Regulatory Updates: What's Changed, What Matters, What’s Next?”

Government Affairs and Observation Committee

During this session, members of both the Government Affairs Committee (GAC) and the Observation (OBS) Committee  discussed the latest Centers for Medicare and Medicaid Services (CMS) regulatory updates on the Medicare Inpatient-Only list and how to operationalize cases that should remain Inpatient; the Medicare Advantage 2026 updates and changes to appeal rights; and Aetna's upcoming Level of Severity Inpatient Policy. Additional discussion focused on the Medicare Change of Status Notification (MCSN) appeals and Quality Improvement Organization (QIO) determination experience, and Managed Care plans' requirement for Special Needs Plan Model of Care (SNP MOC) training. 

Panelists

Joanna Kipnes, MD, MS, FHM
Government Affairs Committee Member
Moderator

Maha Sulieman, MD, FHM, ACPA-C
Observation Committee Member
Q&A Monitor

Edward Hu, MD, ACPA-C 
Government Affairs Committee Member

Stephanie Van Zandt, MD, ACPA-C
Government Affairs Committee Member

Nadine Koser, D.O., ACPA-C
Observation Committee Member, NPAC Vice Chair

Robert Leviton, MD, MPH, FACEP, FAMIA, ACPA-C
Observation Committee Member

Anuja Mohla, DO, MBA, ACPA-C
Observation Committee Member, NPAC Vice Chair