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CMS “Goes Fishing” on Stark Law’s Impediments to Value-Based, Coordinated Care

On June 20, 2018, the Centers for Medicare & Medicaid Services and Department of Health and Human Services issued a “request for information” (RFI) seeking input on strategies to reduce the burden of the federal physician...more

Making Sense of the MACRA Final Rule, Part 2 of 3: Alternative payment Models

Many observers view the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a game changer for the delivery and payment of health care services. On Oct. 14, 2016 the Centers for Medicare & Medicaid Services...more

The Future Is Now: CMS Proposes Broad Bundled Payment Expansion for Cardiac Care Episodes

Furthering the agency’s stated intention to pay for value over volume, the Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule representing the first expansion of mandatory hospital-centric bundled...more

Understanding the Implications of MACRA, MIPS and APMs

On May 9, 2016, the Centers for Medicare & Medicaid Services (CMS) published a notice of proposed rulemaking to implement the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Although the...more

CMS Encourages Continued Participation in Medicare Shared Savings Program with Final Rule

In This Issue: - ACO Eligibility Requirements - Establishing and Maintaining the ACO Participation Agreement - Data Sharing and Assignment of Beneficiaries - Shared Savings and Losses - Waivers of...more

Accountable Care Organization Update

In This Issue: - Summary of Next Generation ACO Model - Summary of Additional Guidance on ACO Pre-Participation & Participation Waivers - For More Information - Excerpt from Summary of Next...more

FY 2014 IPPS/LTCH PPS Final Rule Goes Into Effect October 1, 2013

In This Issue: - What Providers Should Know - Requirements for Inpatient Admissions and Payment Under Medicare Part A - New Rules Permitting Re-billing Under Medicare Part B for Denied Admissions - New HAC...more

Cuts In Services May Leave Bigger Wounds

In a recent open letter, the Illinois Department of Financial and Professional Regulation (the "Department") advised providers of cuts in the Department's Medical Unit that will negatively impact the state's healthcare...more

Notable Healthcare Provisions Passed In The American Taxpayer Relief Act Of 2012

In This E-Alert: - Notable ATRA Provisions - Medicare Extensions - Other Health Provisions - Other Health Extensions - Excerpt from Notable ATRA Provisions: Medicare Physician Payment Update...more

OIG Issues Advisory Opinion On Co-Management Incentive Compensation Arrangement

On January 7, 2012, the OIG posted Advisory Opinion No. 12-22 to address a co-management arrangement between a hospital and physicians that is designed to align incentives by offering compensation based on quality, service,...more

What Hospitals Should Know About Payment Changes For 2013

In response to the government’s continued focus on improving quality of care through payment policy, several changes to new and existing regulatory requirements recently came about through the 2013 Inpatient Prospective...more

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