Debra McCurdy

Debra McCurdy

Reed Smith

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CMS Announces Recompete of Round 1 of the Medicare DMEPOS Competitive Bidding Program for 2017

On April 21, 2015, CMS announced its plans to recompete the supplier contracts awarded under the Round 1 Recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding...more

4/23/2015 - CMS Competitive Bidding DMEPOS Durable Medical Equipment Federal Contractors Medicare Supply Contracts

OIG Releases Medicaid Fraud Control Units Fiscal Year 2014 Annual Report

The OIG has released its Medicaid Fraud Control Units (MFCU) Fiscal Year 2014 Annual Report, which highlights statistical achievements of the 50 MFCUs nationwide, along with related OIG oversight activities. With regard to...more

4/22/2015 - Annual Reports Criminal Prosecution Healthcare Fraud Medicaid OIG

CMS Reschedules Call on Home Health Clinical Templates (April 28)

On April 28, 2015, CMS is hosting its final call to discuss paper and clinical templates intended to assist physicians and practitioners in documenting patient eligibility for Medicare home health benefits. ...more

4/21/2015 - CMS Health Care Providers Healthcare Home Health Care Physicians

President Signs MACRA: Permanently Reforms Medicare Physician Reimbursement Framework, Includes Other Medicare Payment, Program...

On April 16, 2015” (MACRA), which reforms Medicare payment policy for physician services and adopts a series of policy changes affecting a wide range of providers and suppliers. Most notably, MACRA permanently repeals...more

4/17/2015 - CHIP CMS Healthcare Medicaid Medicare Physician SGR Formula Physicians Repeal

FDA, CMS Form Interagency Task Force on LDT Quality Requirements

FDA and CMS have announced that they are establishing an interagency task force to reinforce their collaboration regarding the oversight of laboratory-developed tests (LDTs) -- tests intended for clinical use and designed,...more

4/17/2015 - CMS FDA Interagency Agreement Laboratory Developed Tests

HRSA Moving Ahead on 340B Program Enforcement Rule, Including Manufacturer CMPs for Overcharges to 340B Entities

The Health Resources and Services Administration (HRSA) is seeking White House review of its proposed rule to implement new Affordable Care Act 340B drug discount program enforcement authorities and pricing policies. More...more

4/8/2015 - Affordable Care Act Civil Monetary Penalty Covered Entities Healthcare HRSA Pharmaceutical Manufacturers Prescription Drugs Section 340B

CMS Discusses Medicare Implications of FDA Approval of First Biosimilar Product

CMS has issued an educational article on “Food and Drug Administration Approval of First Biosimilar Product,” and the implications for Medicare coverage. CMS states that its policies “will ensure Medicare beneficiaries will...more

4/2/2015

House and Senate Approve Budget Resolutions with Medicare, Medicaid, ACA Provisions

On March 25, 2015, the House of Representatives approved (with no Democratic votes) H.Con.Res. 27, a budget resolution providing instructions to Congressional committees on the federal spending framework for FY 2016. Among...more

4/1/2015 - Affordable Care Act Federal Budget Healthcare Reform Medicaid Medicare

Health Care Fraud and Abuse Control (HCFAC) Program Reports $3.3 Billion in Recoveries

According to the FY 2014 HCFAC program report, more than $3.3 billion was recovered in FY 2014 as a result of the government’s health care fraud judgments and settlements, including $2.3 billion won or negotiated by the...more

4/1/2015 - CMS Enforcement Statistics Healthcare Healthcare Fraud Medicaid Medicare

Obama Administration Announces Plan to Combat Antibiotic Resistant Bacteria

On March 27, 2015, the Obama Administration released its National Action Plan for Combating Antibiotic Resistant Bacteria (NAP), a five-year, government-wide plan to address the spread of resistant bacteria. The main...more

3/31/2015 - Antibiotic Resistance Antibiotics Healthcare National Action Plan Obama Administration

HHS Publishes Proposed Stage 3 EHR Incentive Program, Health IT Certification Rules

On March 30, 2015, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule on Stage 3 meaningful use criteria, which focus on the advanced use of Electronic Health Record (EHR) technology to promote...more

3/31/2015 - CMS EHR Healthcare Hospitals Meaningful Use Medicaid Medicare Physicians Proposed Regulation

CMS Launches Health Care Payment Learning and Action Network

On March 25, 2015, CMS formally launched the Health Care Payment Learning and Action Network, a public-private partnership intended to support HHS’s goal of moving Medicare and the broader health industry from a...more

3/31/2015 - CMS Fee-for-Service Healthcare Medicare P3s Public-Private Partnerships

OIG Issues 2015 Compendium of Unimplemented Recommendations

The OIG has released its March 2015 “Compendium of Unimplemented Recommendations,” which highlights the OIG’s top 25 recommendations for cost savings and/or quality improvements in HHS programs, along with other significant...more

3/31/2015 - Healthcare OIG

New Postings on the Reed Smith Health Industry Washington Watch Blog - March 2015

The Reed Smith Health Industry Washington Watch blog has been updated to report on recent health policy developments, including the following...more

3/31/2015 - ACOs Affordable Care Act Antibiotic Resistance CMS EHR Healthcare Healthcare Fraud Next Generation ACO (NGACO)

MedPAC Meeting on Medicare Policy (April 2-3, 2015)

On April 2-3, 2015, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss various Medicare policy issues, including...more

3/31/2015 - Healthcare Medicare Medicare Part D MedPAC

GAO Calls for Changes to Medicare Payments to PPS-Exempt Cancer Hospitals

A recent Government Accountability Office (GAO) report, “Medicare: Payment Methods for Certain Cancer Hospitals Should Be Revised to Promote Efficiency,” examines the Medicare reimbursement methodology for cancer hospitals...more

3/31/2015 - Cancer GAO Healthcare Hospitals Inpatient Prospective Payment System Medicare

Senate Recesses Without Taking up House-Approved SGR Fix Legislation

The Senate has adjourned until April 13, 2015 without taking action on the House-approved Medicare Access and CHIP Reauthorization Act, which would repeal the Sustainable Growth Rate (SGR) formula, reform Medicare physician...more

3/30/2015 - CHIP Healthcare Medicare Pending Legislation Physician SGR Formula Physicians

CMS Publishes Update to DME Items Subject to Face-to-Face Encounter, Written Order Prior to Delivery Requirements

Today CMS published a notice updating the Healthcare Common Procedure Coding System (HCPCS) codes on the Durable Medical Equipment (DME) List of “Specified Covered Items” that require a face-to-face encounter and a written...more

3/30/2015 - CMS Durable Medical Equipment Healthcare Medicare Physicians

CMS Publishes Corrections to 2015 Medicare Physician Fee Schedule Final Rule

CMS has published corrections to its final 2015 Medicare physician fee schedule rule. Among other things, the rule reflects a previously-announced correction to the conversion factor for the first quarter of 2015 ($35.7547),...more

3/27/2015 - CMS Final Rules Healthcare Physician Fee Schedule

Obama Administration Finalizes Health Insurance Wraparound Coverage Rule

The Departments of Labor, Health and Human Services, and Treasury published a final rule on March 18, 2015 that amends the definition of excepted benefits to allow group health plan sponsors, in limited circumstances, to...more

3/27/2015 - Affordable Care Act Employer Group Health Plans Final Rules Health Insurance Wraparound Coverage

House Approves Medicare Access and CHIP Reauthorization Act

Repeals SGR Formula, Adopts Medicare and Other Policy Changes - Today the U.S. House of Representatives approved a major Medicare package, the Medicare Access and CHIP Reauthorization Act (MACRA), which would reform...more

3/27/2015 - CHIP DMEPOS Healthcare Medicare Physician SGR Formula Physicians

Congressional Health Policy Hearings

Congressional committees have held several hearings this week on health policy issues. On March 24, the Energy and Commerce Health Subcommittee held a hearing on the 340B drug pricing program....more

3/27/2015 - Congressional Investigations & Hearings Healthcare Prescription Drugs Section 340B

CMS Proposes Removing Two NCDs under Expedited Process

In 2013, CMS adopted an expedited administrative process to remove certain national coverage determinations (NCDs) older than 10 years since their most recent review. In December 2014, CMS removed seven NCDs under this...more

3/27/2015 - CMS Healthcare

CMS Proposed Rules in the Pipeline

CMS recently sent several major proposed rules to the White House Office of Management and Budget for regulatory clearance – the last step before publication in the Federal Register. OMB is reviewing proposed rules to update...more

3/27/2015 - CMS Healthcare Inpatient Prospective Payment System OMB Patient Prospective Payment System Proposed Regulation Skilled Nursing Facility

Ways & Means Committee Schedules March 24 Hearing on Use of Data Analysis to Stop Medicare Fraud

On March 24, the House Ways and Means Subcommittee on Oversight is holding a hearing on CMS’s use of the Fraud Prevention System (FPS) to identify and stop Medicare fraud. ...more

3/23/2015 - CMS Congressional Investigations & Hearings Healthcare Fraud Medicare

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