Elizabeth K. Isbey

Elizabeth K. Isbey

McDermott Will & Emery

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CMS Finalizes Several Changes for Skin Substitutes in CY 2015 Outpatient Prospective Payment System Final Rule

On October 31, 2014, the Centers for Medicare & Medicaid Services (CMS) released its annual final rule (Final Rule) setting the payment rates and coverage policies for items and services reimbursed under the Outpatient...more

11/17/2014 - CMS Final Rules Patient Prospective Payment System

CMS Finalizes 2015 Home Health Prospective Payment System Rule

The Centers for Medicare & Medicaid Services (CMS) published the annual final rule on the Medicare home health prospective payment system (HH PPS) rates for calendar year (CY) 2015 in the November 6, 2014, Federal Register...more

11/14/2014 - CMS Final Rules Patient Prospective Payment System

CMS Proposes Major Update of Home Health Agency Conditions of Participation Focusing on Care and Quality Standards

Proposed Revisions to HHA Conditions of Participation - The Centers for Medicare & Medicaid Services (CMS) published its proposed update to the home health agency (HHA) Conditions of Participation (CoPs) in the October...more

11/5/2014 - CMS Healthcare Home Health Agencies Medicare Medicare Participation Standards Proposed Amendments

OIG Proposes Expanding Anti-Kickback Statute Safe Harbors and Revising Civil Monetary Penalty Regulations

On October 2, 2014, the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) published a proposed rule containing revisions to both the Anti-Kickback Statute (AKS) safe harbors and the civil...more

10/8/2014 - Affordable Care Act Anti-Kickback Statute Civil Monetary Penalty Cost-Sharing Healthcare Medicare Part D OIG Pharmacies Proposed Regulation Safe Harbors Waivers

CMS Proposes Update to 2015 Home Health Prospective Payment System for Comment

The Centers for Medicare & Medicaid Services (CMS) published its proposed update of the Medicare home health prospective payment system (HH PPS) rates for calendar year (CY) 2015 in the July 7, 2014 Federal Register. In...more

7/18/2014 - CMS Healthcare Home Health Care Patient Prospective Payment System

Congress Approves Legislation Extending and Changing Medicare Programs

On March 31, 2014, the U.S. Senate approved comprehensive Medicare legislation reauthorizing and extending dozens of Medicare payment enhancements, but also making several substantive changes that will profoundly impact...more

4/2/2014 - Healthcare Healthcare Reform Medicare Shareholders

CMS Releases Proposed Calendar Year 2014 Updates to Home Health Prospective Payment System

On June 27, 2013, the Centers for Medicare & Medicaid Services (CMS) released its proposed Calendar Year 2014 rate update to the Home Health Prospective Payment System. In addition to reducing reimbursement rates, CMS is...more

7/9/2013 - Affordable Care Act CMS Healthcare Healthcare Professionals Home Health Care Medicaid Medicare Reimbursements Social Security Act

Significant Proposed Changes for Federal Health Care Programs in President’s Fiscal Year 2014 Budget Plan

On April 10, 2013, President Obama released his budget proposal for fiscal year (FY) 2014 (the Budget). The President reiterated his long-standing goal of reducing the deficit by $4.3 trillion over 10 years and his...more

4/19/2013 - Bad Debt Barack Obama Biologics CMS Deficit Reduction Federal Budget Fraud and Abuse Generic Drugs Healthcare Hospitals Medicaid Medicare Medicare Advantage Medicare Part D Patient Self-Referral Pharmaceutical Physician Payments

CMS Offers Partial Concession to Hospitals by Issuing Ruling, Proposed Rule on Part B Re-Billing

The U.S. Centers for Medicare & Medicaid Services (CMS) recently released both a “ruling” and a proposed rule intended to address growing concern among hospitals about billing Medicare Part B following a medical necessity...more

3/29/2013 - CMS Hospitals Medicare Medicare Part B

The American Taxpayer Relief Act of 2012 and Anticipated Medicare and Medicaid Payment Reforms

On January 1, 2013, the U.S. Congress approved the American Taxpayer Relief Act of 2012 (the Act), concluding a protracted debate on how to prevent the United States from falling over the proverbial “fiscal cliff.” President...more

1/9/2013 - American Taxpayer Relief Act Fiscal Cliff Income Taxes Medicaid Medicare

Reimbursement Issues Facing Molecular Pathology Services in Calendar Year 2013 and Beyond

The Centers for Medicare & Medicaid Services recently issued final regulations and a final payment guidance that address reimbursement for laboratories furnishing molecular pathology services. While the publications answer...more

11/15/2012

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