Debra McCurdy

Debra McCurdy

Reed Smith

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House GOP Moving Ahead on Controversial ACA Repeal & Replace Bill; First of Three Planned Phases of Health Reform

The House of Representatives is moving ahead on the Republican plan -– the American Health Care Act (AHCA) – that would repeal and replace major provisions of the Affordable Care Act (ACA). On March 16, 2017, the House Budget...more

3/22/2017 - Affordable Care Act Health Insurance Healthcare Reform Proposed Legislation Repeal Trump Administration

Congressional Panels Examining Pharmaceutical Distribution Systems, FDA Drug User Fees

Two Congressional committees are holding hearings this week on FDA user fees: a March 21 Senate Health, Education, Labor, and Pensions Committee hearing and a March 22 Energy and Commerce Subcommittee on Health hearing....more

3/22/2017 - FDA Pharmaceutical Industry User Fees

Price, Verma Taking a Fresh Look at Obama Administration’s EPM/CJR Final Rule; Changes Pushed Back to at Least October 1, 2017

HHS Secretary Thomas Price and CMS Administrator Seema Verma have signaled that the Trump Administration is eyeing changes to one of the last major Medicare policies issued by the Obama Administration. Specifically, CMS is...more

3/22/2017 - CCJR CMS Episode Payment Models (EPM) HHS Trump Administration

340B Ceiling Price/CMP Rule Effective Date Pushed Back to May 22, 2017 — “At the Earliest”

The Health Resources and Services Administration (HRSA) is delaying the effective date of its January 5, 2017 final rule on the calculation of the ceiling price and application of civil monetary penalties (CMPs) under the...more

3/20/2017 - Civil Monetary Penalty Drug Pricing HRSA Prescription Drugs Section 340B

Trump Administration Proposes 17.9% Cut to HHS Programs, Doubling of FDA User Fees

The Trump Administration is calling for deep cuts to Department of Health and Human Services (HHS) funding for fiscal year (FY) 2018 along with a $1 billion hike in Food and Drug Administration (FDA) user fees in its “budget...more

3/17/2017 - Budgets FDA HHS NIH Trump Administration

Senate Confirms Verma as CMS Administrator; Trump Nominates Gottlieb for FDA, Hargan as Deputy HHS Secretary

The Senate has approved the nomination of Seema Verma to be CMS Administrator on a vote of 55 to 43. In other nomination news, President Trump has nominated Scott Gottlieb to be Commissioner of Food and Drugs. Dr. Gottlieb is...more

3/17/2017 - CMS FDA HHS Trump Administration

Trump Administration Signals More Administrative Flexibility for State Medicaid Programs, with Emphasis on “Most Vulnerable...

In her first act as CMS Administrator, Seema Verma joined HHS Secretary Tom Price in writing to the nation’s Governors to urge collaboration on improving the Medicaid program, with an emphasis on services for “truly...more

3/17/2017 - Affordable Care Act CMS HHS Medicaid Trump Administration

Post-Acute Care Providers Targeted for Cuts in MedPAC’s Latest Report to Congress

The Medicare Payment Advisory Commission (MedPAC) has released recommendations to Congress regarding how Medicare fee-for-service payment system rates should be adjusted in 2018. One of the focus areas for MedPAC is...more

3/17/2017 - Ambulatory Surgery Centers Health Care Providers Long Term Care Facilities MedPAC Skilled Nursing Facility

Regulatory “Freeze” Thaws for HHS: Medicare FY 2018 IPPS/LTCH Rulemaking Process Gets Underway

The Centers for Medicare & Medicaid Services (CMS) is moving ahead on its annual Medicare hospital payment update rule – and it actually is ahead of last year’s pace. Specifically, on March 8, 2017 CMS sent to Office of...more

3/10/2017 - HHS Inpatient Prospective Payment System (IPPS) Long Term Care Facilities Medicare OMB

CMS Exploring Pediatric Alternative Payment Model Concepts

CMS is seeking public input on ways to improve the quality and reduce the cost of care for children and youth enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). In particular, CMS is interested in...more

3/9/2017 - Alternative Payment Models (APM) CHIP CMS Comment Period Medicaid

Cuts to Medicare DMEPOS Payment Based on Competitive Bidding Prices – Opportunity to Comment

CMS is seeking input from stakeholders on how it should use data from the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) competitive bidding program to adjust (cut) Medicare DMEPOS fee schedule...more

3/9/2017 - CMS Competitive Bidding DMEPOS Durable Medical Equipment

OIG Tallies Medicaid Fraud Control Unit Achievements in FY 2016

The OIG has released national and state-by-state data quantifying State Medicaid Fraud Control Unit (MFCUs) accomplishments in fiscal year 2016. During this period MFCUs were credited with a total of: - 1,721 indictments...more

3/9/2017 - Health Care Providers Healthcare Fraud Medicaid OIG

OIG Warns Public: Do Not Fall for “OIG Hotline” Scammers

The HHS Office of Inspector General (OIG) is warning the public that scammers are spoofing the OIG’s hotline telephone number to obtain personal information from individuals that then can be used to steal money from the...more

3/9/2017 - HHS OIG Scams

2018 “Next Generation” Accountable Care Organization (ACO) Models

CMS is soliciting applications for 2018 Next Generation ACOs, an Innovation Center initiative intended to promote Medicare quality improvement and care coordination. Letters of intent are due May 4, 2017. ...more

3/9/2017 - ACOs CMS Medicare

House Judiciary Committee Advances Medical Liability, Insurance Antitrust Reform Bills

The House Judiciary Committee has approved HR 1215, the “Protecting Access to Care Act of 2017.” The bill includes a variety of medical liability reforms, including a $250,000 cap on noneconomic damages, limits on contingency...more

3/9/2017 - Antitrust Provisions Health Insurance Insurance Industry McCarran-Ferguson Act Medical Liability Proposed Legislation

CMS Releases Proposed 2018 Medicare Advantage/Part D Reimbursement Methodologies and Policies

CMS has released its 2018 Advance Notice and Call Letter, which outline proposed updates to Medicare Advantage (MA) and Part D plan reimbursement methodologies and policies. CMS notes that it its proposed policies focus on...more

2/24/2017 - Alternative Payment Models (APM) CMS Health Care Providers Medicare Advantage Medicare Part D

CMS Schedules 2017 Meetings to Consider HCPCS Code Applications

CMS has just announced the dates for its annual meetings to discuss pending applications for new and revised HCPCS codes: - May 16 – 18, 2017: Drugs/Biologicals/Radiopharmaceuticals/Radiologic Imaging Agents - June...more

2/24/2017 - CMS HCPCS Health Care Providers

Medicare & Medicaid Remain Vulnerable to Fraud and Abuse, GAO Warns

The Government Accountability Office (GAO) is out with the latest installment of its “High-Risk Series,” which identifies federal programs “that are especially vulnerable to waste, fraud, abuse, and mismanagement, or that...more

2/24/2017 - CMS GAO Health Care Providers HHS Medicaid Medicare

CMS Teleconference to Discuss SNF Value-Based Purchasing Program (March 15)

On March 15, 2017, CMS is hosting a call to discuss the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Program, which is scheduled to begin in fiscal year 2019. The call will focus on confidential quarterly...more

2/24/2017 - CMS Health Care Providers Skilled Nursing Facility

CMS Proposes Changes to Stabilize ACA Health Insurance Markets

At the same time Republican Congressional leaders are attempting to develop legislation to repeal and replace the Affordable Care Act (ACA), CMS has published a proposed rule that is intended to help stabilize the Affordable...more

2/24/2017 - Affordable Care Act CMS Health Insurance Health Insurance Exchanges Open Enrollment

Trump Temporarily Tables Effective Date of the New Episode Payment Model Rule – But No Change to July 1, 2017 Implementation

As mandated by the Trump Administration’s regulatory review policy, CMS is delaying the effective date of its January 3, 2017 final rule establishing mandatory Medicare episode payment models (EPM) for acute myocardial...more

2/22/2017 - CMS Episode Payment Models (EPM) Regulatory Freeze Trump Administration

ICD-10 Coordination and Maintenance Committee Meeting Scheduled for March 7-8, 2017

The ICD-10 Coordination and Maintenance Committee is meeting on March 7 and 8, 2017, to discuss proposed code changes to ICD-10-CM and ICD-10-PCS. The March 7, 2017 session will focus on procedure codes, and the March 8...more

2/21/2017 - CMS Health Care Providers ICD-10

House Panel Votes to Tighten Medicaid Income Standard

The House Energy and Commerce Subcommittee on Health has approved two bills that would modify Medicaid eligibility rules to consider additional sources of income. First, HR 829 would establish standards for states to consider...more

2/14/2017 - Eligibility Medicaid Modified Adjusted Gross Income

CMS Provides Sneak Preview of Future DMEPOS Competitive Bidding Plans Before Retracting Announcement

One week after unveiling the next round of Medicare durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) competitive bidding, the Centers for Medicare & Medicaid Services (CMS) has announced a “temporary...more

2/14/2017 - CMS Competitive Bidding DMEPOS Durable Medical Equipment Medicare

Regulatory Freeze Notwithstanding, Trump Administration Increases Health Fraud CMPs

The Department of Health and Human Services (HHS) is once again applying an inflation increase to maximum civil monetary penalty (CMP) amounts for HHS agencies and programs – less than five months after the last inflation...more

2/3/2017 - Civil Monetary Penalty DOJ False Claims Act (FCA) HHS Inflation Adjustments

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