Bruce A. Johnson

Bruce A. Johnson

Polsinelli

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Making Sense of the MACRA Final Rule – Part 3 of 3: Merit Based Payment Incentive System (MIPS)

The Centers for Medicare & Medicaid Services (CMS) recently released its final rule with comment period implementing the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Among its numerous changes,...more

11/9/2016 - Alternative Payment Models (APM) CEHRT CMS Health Care Providers Healthcare Medicare Medicare Access and CHIP Reauthorization (MACRA) MIPS Physician Medicare Reimbursements Physicians PQRS Quality Payment Program (QPP) Sustainable Growth Rate (SGR)

Making Sense of the MACRA Final Rule, Part 2 of 3: Alternative payment Models

Many observers view the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a game changer for the delivery and payment of health care services. On Oct. 14, 2016 the Centers for Medicare & Medicaid Services...more

11/2/2016 - ACOs Alternative Payment Models (APM) CEHRT CMS Electronic Health Record Incentives Health Care Providers Healthcare Medicaid Medicare Medicare Access and CHIP Reauthorization (MACRA) MIPS Physician Medicare Reimbursements Physicians PQRS Quality Payment Program (QPP)

Understanding the Implications of MACRA, MIPS and APMs

On May 9, 2016, the Centers for Medicare & Medicaid Services (CMS) published a notice of proposed rulemaking to implement the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Although the...more

6/23/2016 - ACOs Alternative Payment Models (APM) CMS Health Care Providers Medicaid Medicare Medicare Access and CHIP Reauthorization (MACRA) MIPS PQRS Value-Based Payments

CMS Publishes Proposed Rule Implementing MACRA Physician Payment Model

On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) posted a pre-publication version of a proposed rule implementing changes to Medicare payment for physician services authorized under the bipartisan...more

5/2/2016 - Alternative Payment Models (APM) CMS Comment Period Electronic Health Record Incentives Fee-for-Service Health Care Providers Medicare Medicare Access and CHIP Reauthorization (MACRA) MIPS Physicians PQRS

Tuomey Resolves Stark Law and False Claims Act Judgment for $72.4 Million

The Department of Justice announced on October 16, 2015 a settlement agreement with Tuomey Healthcare System that resolves a $237 million judgment against the system involving claims submitted to the Medicare program in...more

10/27/2015 - Corporate Integrity Agreement DOJ False Claims Act (FCA) Healthcare Medicare Physician Compensation Arrangements Stark Law Tuomey

Payment Innovation: 30 Day Window to Provide CMS Comments on Physician Payment Changes Under MACRA Begins

On September 28, 2015, the Centers for Medicare & Medicaid Services (CMS) published a Request for Information (RFI) seeking stakeholder comments related to innovative physician payment models required by the Medicare Access...more

10/1/2015 - Alternative Payment Models (APM) CHIP CMS EHR Electronic Health Record Incentives Health Care Providers Healthcare Hospitals Medicaid Medicare Medicare Access and CHIP Reauthorization (MACRA) MIPS Physician Payments Physicians PQRS Request For Information Value-Based Payments

Practices, Optics and Implications: A Cautionary Tale from the North Broward Hospital District Settlement

The $69.5 million settlement by North Broward Hospital District in Fort Lauderdale, Florida to resolve False Claims Act allegations paints a cautionary tale of the importance of hospital practices and optics in connection...more

9/21/2015 - Compliance Fair Market Value False Claims Act (FCA) Healthcare Hospitals Physicians Settlement Stark Law Unfair Competition Wage and Hour Whistleblowers

CMS Encourages Continued Participation in Medicare Shared Savings Program with Final Rule

In This Issue: - ACO Eligibility Requirements - Establishing and Maintaining the ACO Participation Agreement - Data Sharing and Assignment of Beneficiaries - Shared Savings and Losses - Waivers of...more

7/7/2015 - ACO Participant Agreements ACOs CMS Data-Sharing Electronic Health Record Incentives Healthcare Medicaid Medicare Medicare Shared Savings Program Skilled Nursing Facility SNF

Health Reform + Related Health Policy News - December 2013

In This Issue: - Top News ..CMS Releases Payment Rules for the Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System, Renal Dialysis and Home Health ..President Signs the Drug Quality...more

12/17/2013 - CMS Drug Compounding FDA Health Insurance Exchanges Medicaid Medicare Pharmacies Physician Fee Schedule Stark Law

Clinical Integration On A Promise And A Plan Federal Trade Commission Declines To Challenge Norman PHO On Antitrust Grounds

In This Issue: - Norman PHO - Key Conclusions - Implications for Established and Newly Forming Networks - Excerpt from Norman PHO: The Norman PHO is comprised of a single hospital system and...more

3/14/2013 - Clinically Integrated Networks (CINs) Competition FTC Hospitals Norman PHO

Health Reform + Related Health Policy News Update - February 6, 2013

In This Issue: - Top News ..CMS Announces Round 2 Competitive Bidding Single Payment Amounts ..CBO Lowers SGR Repeal Cost by $100 Billion ..Republicans Press HRSA on 340B Audits ..HHS Proposes...more

2/7/2013 - CMS Competitive Bidding Contraceptive Coverage Mandate FDA GAO Health Insurance Exchanges HHS Medicaid Shared Responsibility Rule Sunshine Act

Health Reform + Related Health Policy News Update: January 30, 2013

In This Issue: - Top News ..CMS, IRS Issue Proposed Rules on Health Insurance Mandate, Minimum - Essential Coverage ..Insurers Weigh Options for Exchange Participation ..Quality Improvements in Care...more

1/31/2013 - Affordable Care Act CMS DOL Health Insurance HHS HIPAA Individual Mandate IRS

Health Reform + Related Health Policy News Update - January 24, 2013

In This Issue: - OMB Directs Department Heads to Prepare for Sequestration - HHS Finalizes Omnibus HIPAA Rule, Enhances Privacy Requirements - SCOTUS Says Equitable Tolling Not a Factor in DSH Case - Report...more

1/25/2013 - Data Protection DSH Equitable Tolling HIPAA HIPAA Omnibus Rule HITECH Hospitals Medicaid Medicare OMB Pay-For-Delay Pharmaceutical Industry SCOTUS Sequestration

Health Reform + Related Health Policy News Update - January 16, 2013

In This Issue: - Fiscal Cliff Deal Lengthens Medicare Overpayment Recovery Period - Cutting Medicaid Provider Tax May Shift Costs to States, CRS Finds - MedPAC Finalizes Payment Recommendations, GAO Solicits...more

1/18/2013 - American Taxpayer Relief Act CDC CMS Fiscal Cliff GAO Medicaid Medicare MedPAC OIG Overpayment SMART

Health Reform + Related Health Policy News - November 28, 2012

In This Issue: - CMS Releases FY 2012 Financial Report; Misses Target forReductions in Improper Payments - CMS Releases Guidance on Medicaid/CHIP Issues - HHS Secretary Extends Deadline for Decision on...more

12/3/2012 - CMS FDA Health Insurance Exchanges HHS Medicaid Medical Devices Medicare OIG

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