Debra McCurdy

Debra McCurdy

Reed Smith

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Latest Publications


GAO Assesses Considerations for Expansion of the Medicare Appropriate Use Criteria Program

On September 30, 2015, the Government Accountability Office (GAO) released a report entitled “Medicare: Considerations for Expansion of the Appropriate Use Criteria Program.” In addition to describing CMS’s plans for...more

10/9/2015 - CMS Diagnostic Imaging Services GAO Healthcare Healthcare Providers Medicare

CMS Announces Medicare Part D Medication Therapy Management Innovation Model

The latest CMS “innovation model” will test whether providing Medicare Part D prescription drug plan (PDP) sponsors with financial incentives and flexibility with regard to medication therapy management (MTM) program...more

10/9/2015 - CMS Healthcare Innovation Medicare Part D Payment Systems Prescription Drug Plans

Senate HELP Committee Approves Mental Health, Opioid Abuse, Drug Scheduling Legislation

On September 30, 2015, the Senate Health, Education, Labor, and Pensions (HELP) Committee approved the following bipartisan legislation: S. 799, the Protecting Our Infants Act (to combat the rise of prenatal opioid abuse and...more

10/9/2015 - Congressional Committees Controlled Substances Act FDCA Healthcare HELP Mental Health Mental Health Initiatives Pending Legislation Substance Abuse Transparency

ONC Releases Final Health IT Strategic Plan, Draft Interoperability Standards Advisory

The Office of the National Coordinator for Health Information Technology (ONC) has released its final Federal Health IT Strategic Plan for 2015-2020. The 50-page document details how the federal government intends to...more

10/8/2015 - Comment Period Health Information Technologies Healthcare Healthcare Costs Healthcare Providers Information Technology Infrastructure Innovation Medical Research ONC Scientific Research Strategic Planning

CMS Posts CY 2016 Amount in Controversy Thresholds for Medicare Appeals

CMS has published a notice announcing the annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process....more

10/8/2015 - Administrative Hearings CMS Healthcare Healthcare Professionals Judicial Review Medicare Medicare Appeals Council Threshhold Requirements

OIG Flags $171 Million in Potentially Questionable Billing for Medicare Ophthalmology Services

The OIG has issued a report entitled “Questionable Billing for Medicare Ophthalmology Services.” The OIG concludes that most Medicare providers billing for ophthalmology services in 2012 did not demonstrate what the OIG...more

10/8/2015 - Billing CMS Healthcare Healthcare Providers Medicare OIG

“Ensuring Access to Clinical Trials Act” Sent to President

On September 28, 2015, the House of Representatives approved by voice vote S. 139, the Ensuring Access to Clinical Trials Act. This legislation would allow individuals to participate in clinical trials for rare diseases...more

10/7/2015 - Clinical Trials Eligibility Medicaid Pending Legislation Supplemental Security Income (SSI)

House Ways and Means Committee Approves Bills to Repeal ACA Taxes, Mandates, IPAB

On September 29, 2015, the House Ways and Means Committee approved budget “reconciliation” legislation that calls for repeal of five provisions of the Affordable Care Act (ACA). Specifically, the legislation would repeal the...more

10/7/2015 - Affordable Care Act Cadillac Tax Congressional Committees Employer Mandates Individual Mandate IPAB Medical Device Tax Proposed Legislation Repeal

OIG Calls for Stronger HIPAA Compliance Efforts

The OIG has issued two reports calling for stronger ONC oversight of covered entity compliance with HIPAA standards. In the first report, “OCR Should Strengthen Its Oversight of Covered Entities’ Compliance with the HIPAA...more

10/7/2015 - Audits Compliance Corrective Actions Covered Entities Data Breach Data Security Documentation Health Information Technologies HIPAA OCR OIG Patient Privacy Rights

CMS Corrects FY 2016 Medicare Payment Rules

CMS has released corrections to a number of fiscal year (FY) 2016 final Medicare payment rules. Specifically, on October 5, 2015, CMS is publishing corrections to...more

10/7/2015 - CMS Corrections Final Rules Healthcare Healthcare Professionals Hospice Hospitals IPPS Long Term Care Facilities Medicare Payment Systems Psychiatric Hospitals Skilled Nursing Facility

Congress Clears Bill to Block ACA Change to Definition of Small Employer; House Votes to Broaden ACA Religious Exemption

The House and Senate have approved a bill (H.R. 1624) that would amend the Affordable Care Act’s definition of “small employer” to reduce the number of employers covered by new health insurance coverage requirements set to go...more

10/7/2015 - Affordable Care Act Employer Mandates Health Insurance Individual Mandate Pending Legislation Proposed Legislation Religious Exemption Small Employers

OIG Again Calls for Reforms to Medicare SNF Reimbursement Policy

The HHS Office of Inspector General (OIG) continues to question the appropriateness of payments to skilled nursing facilities (SNFs) under the Medicare SNF prospective payment system (PPS). Based on Medicare Part A SNF claims...more

10/6/2015 - CMS HHS Medicare Medicare Part A OIG Payment Systems Skilled Nursing Facility

MedPAC Meeting on Medicare Policies (Oct. 8-9)

The next Medicare Payment Advisory Commission (MedPAC) meeting is scheduled for October 8 -9, 2015. Topics on the agenda include: Medicare drug spending; Alternative Payment Models and the Merit-based Incentive Payment...more

10/6/2015 - Alternative Payment Models (APM) Benchmarks Healthcare Healthcare Professionals Medicare Medicare Advantage MedPAC Prescription Drugs Star Ratings

OHRP to Host Oct. 20 Meeting on Proposed Overhaul of Common Rule

On October 20, 2015, the HHS Office of the Assistant Secretary for Health, Office for Human Research Protections (OHRP) is hosting a public town hall meeting to respond to questions related to its September 8, 2015 proposed...more

10/6/2015 - Clinical Trials HHS Medical Research Public Meetings Scientific Research The Common Rule

CMS to Host Call on Implementation of the IMPACT Act

On October 21, 2015, CMS is hosting a provider call to discuss the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The call will cover...more

10/2/2015 - CMS Healthcare Providers Home Health Agencies IMPACT Act Inpatient Quality Reporting Inpatient Rehab Facilities Long Term Care Facilities Medicare New Legislation Skilled Nursing Facility

CMS Releases Preliminary 2016 Determinations for New Clinical Lab Tests, Announces October 19 Open Meeting on Clinical Lab...

CMS has announced its preliminary 2016 clinical laboratory fee schedule (CLFS) payment determinations for new and reconsidered test codes. These preliminary determinations will be the subject of an October 19, 2015 meeting...more

10/2/2015 - CLFS Clinical Laboratories CMS Payment Schedules Public Meetings

Congressional Hearings to Focus on Health IT, Biosimilars, Medicaid Program Legislation

Two Congressional committees are holding hearings this week on health policy issues. First, the Senate Health, Education, Labor and Pensions (HELP) Committee has scheduled a September 16, 2015 hearing on “Achieving the...more

9/15/2015 - Biosimilars Clinical Trials Congressional Investigations & Hearings Medicaid PACE Pending Legislation Social Security Act Special Needs Trust State Medicaid Programs Supplemental Security Income (SSI)

Bipartisan Health Policy Bills Advance

On September 8, 2015, the House of Representatives approved the following bipartisan bills by voice vote: ..H.R. 1344, the Early Hearing Detection and Intervention Act of 2015 – to reauthorize a program for early...more

9/15/2015 - Controlled Substances Healthcare Medical Research Pending Legislation Stem cells

CMS Extends Comment Period on Proposed Rule to Reform LTC Requirements

On September 15, 2015, CMS published a notice extending by 30 days the comment period for its July 16, 2015 proposed rule entitled “Reform of Requirements for Long-Term Care Facilities.” Specifically, the comment period has...more

9/15/2015 - CMS Comment Period Healthcare Professionals Healthcare Reform Long Term Care Facilities Long-Term Care Medicaid Medicare Proposed Regulation

CMS Schedules Provider Calls on Medicare Quality Programs

CMS is hosting several calls and webcasts in September and October 2015 on various Medicare quality programs, including the following...more

9/10/2015 - CMS Dialysis Providers Electronic Health Record Incentives Healthcare Providers Medicare Physicians Quality of Care Standards Star Ratings Value-Based Payments

House Hearings to Focus on ACA Insurance Issues

On September 9, 2015, the House Energy and Commerce Committee is holding a hearing on H.R. 1624, Protecting Affordable Coverage for Employees Act of 2015. The legislation would amend the Public Health Service Act to redefine...more

9/10/2015 - Affordable Care Act Congressional Committees Congressional Investigations & Hearings Health Insurance Healthcare Healthcare Reform Proposed Amendments Public Health Insurance Marketplace Public Health Service Act

House Energy & Commerce Committee Schedules Hearing to Review Medicaid Program Integrity Legislation

On September 11, 2015, the House Energy & Commerce Subcommittee on Health will hold a hearing to discuss legislative proposals intended to reduce Medicaid waste, fraud, and abuse. Bills to be discussed include...more

9/9/2015 - Congressional Committees Congressional Investigations & Hearings Fraud Abuse and Waste Medicaid Medicaid Reform Proposed Legislation

CMS Equity Plan Tackles Health Disparities

On September 8, 2015, CMS released its first “CMS Equity Plan for Improving Quality in Medicare,” which seeks to reduce health disparities among Medicare populations that experience disproportionately high burdens of disease,...more

9/9/2015 - CMS Data Analytics Data Collection Disabilities Disparate Impact Disparate Treatment Equity Plans Gender Equity Healthcare Healthcare Facilities Healthcare Providers Medicare Race Rural Health Care Providers

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