decisionhealth Newsletters, Coder Pink Sheets - 2021 Issue 7 (July)
Getting paid: Good guidance rule gives practices a new way to challenge CMS guidelines
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Article Overview
This article covers HHS’s good guidance rule and its impact on CMS guidance documents affecting healthcare billing and compliance. It is aimed at practices, coders, compliance staff, and administrators who track regulatory guidance from CMS and HHS. The article summarizes the petition process for challenging guidance, the standards for identifying significant guidance, and the notice and transparency requirements that apply to new guidance documents.
Why This Topic Matters
The rule affects how healthcare organizations monitor and respond to agency guidance, especially when guidance may influence compliance expectations. Understanding the process helps readers recognize when guidance is being modified, withdrawn, or subjected to formal review.
Article Sections
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A new way to challenge guidelines
This section introduces the petition process available under the good guidance rule and the types of concerns that can be raised about agency guidance documents.
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New guidance will have more detail
This section outlines the general publication and transparency requirements for new HHS guidance documents and explains the concept of significant guidance subject to additional review.
What You Will Learn
- How the good guidance rule changes the review of HHS guidance documents
- What types of concerns can be raised through a petition to HHS
- Which general requirements apply to new HHS guidance documents
- What makes a guidance document significant under the rule
- How the rule affects monitoring for CMS and HHS guidance updates
Who Should Read This
- Medical coders
- Compliance staff
- Practice administrators
- Healthcare billing professionals
- Revenue cycle teams
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