Under Medicare, a plethora of policies directly correlate to whether the patient or provider is located in an urban or rural area when the service is delivered. These policies range from rules that limit coverage of...more
On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the Hospital Inpatient Prospective Payment System (IPPS) final update for fiscal year (FY) 2025, along with proposed policy and regulation changes....more
On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Final Rule [CMS-1786-FC]. The...more
On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) finalized the rule Medicare Program; Hospital Outpatient Prospective Payment System: Remedy for the Calendar Years 2018–2022 to addresses how the...more
11/6/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Final Rules ,
Healthcare ,
Healthcare Facilities ,
Healthcare Reform ,
Hospitals ,
Medical Reimbursement ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Prescription Drugs ,
Section 340B
On August 1, 2023, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) final rule. The rule updates Medicare payment policies and quality reporting...more
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule [CMS-1786-P],...more
On July 7, 2023, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule Hospital Outpatient Prospective Payment System: Remedy for 340B-Acquired Drugs Purchased in Cost Years 2018-2022 to address how...more
You won’t want to miss four days of exclusive, virtual events that bring together industry leaders, emerging standouts, innovators and investors from across the industry landscape at the largest healthcare investment...more
1/6/2021
/ Business Development ,
Business Disruption ,
Business Strategies ,
Collaboration ,
Coronavirus/COVID-19 ,
Digital Health ,
Funding Arrangements ,
Health Care Providers ,
Health Technology ,
Healthcare Facilities ,
Hospitals ,
Innovation ,
Investors ,
Legislative Agendas ,
Life Sciences ,
Physicians ,
Private Equity ,
Regulatory Requirements ,
Webinars
You won’t want to miss four days of exclusive, virtual events that bring together industry leaders, emerging standouts, innovators and investors from across the industry landscape at the largest healthcare investment...more
1/6/2021
/ Biden Administration ,
Coronavirus/COVID-19 ,
Digital Health ,
Funding Arrangements ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Reform ,
Hospitals ,
Innovation ,
Investors ,
Joint Venture ,
Legislative Agendas ,
Life Sciences ,
Partnerships ,
Physicians ,
Private Equity ,
Special Purpose Acquisition Companies (SPACs) ,
Webinars
You won’t want to miss four days of exclusive, virtual events that bring together industry leaders, emerging standouts, innovators and investors from across the industry landscape at the largest healthcare investment...more
1/6/2021
/ Acquisitions ,
Biopharmaceutical ,
Business Valuations ,
Buyers ,
Coronavirus/COVID-19 ,
Digital Health ,
Funding Arrangements ,
Health Care Providers ,
Health Technology ,
Healthcare Facilities ,
Hospitals ,
Innovation ,
Investors ,
Life Sciences ,
Liquidity ,
Mergers ,
Partnerships ,
Pharmaceutical Industry ,
Physicians ,
Private Equity ,
Sellers ,
Telehealth ,
Webinars
You won’t want to miss four days of exclusive, virtual events that bring together industry leaders, emerging standouts, innovators and investors from across the industry landscape at the largest healthcare investment...more
1/6/2021
/ Coronavirus/COVID-19 ,
Digital Health ,
Funding Arrangements ,
Health Care Providers ,
Health Information Technologies ,
Healthcare Facilities ,
Hospitals ,
Innovation ,
Investors ,
Life Sciences ,
Physicians ,
Private Equity ,
Webinars
[co-authors: Mara McDermott and Katie Waldo, McDermott+Consultants]
This report from McDermott Will & Emery and McDermott+Consulting provides a detailed analysis of the latest Provider Relief Fund (PRF) distributions,...more
9/14/2020
/ Children's Health Insurance Program (CHIP) ,
Dental Practice ,
Department of Health and Human Services (HHS) ,
Fund Distribution ,
Health Care Providers ,
Hospitals ,
Indian Health Service (IHS) ,
Medicaid ,
Medicare ,
Nursing Homes ,
Provider Relief Fund ,
Rural Health Care Providers ,
Skilled Nursing Facility
Background On November 15, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (Final Rule) that requires hospitals to establish, update and make public a list of their standard charges for items and...more
With COVID-19 applying financial pressures on hospitals and health systems of all sizes and geographic reach, the road to recovery presents a variety of challenges. However, the need to restructure and address financial and...more
5/26/2020
/ Best Practices ,
Business Development ,
Business Opportunities ,
Business Strategies ,
Capital Markets ,
Coronavirus/COVID-19 ,
Corporate Governance ,
Debt Restructuring ,
Economic Downturn ,
Financial Distress ,
Health Care Providers ,
Healthcare Facilities ,
Hospitals ,
Insolvency ,
Physicians ,
Webinars
Hospitals and health systems are facing consumer demand for innovation, the need to expand and enhance streams of revenue and the push for improved quality, all while navigating changing regulations, federal enforcement,...more
2/6/2020
/ Antitrust Litigation ,
Centers for Medicare & Medicaid Services (CMS) ,
CMIA ,
Cyber Attacks ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Hospitals ,
Medicare ,
No-Poaching ,
OCR ,
Popular ,
Ransomware
On November 15, the Trump Administration released a final rule requiring hospitals to publicly disclose hospital charges, including negotiated prices with third-party payers by January 1, 2021. We outline key considerations...more
The Centers for Medicare and Medicaid Services has released proposed updates to payment rates and regulations applicable to the Hospital Outpatient Prospective Payment System for Calendar Year 2020, including proposals...more
In St. Francis Medical Center v. Azar, 277 hospitals challenged Medicare payment decisions over the past two decades. This recent DC Circuit Court remand may open the door to hospitals receiving additional reimbursement from...more
The Helping Ensure Low-income Patients have Access to Care and Treatment (HELP ACT) is the third 340B-related legislation to be introduced this month. The HELP ACT goes well beyond the 340B PAUSE Act in the scope of its...more
In late December 2017, Republican Rep. Larry Bucshon (with bi-partisan support) introduced the “340B Protecting Access for the Underserved and Safety-net Entities Act” (340B PAUSE Act), legislation that would implement a...more
On December 7, 2016, the US Congress enacted the 21st Century Cures Act, substantial legislation intended to accelerate “discovery, development and delivery” of medical therapies by encouraging biomedical research investment,...more
1/21/2017
/ 21st Century Cures Act ,
Ambulatory Surgery Centers ,
Digital Health ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Hospitals ,
Long Term Care Facilities ,
Manufacturers ,
Medical Devices ,
Medicare ,
Medicare Advantage ,
MedPAC ,
Mental Health ,
Mental Health Parity Rule ,
National Institute of Health (NIH) ,
Off-Campus Departments ,
Opioid ,
Patients ,
Pharmaceutical Industry ,
Research and Development ,
Small Business ,
Substance Abuse ,
Telehealth ,
Transparency
The 21st Century Cures Act encourages biomedical research investment and facilitates innovation review and approval processes, but also serves as a vehicle for a wide variety of other health-related measures, including...more
The Centers for Medicare & Medicaid Services released the calendar year 2017 final rule implementing changes to the Medicare hospital Outpatient Prospective Payment System, or OPPS, including provisions implementing Section...more
In Depth -
Background -
On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) released the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule, which includes proposed regulations to...more
7/12/2016
/ Ambulatory Surgery Centers ,
Bipartisan Budget Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Hospitals ,
Medicare ,
MPFS ,
Off-Campus Departments ,
OIG ,
OPPS ,
Payment Systems ,
Physician Fee Schedule ,
Proposed Rules ,
Section 340B
In Depth -
On April 27, the Centers for Medicare and Medicaid Services (CMS) unveiled the much-anticipated (and, for some, feared) proposal to implement the physician payment reforms required under the Medicare Access to...more