PYA Webinar Recast

As in the lyrics of "Auld Lang Syne," the beginning of a new year leads us to reflect nostalgically. For compliance experts, that means considering what the compliance industry learned from implementing the new and refreshed Office of Inspector General (OIG) General Compliance Program Guidance (GCPG) in 2024 while we set the stage for 2025.

Learning objectives for this session included the following:

• Discussed GCPG implementation best practices identified from serving clients in 2024
• Shared key concepts with which clients are still struggling and steps they are taking to comply with the GCPG's expectations
• Provided an overview of the latest industry segment-specific guidance for Skilled Nursing Facilities
• Summarized significant settlements and cases that pressure-tested organizations' compliance programs in 2024

Let's Talk Compliance: Trends Affecting the Health Care & Life Sciences Sector

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.

On Dec. 21, 2024, President Biden signed the American Relief Act, 2025 (ARA), into law, narrowly avoiding a federal government shutdown. Unlike the more comprehensive bill defeated in the House of Representatives two days earlier after President-elect Trump raised objections, the ARA is a temporary solution to keep the federal government operating through the end of March.

On Jan. 15, 2025, PYA's Martie Ross and Kathy Reep discussed the new law's impact, both by what's included and what's not. Ross and Reep prognosticated what will happen in the first months of the Trump administration to address critical outstanding issues such as:

• Medicare telehealth coverage
• Medicare physician pay cut
• Price transparency
• Site-neutral payments
• Medicaid DSH payments
• Hospital-at-home demonstration project

Also, Martie and Kathy discussed two proposed rules released in December: the Contract Year 2026 Medicare Advantage and Part D Proposed Rule and the proposed updates to the HIPAA Security Rule. To wrap things up, they also discussed the impact of the January 7, 2025, final rule from the Consumer Financial Protection Bureau prohibiting creditors from considering medical debt in credit eligibility decisions.

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.

Twice each year, PYA's Center for Rural Health Advancement presents a deep dive into the most challenging regulatory and reimbursement issues facing rural health providers and the communities they serve.

Our second "Let's Get Rural" webinar took place December 5, 2024. During this webinar, PYA's Martie Ross and Kathy Reep joined Realty Trust Group's Colton Hager to provide practical insights and advice for rural health leaders on the following topics:

• Provisions in 2025 Medicare Physician Fee Schedule Final Rule impacting rural health clinics
• Telehealth update
• Rural Emergency Hospital program update
• Respiratory disease reporting requirements
• Maternal health Conditions of Participation
• New anti-discrimination regulations
• Impact of new TEAM Payment Model on rural providers
• Changes to HIPAA Privacy Rule
• Price transparency update
• Medicare co-insurance for critical access hospitals
• Impact of Supreme Court's Loper Bright decision

This webinar is part of PYA's Let's Get Rural series, which reflects PYA's commitment to helping rural health providers preserve access to high-quality services for their communities.

Learn more:

• Check out the first Let's Get Rural webinar of 2024, presented on June 13: "Managing Regulatory and Reimbursement Challenges."
• Learn more about PYA's Center for Rural Health Advancement.

If you would like assistance with the unique needs of rural healthcare, including regulatory impacts, reimbursement opportunities, or any matter involving compliance, valuation, or strategy and transactions, our executives would be happy to assist.

Attendees of the live webinar were eligible for 1.5 CPE credits in Specialized Knowledge.

On December 4, 2024, Kimberly Campbell, Katie Croswell, Carine Leslie, Brian Raabe, and Valerie Rock went deeper into the final rule to address the following:

• Global surgery payment accuracy
• Evaluation & management services (including HCPCS G2211)
• New reimbursement for preventive services
• Digital therapeutics for behavioral health
• Supervision of outpatient therapy services
• Opioid treatment programs
• Skin substitutes

On November 13, PYA presented "2025 Hospital Outpatient Prospective Payment System Final Rule." in which Martie Ross and Kathy Reep discussed key provisions of the 2025 Hospital OPPS Final Rule and related developments.

The four webinars are 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 November 20, 2024, Miriam Murray, Valerie Rock, and Martie Ross covered the following topics from the final rule:

• 2025 payment rate reductioc
• Deadline for reporting overpayments
• Advanced primary care management payments
• Telehealth
• Rural health clinics and federally qualified health centers

The four webinars are 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 November 1, 2024, the Centers for Medicare & Medicaid Services published the 2025 Hospital Outpatient Prospective Payment System (OPPS) Final Rule. During this webinar, PYA's Martie Ross and Kathy Reep discussed key provisions of the 2025 Hospital OPPS Final Rule and related developments, including the following:

• Updated Hospital OPPS Payment Rates
• Updated Ambulatory Surgical Center Payment Rates
• Hospital OPPS and ASC Quality Programs
• Maternal Health Conditions of Participation
• New Appeals Process Relating to Observation Stays

The webinar took place on November 13, 2024.

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 340B environment has continued to evolve, and this year has been particularly busy as the drug pricing program is targeted and challenged. Covered Entities (CEs) and other professionals are invited to join us for an update on federal and state regulatory and legislative activity along with a discussion on the administrative dispute resolution process, Medicare Advantage payer litigation, and how CEs can continue to maintain a compliant 340B program despite these challenges.

Attendees learned more about the latest challenges to the 340B drug pricing program and how you can maintain a compliant program during this webinar which took place on October 23, 2024.

During this webinar, PYA's Sarah Bowman discussed key updates to 340B as attendees learned from these objectives:

• Discussed key state and federal legislative activity
• Provided a regulatory update
• Reviewed the status of drug manufacturer restrictions and the Administrative Dispute Resolution process
• Described Medicare Advantage payer litigation activity
• Discussed HRSA Audit activity and Covered Entity best practices

This webinar was 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.

Covered entities and business associates must comply with the new HIPAA Privacy Rule requirements regarding reproductive healthcare by Dec. 23, 2024. Over the summer, new anti-discrimination requirements for healthcare providers detailed in new regulations promulgated under Section 1557 of the Affordable Care Act and Section 504 of the Rehabilitation Act of 1973 took effect.

PYA's Karin Anderson and Martie Ross detailed what providers need to do now to comply with these new rules during this webinar which took place on October 9, 2024.

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.

In this final episode of PYA's Revenue Recharge series, we reviewed other net revenue opportunities from governmental payers. In addition, we recapped the first six episodes and provided a sample assessment tool to help identify your net revenue opportunities.

The webinar took place on September 26, 2024.

PYA Director of Reimbursement Services Emily Wetsel and Principal Bob Paskowski addressed the following key learning objectives:

• Identify net revenue opportunities from government-funded sources
• Recap the highlights from Episodes 1-6
• Share a sample assessment tool for net revenue opportunities

This webinar was Episode 7 of PYA's Revenue Recharge series. In the series, PYA shares ways health systems and physicians can identify revenue opportunities, leading to a more sustainable and visionary future and better healthcare for patients. By addressing net revenue opportunities in your operational planning, you can support your mission.

Watch previous episodes of the Revenue Recharge webinar series.

If you would like assistance with revenue management and strategies or any other area related to healthcare operations, strategy and transactions, or valuation, our executives would be happy to assist.

For decades, healthcare providers have been challenging regulations in court. In many cases, judges cited Chevron deference as the basis for upholding agencies' interpretations of authorizing statutes. In summer 2024, however, the Supreme Court in Loper Bright Enterprises overruled Chevron, ruling that courts–not agencies–are responsible for interpreting ambiguous statutory provisions.

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

• Gave a straightforward explanation of Chevron deference and the practical impact of the Loper Bright Enterprises decision
• Addressed the immediate and longer-term impacts—both good and bad—of the Supreme Court's decision on healthcare providers
• Discussed lessons learned from earlier lawsuits challenging healthcare regulations and what they expect to see from providers looking to protect their interests through the rulemaking process and subsequent litigation.

The webinar took place on September 25, 2024.

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 reimbursement, regulatory impacts, or any matter involving compliance, valuation, or strategy and transactions, our executives would be happy to assist.