Jason Caron

Jason Caron

McDermott Will & Emery

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Shifting Hospice Reimbursement – Moving in the Direction of Aligning Payment with Resource Concentration

The United States Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) published its update to the home health prospective payment system (HHPPS) for fiscal year (FY) 2016 in the August...more

8/20/2015 - Bundled Payments CMS HHS Home Health Care Hospice Medicaid Medicaid Reimbursements Patient Prospective Payment System

CMS Proposes Value-Based Purchasing Model, Other Updates to the 2016 Home Health Prospective Payment System

The U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) published its proposed update to the home health prospective payment system (HHPPS) for calendar year (CY) 2016 in the July...more

7/20/2015 - Affordable Care Act Beneficiaries CMS Comment Period Healthcare Healthcare Providers HHS Home Health Agencies Home Health Care IMPACT Act Medicaid Medicare OASIS Proposed Regulation Value-Based Purchasing

Recent DOJ and OIG Actions Show Growing Federal Scrutiny of Physician Financial Arrangements

Over the last month the Office of Inspector General (OIG) of the Department of Health and Human Services and the Department of Justice (DOJ) have each taken actions that suggest an increasing appetite to examine the financial...more

7/2/2015 - Anti-Kickback Statute CMP Law DOJ False Claims Act Fraud Alerts Healthcare Medical Directors OIG Physician Compensation Arrangements Physicians Stark Law

Court Upholds CMS' Prohibition on 'Under-Arrangements' Transactions, Strikes Down CMS' Prohibition on 'Per-Click' Equipment Rental...

A 2008 rule change from the Centers for Medicare and Medicaid (CMS)—which effectively prohibited referring physician-owned companies from furnishing hospital services “under arrangements”—has withstood a challenge by a...more

6/30/2015 - CMS DHS Hospitals Physician Ownership Physicians Stark Law

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 Finalizes Proposal to Remove Continuing Medical Education Exclusion from Sunshine Act Regulations

On October 31, 2014, the Centers for Medicare & Medicaid Services (CMS) issued its final Medicare physician fee schedule rule for CY 2015 (the Final Rule), which also includes certain changes to the Sunshine Regulations. ...more

11/13/2014 - CMS Continuing Medical Education Final Rules Medicare Pharmaceutical Pharmaceutical Manufacturers Physician Fee Schedule Physicians Sunshine Act

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

CMS Proposes Rule to Expand Authorization Program, Solicits Comments on Implementation

On May 28, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) published a proposed rule to establish a prior authorization process for certain durable medical equipment,...more

6/17/2014 - CMS DMEPOS Durable Medical Equipment Healthcare HHS Prior Authorization Social Security Act

OIG Proposes Rule to Expand Civil Monetary Penalties and Solicit Comments on Penalty for Failure to Report and Return Overpayments...

Department of Health and Human Services, Office of Inspector General’s (OIG) proposed rule expands the use of civil monetary penalties and solicits comments on the penalty for failure to report and return overpayments. ...more

5/29/2014 - Civil Monetary Penalty CMS Healthcare HHS OIG Overpayment

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

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

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