The Final Rule

Availity Responds to CMS Interoperability and Prior Authorization Final Rule with Advanced Solutions for Healthcare Interoperability

Retrieved on: 
Wednesday, March 27, 2024
Technology, Finance, Public Policy, Government, Healthcare Reform, Professional Services, Software, Health, General Health, Data Management, Principal, Fast Healthcare Interoperability Resources, Organization, Interoperability, FHIR, DTR, MIPS, Communication, Health Level 7, CHIP, CRD, Hospital, Prior authorization, Acquisition, The Final Rule, Medicaid, API, Documentation, PAS, Medicare, CMS, FFS, Health insurance

The Final Rule aims to enhance interoperability and streamline the prior authorization process by mandating certain health plans to implement specific Health Level Seven International® (HL7®) Fast Healthcare Interoperability Resources (FHIR®) APIs.

Key Points: 
  • The Final Rule aims to enhance interoperability and streamline the prior authorization process by mandating certain health plans to implement specific Health Level Seven International® (HL7®) Fast Healthcare Interoperability Resources (FHIR®) APIs.
  • The Final Rule requires health plans to support a FHIR API for prior authorization by Jan. 1, 2027.
  • The Final Rule requires provider organizations to attest to utilizing a Prior Authorization API to submit at least one authorization request in 2027.
  • Providers will be able to connect to Availity to access the Prior Authorization API for multiple payers.

Numerous Amici Join NCLA’s Ask for Supreme Court to Rule Against ATF’s Unilateral Bump Stock Ban

Retrieved on: 
Friday, February 2, 2024
Firearm, Buckeye Institute, National Shooting Sports Foundation, Policy, Education, Independence, Congress, Army, Supreme court, Independence Institute, Philip Van Cleave, Rule, Research, Bureau, Tobacco, The Final Rule, National Rifle Association, Fifth, Second, Pacific Legal Foundation, NCLA, Machine, Judge, Ambiguity, Court, Palmetto State Armory, National Association

Representing Texas gun shop owner and Army veteran Michael Cargill, NCLA challenges the Bureau of Alcohol, Tobacco, Firearms and Explosives’ Bump Stock Final Rule and ATF’s expansion of the criminal scope of a statute by administrative fiat.

Key Points: 
  • Representing Texas gun shop owner and Army veteran Michael Cargill, NCLA challenges the Bureau of Alcohol, Tobacco, Firearms and Explosives’ Bump Stock Final Rule and ATF’s expansion of the criminal scope of a statute by administrative fiat.
  • The Final Rule reversed ATF’s long-standing recognition that bump-stock-equipped firearms are not illegal machine guns, and the U.S. Court of Appeals for the Fifth Circuit rightly shot down the Rule early last year.
  • NCLA thanks the amicus parties for standing with Mr. Cargill and thousands of other legal purchasers of bump stocks.
  • Excerpts follow:
    “In the best tradition of our separation of powers jurisprudence, this Court should apply the criminal laws that Congress has written with unmistakable clarity.

Valencia Technologies Corporation announced today that the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS), published the 2024 Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment

Retrieved on: 
Tuesday, November 7, 2023
Patient, FDA, ASC, Health, Ambulatory Surgery Center Association, Medicare, OAB, The Final Rule, PMA, United, AMA, Addendum, Quality of life, Leg, APC, Physician, Safety, CPT, Outpatient surgery, Hospital, Urinary incontinence, CMS

VALENCIA, Calif., Nov. 7, 2023 /PRNewswire/ -- As outlined in the 2024 Medicare Program: HOPPS and ASC Payment Systems Final Rule, CMS has confirmed that new Category III CPT code 0816T for reporting the eCoin system implantable tibial nerve stimulation procedure across all service locations has been assigned to Medicare Hospital Outpatient Prospective Payment System Ambulatory Payment Classification (APC) 5464 beginning CY'24. In the hospital outpatient site of service, APC 5464 has been assigned a Medicare unadjusted, national average payment rate of US$20,865, as referenced in Addendums A and B of the Final Rule. 

Key Points: 
  • Furthermore, CPT code 0816T describing the eCoin system procedure has been categorized as device-intensive by CMS.
  • This categorization ensures a more comprehensive Medicare payment in the Ambulatory Surgery Center (ASC) in comparison to procedures not deemed device-intensive.
  • Ann Decker, VP of Reimbursement for Valencia Technologies, commented, "The payment Rules for Hospital outpatient (HOPPS) and Ambulatory Surgery Center (ASC) by CMS are a testament to the constructive discussions between Valencia Technologies and CMS.
  • Patients are encouraged to visit Valencia's patient website at www.eCoin.us for more information about this novel therapy for UUI.

U.S. Supreme Court Agrees to Hear NCLA Case Against ATF’s Unilateral Bump-Stock Ban

Retrieved on: 
Friday, November 3, 2023
Sokolow et al v. Palestine Liberation Organization et al, Supreme court, ATF, United States Department of Commerce, Judge, Texas Court of Criminal Appeals, Social media, United States Court of Appeals for the Tenth Circuit, Bump stock, Department of Treasury, Bureau of Alcohol, Tobacco & Firearms v. Galioto, Solicitor, NCLA, Garland v. Gonzalez, Congress, Navy-Marine Corps Court of Criminal Appeals, Tobacco, Commerce, Court, Federation, Firearm, United States Court of Appeals for the District of Columbia Circuit, Bureau, Law of the United Kingdom, The Administrative State, Speech, United States Court of Appeals for the Sixth Circuit, The Final Rule, United States courts of appeals, Trump, United States Court of Appeals for the Fifth Circuit, Fifth, Army, Administration, En banc, Constitution, Same-sex marriage in the Sixth Circuit, Supreme, Cargill

Today, the Court granted the government’s request for a writ of certiorari in NCLA’s challenge to the Bureau of Alcohol, Tobacco, Firearms and Explosives’ unilateral bump-stock ban.

Key Points: 
  • Today, the Court granted the government’s request for a writ of certiorari in NCLA’s challenge to the Bureau of Alcohol, Tobacco, Firearms and Explosives’ unilateral bump-stock ban.
  • Garland v. Cargill will be NCLA’s fourth case argued before the U.S. Supreme Court in under 2 years.
  • As these cases show, we will fight all the way to the Supreme Court to protect civil liberties from federal agencies’ attacks.
  • We are confident the U.S. Supreme Court will right this wrong for Michael Cargill and all Americans.”

U.S. Supreme Court Agrees to Hear NCLA Relentless Case Challenging Chevron Deference

Retrieved on: 
Friday, October 13, 2023
Loligo, Congress, Magnuson–Stevens Fishery Conservation and Management Act, Government, Fishery, Court, Sokolow et al v. Palestine Liberation Organization et al, NOAA, Supreme, Commerce, National Marine Fisheries Service, NCLA, Supreme court, Supreme Court of the United States, The Final Rule, Ambiguity, U.S. Department of Defense Strategy for Operating in Cyberspace, Logic, Relentless, Illex, Atlantic Ocean

Washington, D.C., Oct. 13, 2023 (GLOBE NEWSWIRE) -- Today, the U.S. Supreme Court agreed to hear the New Civil Liberties Alliance’s Relentless Inc., et al.

Key Points: 
  • Washington, D.C., Oct. 13, 2023 (GLOBE NEWSWIRE) -- Today, the U.S. Supreme Court agreed to hear the New Civil Liberties Alliance’s Relentless Inc., et al.
  • The case will be argued before the U.S. Supreme Court during the January 2024 argument session in tandem with the case of Loper Bright Enterprises, et al.
  • In Relentless and Loper Bright, the U.S. Supreme Court will consider whether to overrule Chevron.
  • NCLA was founded to right this wrong, and we look forward to doing so at the U.S. Supreme Court for our clients and all Americans.”

NCLA Amicus Brief Challenges Supreme Court to Deep-Six Chevron Deference and at-Sea Monitor Rule

Retrieved on: 
Monday, July 24, 2023
Supreme, GPS, The Final Rule, National Oceanic and Atmospheric Administration, United States Court of Appeals for the Fifth Circuit, National Marine Fisheries Service, Person, Judgement, Government, CODA, NOAA, Supreme court, Law of the United Kingdom, Magnuson–Stevens Fishery Conservation and Management Act, Court, NCLA, United States Court of Appeals for the First Circuit, Executive (government), Constitution, Fishery, Commerce, Tobacco, Relentless

NCLA’s amicus brief—co-authored by founder Philip Hamburger—makes important arguments against Chevron deference that the Court has never evaluated.

Key Points: 
  • NCLA’s amicus brief—co-authored by founder Philip Hamburger—makes important arguments against Chevron deference that the Court has never evaluated.
  • Last month, NCLA filed a petition for a writ of certiorari with the Supreme Court challenging the same Final Rule and Chevron in Relentless v. Dept.
  • of Commerce give the Supreme Court every opportunity to correct its Chevron error, restoring judicial independence and due process.
  • Absent Chevron deference, no judge would read the Magnuson-Stevens Act to authorize forcing these fishermen to pay for at-sea monitors.”

NCLA Cert Petition Joins Effort Asking U.S. Supreme Court to Overturn Chevron and Scrap Fishy Rule

Retrieved on: 
Wednesday, June 14, 2023
Loligo, Supreme, GPS, National Marine Fisheries Service, Office of Inspector General, U.S. Department of Health and Human Services, United States Court of Appeals for the Fifth Circuit, The Final Rule, Fishery, The Administrative State, First Circuit Court of the Supreme People's Court, Language, Government, First, Congress, NOAA, MSA, Gulf of Mexico, Administration, Logic, Supreme court, Law of the United Kingdom, NCLA, Court, Magnuson–Stevens Fishery Conservation and Management Act, United States Court of Appeals for the First Circuit, Supreme Court of the United States, Commerce, Illex, Relentless, Atlantic Ocean

Unfortunately, relying on Chevron deference to do the heavy lifting, the First Circuit Court of Appeals upheld that rule.

Key Points: 
  • Unfortunately, relying on Chevron deference to do the heavy lifting, the First Circuit Court of Appeals upheld that rule.
  • Today, the New Civil Liberties Alliance petitioned the U.S. Supreme Court for a writ of certiorari in Relentless Inc., et al.
  • of Commerce, et al., seeking to overturn the Chevron precedent and vacate the rule.
  • But even if the Court does not grant cert in Relentless, NCLA still anticipates the Court will decide the Chevron question in Loper Bright’s favor.

NCLA Endorses Request for U.S. Supreme Court to Rule on ATF’s Unilateral Bump Stock Ban

Retrieved on: 
Thursday, June 8, 2023
Supreme, Army, Bump stock, Department of Treasury, Bureau of Alcohol, Tobacco & Firearms v. Galioto, Court of cassation, United States courts of appeals, Bureau, Tobacco, United States Court of Appeals for the District of Columbia Circuit, En banc, The Final Rule, High court, United States Court of Appeals for the Sixth Circuit, United States Court of Appeals for the Tenth Circuit, Government, Fifth, Navy-Marine Corps Court of Criminal Appeals, Congress, Solicitor General of Texas, Air Force Court of Criminal Appeals, ATF, United States Court of Appeals for the Fifth Circuit, Supreme court, Law of the United Kingdom, NCLA, Court, Same-sex marriage in the Sixth Circuit, Constitution, Firearm

That petition asks the Court to hear NCLA’s challenge to the Bureau of Alcohol, Tobacco, Firearms and Explosives’ unilateral bump stock ban.

Key Points: 
  • That petition asks the Court to hear NCLA’s challenge to the Bureau of Alcohol, Tobacco, Firearms and Explosives’ unilateral bump stock ban.
  • That rule reversed ATF’s long-standing recognition that bump stock-equipped firearms are not illegal machineguns.
  • NCLA urges the Supreme Court to resolve this issue and safeguard Americans’ rights against administrative agency power grabs.
  • We agree it is high time for the High Court to weigh in on the lawfulness of ATF’s bump stock ban and reassert Congress’s primacy.”

Food Industry Addresses U.S. FDA Requirements for Additional Traceability Records With New Guidance

Retrieved on: 
Tuesday, March 7, 2023
FDA Food Safety Modernization Act, GS1, Movement, GS1 US, The Final Rule, Bioterrorism, KDES-FM, Food, Public Health Security and Bioterrorism Preparedness and Response Act of 2002, FSMA, Food industry, Ralph R. McKee CTE High School, FDA, Regulation of food and dietary supplements by the U.S. Food and Drug Administration, Public health, Record, Critical, Guideline, Medical device

EWING, N.J., March 7, 2023 /PRNewswire/ -- GS1 US® has published a new guideline to help the food industry leverage GS1 Standards to help address the U.S. Food and Drug Administration's (FDA's) Food Traceability Final Rule, which requires additional traceability records for certain foods under Section 204 of the Food Safety Modernization Act (FSMA).

Key Points: 
  • EWING, N.J., March 7, 2023 /PRNewswire/ -- GS1 US® has published a new guideline to help the food industry leverage GS1 Standards to help address the U.S. Food and Drug Administration's (FDA's) Food Traceability Final Rule, which requires additional traceability records for certain foods under Section 204 of the Food Safety Modernization Act (FSMA).
  • The Final Rule mandates companies that physically handle certain foods on the FDA Food Traceability List keep additional records to assist in tracebacks during an investigation of a foodborne illness outbreak.
  • The new guidance document highlights how voluntary GS1 Standards will help prepare systems and business processes to meet the January 2026 compliance deadline.
  • "This guideline will help all companies that handle food to maximize supply chain visibility and ultimately advance food safety practices."

In NCLA Win, Fifth Circuit Tosses Back NMFS Rule Trying to Track Charter Boats Without a Warrant

Retrieved on: 
Friday, February 24, 2023
Fourth, VMS, Government, United States Court of Appeals for the Fifth Circuit, Comment, NCLA, Fourth Amendment, Constitutional right, Administrative Procedure Act, Vessel monitoring system, GPS, Administrative Procedure Act (United States), Software, Court, Privacy, The Final Rule, MSA, National Marine Fisheries Service, APA, United States Department of Commerce, Fifth Circuit Four, NMFS, Gulf of Mexico, Rule, Administration, Language, Commerce, Magnuson–Stevens Fishery Conservation and Management Act

NCLA represents more than 1,300 federally permitted charter boat owners in the class-action lawsuit, Mexican Gulf Fishing Company v. U.S. Department of Commerce.

Key Points: 
  • NCLA represents more than 1,300 federally permitted charter boat owners in the class-action lawsuit, Mexican Gulf Fishing Company v. U.S. Department of Commerce.
  • NCLA also complained that the rule required reporting economic data that had nowhere been specified by the agencies in proposing the rule for comment.
  • NCLA commends the Fifth Circuit for recognizing the financial and privacy costs associated with NMFS’s ill-conceived regulation.
  • As the Fifth Circuit held, government agencies are not free to duck hard questions, nor may they avoid considering a rule’s costs and benefits.