of patient rights in accessing their own health information, and HIPAA's amendments to protect reproductive healthcare information.

Learning objectives for this session included the following:

• Discussed trends in healthcare cybersecurity, including expected updates to the HIPAA Security Rule, HHS' Security Risk Analysis enforcement initiative, and recent HHS ransomware settlements
• Provided a refresher on HIPAA's right for individuals to access their own information, in light of HHS' continued HIPAA Right of Access enforcement initiative
• Discussed the status of HIPAA's recent amendments to provide additional protections for reproductive healthcare information under the incoming Trump administration
• Shared effective strategies for cyber event response, focusing on containment, mitigation, and recovery, with lessons learned from recent cyber incidents in healthcare
• Explored the role of artificial intelligence in enhancing cybersecurity defenses, including its applications in threat detection, anomaly analysis, and predictive security measures
• Explained how to manage cyber risks with third-party vendors, emphasizing the importance of vendor risk assessments, contract provisions, and ongoing monitoring to ensure compliance and safeguard sensitive information

On January 23-24, PYA and Foley & Lardner LLP presented the seventh annual Let's Talk Compliance virtual conference. The event was moderated by Foley Health Care Partner Jana Kolarik and PYA Principal Angie Caldwell. Panelists included attorneys from Foley's Health Care & Life Sciences Sector as well as PYA's healthcare consulting, compliance, and cybersecurity experts. Each day featured two sessions that covered relevant and trending topics in healthcare and life sciences compliance.