Debra McCurdy

Debra McCurdy

Reed Smith

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CMS Call: Countdown to ICD-10 (Aug. 27)

On August 27, 2015, CMS is hosting a call to help health care providers prepare for ICD-10 implementation on October 1, 2015. CMS staff will be joined by representatives of the American Health Information Management...more

7/28/2015 - AHIMA American Hospital Association CMS Healthcare Healthcare Professionals Healthcare Providers ICD Codes ICD-10 Medicaid Medicare

CMS Call on Proposed Reform of LTC Facility Requirements (Aug.11)

On August 11, 2015, CMS is hosting a provider call to discuss its proposed rule to reform the Medicare and Medicaid participation requirements for long-term care (LTC) facilities. A question and answer session will follow the...more

7/28/2015 - CMS Healthcare Healthcare Professionals Healthcare Providers Long Term Care Facilities Long-Term Care Medicaid Medicare Proposed Regulation

CMS Proposes “Comprehensive Care for Joint Replacement” Model; Would Mandate Bundled Acute/Post-Acute Medicare Payment in 75 MSAs,...

On July 14, 2015, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule to establish a Medicare Comprehensive Care for Joint Replacement (CCJR) model. Under the proposed rule, CMS would provide a...more

7/23/2015 - Alternative Payment Models (APM) Beneficiaries BPCI CMS Comment Period Fee-for-Service Gainsharing Hospitals Medicaid Medicare Proposed Regulation Waivers

CMS Fraud Prevention System Credited with $820 Million in Medicare Savings to Date

CMS has announced that its Fraud Prevention System identified or prevented $820 million in inappropriate Medicare payments during its first three years, including $454 million in 2014 alone. The Fraud Prevention System uses...more

7/22/2015 - CMS Data Analytics Data Protection Fraud Prevention Health Care Providers Healthcare Healthcare Fraud Medicare

Medicare/Medicaid Requirements for Long-Term Care Facilities

On July 13, 2015, CMS issued a much-anticipated proposed rule seeking to consolidate the long-term care (LTC) facility participation requirements for the Medicare and Medicaid programs. This major proposal marks the first...more

7/22/2015 - CMS Comment Period Healthcare Healthcare Providers Long Term Care Facilities Long-Term Care Medicaid Medicare Patient Safety Proposed Regulation Quality of Care Standards

CMS Proposes “Comprehensive Care for Joint Replacement” Model

On July 14, 2015, CMS published a proposed rule to establish a Medicare Comprehensive Care for Joint Replacement (CCJR) model. Under the proposed rule, CMS would provide a bundled payment to hospitals in selected geographic...more

7/22/2015 - Bundled Payments CMS Comment Period Fee-for-Service Healthcare Healthcare Providers Hospitals Medicaid Medicare Proposed Regulation Reconciliation

Final FY 2016 Medicare Payment Rules on the Horizon

Despite the recent flurry of activity on Medicare payment rules, more are in the pipeline. CMS has sent the final fiscal year (FY) 2016 Medicare skilled nursing facility, hospice, inpatient rehabilitation facility, and...more

7/22/2015 - CMS Federal Register Healthcare Healthcare Providers Hospice Hospitals Inpatient Rehab Facilities Long Term Care Facilities Medicaid Medicare OMB Proposed Regulation Psychiatric Hospitals Skilled Nursing Facility

Congress Clears Bipartisan DME & Home Care Bills

On July 15, 2015, the House of Representatives approved by voice vote the following two bills...more

7/21/2015 - Durable Medical Equipment Healthcare Home Health Care Medical Devices Medicare Pending Legislation

July Congressional Committee Hearings on Health Policy Issues

Congressional committees continue to hold hearings on various health policy topics, including the following: ..A Senate Finance Committee hearing today focused on “Reviewing Controls.” ..The House...more

7/17/2015 - Beneficiaries Congressional Investigations & Hearings Health Information Technologies Healthcare Healthcare Providers Hospitals Medical Research Medicare Medicare Part D Physicians Public Policy Rural Health Care Providers Small Business

CMS Extends Medicare Prior Authorization for Power Mobility Devices Demonstration through August 2018

CMS has announced that it is extending its Medicare Prior Authorization for Power Mobility Devices (PMDs) demonstration for three years, through August 31, 2018. This demonstration was launched on September 1, 2012 in seven...more

7/17/2015 - CMS Healthcare Healthcare Fraud Healthcare Providers Medical Devices Medicare Prior Authorization

White House Releases Proposed Precision Medicine Initiative Privacy Framework

Earlier this year, President Obama launched a high-profile “Precision Medicine Initiative” (PMI) to develop treatments, diagnostics, and prevention strategies tailored to the individual genetic characteristics of each...more

7/17/2015 - Barack Obama Comment Period Data Analytics Data Collection Data Security Data-Sharing Healthcare Human Genes Medical Research New Guidance Obama Administration Patient Privacy Rights Personally Identifiable Information Public Comment

CMS Proposed Medicare Home Health PPS Rule Would Reduce HHA Payments by $350 Million in 2016

CMS has released its proposed calendar year (CY) 2016 Medicare home health prospective payment system (HH PPS) update, which CMS estimates would reduce overall Medicare payments to home health agencies (HHAs) by $350 million...more

7/9/2015 - CMS Healthcare Home Health Agencies Medicare Patient Prospective Payment System Proposed Regulation

CMS Proposes $43 Million CY 2016 Medicare OPPS Rate Cut; Small Increase in ASC Payments

On July 8, 2015, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule to update the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) Payment...more

7/9/2015 - CMS Healthcare Hospitals Outpatient Quality Reporting Patient Prospective Payment System Proposed Regulation Reporting Requirements Two-Midnight Rule

GAO Report Examines Hospital Financial Incentives to Prescribe 340B Drugs to Medicare Beneficiaries

The Government Accountability Office (GAO) has issued a report examining financial and other characteristics of hospitals that participate in the 340B Drug Pricing Program, focusing on disproportionate share hospitals (DSH)...more

7/9/2015 - 340B CMS Drug Pricing GAO Health Care Providers Healthcare Hospitals HRSA Medicare Medicare Part B Prescription Drug Coverage Prescription Drugs Reimbursements

Revised House 21st Century Cures Bill Released Ahead of House Vote

Later this week, the House of Representatives is expected to consider the H.R. 6, the 21st Century Cures Act. Ahead of the House vote, the House Rules Committee released a revised version of the bill with new funding offsets...more

7/7/2015 - 21st Century Cures Initiative Civil Monetary Penalty Drug Manufacturers Drug Pricing Durable Medical Equipment FDA Generic Drugs Health Information Technologies Healthcare Healthcare Reform Medicaid Medical Devices Medicare NIH Pharmaceutical Manufacturers Prescription Drug Plans Proposed Legislation

CMS Announces Efforts to Ease ICD-10 Transition

Today CMS announced steps to help physicians prepare for the switch to ICD-10 coding on October 1, 2015. Most significantly, CMS announced that during the first year after ICD-10 implementation, Medicare contractors will not...more

7/7/2015 - Claims Processing Systems CMS Health Care Providers Healthcare Professionals ICD Codes ICD-10 Meaningful Use Medicaid Medicare Physician Medicare Reimbursements Physicians

House Panels to Review Small Business Health Care, Medicaid Program Status

Two Congressional hearings are scheduled this week on health policy issues: ..On July 7, 2015, the Senate Health, Education, Labor and Pensions Committee has scheduled a hearing on “Small Business Health Care Challenges...more

7/7/2015 - Healthcare Medicaid

CMS Releases CY 2016 ESRD PPS Proposed Rule

On June 26, 2015, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule to update the Medicare end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2016. CMS...more

6/30/2015 - CMS Medicare Physician Medicare Reimbursements

CMS Proposed 2016 Medicare Payment Rules in the Pipeline

CMS recently sent several major proposed Medicare CY 2016 payment rules to the White House Office of Management and Budget (OMB) for regulatory clearance – the last step before publication in the Federal Register....more

6/30/2015 - CMS Medicare OMB Physician Fee Schedule Physician Medicare Reimbursements

CMS Revises Expands ACO “Investment Model” Opportunities

As previously reported, CMS announced a Medicare Shared Savings Program/Accountable Care Organization (ACO) “Investment Model” last fall to better coordinate care in rural and underserved areas where inadequate access to...more

6/30/2015 - ACOs CMS Medicare Medicare Shared Savings Program

Congressional Health Policy Hearings - June 2015 #2

A House Ways and Means Subcommittee on Oversight hearing recently reviewed the effects of the Affordable Care Act (ACA) on health insurance premiums. In addition, a House Energy and Commerce Health Subcommittee hearing...more

6/30/2015 - Affordable Care Act Health Insurance Premiums Proposed Legislation

MedPAC Report to Congress on Medicare and the Health Care Delivery System

The Medicare Payment Advisory Commission (MedPAC) has released its June 2015 Report to the Congress on Medicare and the Health Care Delivery System. The report includes a series of recommendations on Medicare hospital...more

6/26/2015 - HHS Hospitals Medicare Medicare Advantage Medicare Part B MedPAC Prescription Drugs RACs Recovery Audit Skilled Nursing Facility

Obama Administration Announces Record Medicare Strike Force "Takedown"

On June 18, 2015, HHS Secretary Sylvia M. Burwell and Attorney General Loretta E. Lynch announced that a nationwide Medicare Fraud Strike Force sweep resulted in health fraud charges against 243 individuals involving...more

6/26/2015 - Durable Medical Equipment False Billing Health Care Providers Healthcare Fraud HHS Medicare Medicare Fraud Strike Force Prescription Drugs

House Passes Bills to Repeal ACA Medical Device Tax and IPAB, Revise Medicare Advantage Policy

The House of Representatives has taken action on a number of bills to modify certain Affordable Care Act (ACA) provisions, revise Medicare Advantage policies, and make other health policy changes. On June 23, 2015, the...more

6/26/2015 - Affordable Care Act Healthcare Healthcare Reform IPAB Medicare Medicare Advantage

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