Kiel Yager on Medicare

CMS Releases Proposed Rule to Update e-Prescribing Standards

On June 17, 2019, CMS released a proposed update to the transaction standard for the Medicare Prescription Drug Benefit Program’s (Part D) e-prescribing program (Proposed Rule). Specifically, the Proposed Rule would require...more

6/28/2019 / Centers for Medicare & Medicaid Services (CMS) , Comment Period , EHR , Electronic Prescribing , Medicare , Medicare Part D , Prescription Drugs , Proposed Rules

CMS Proposes National Coverage Decision For CAR-T Cancer Therapy

On February 15, 2019, CMS released a proposal to provide nationwide coverage for a new cancer therapy, Chimeric Antigen Receptor T-cell Therapy (CAR-T Therapy), for Medicare patients. The proposed nationwide coverage decision...more

2/26/2019 / American Cancer Society , Centers for Medicare & Medicaid Services (CMS) , Clinical Trials , Health Care Providers , Healthcare , Medicare , Prescription Drugs

CMS Releases Contract Year (CY) 2020 Medicare Advantage and Part D Flexibility Proposed Rule

On October 26, 2018, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule revising Medicare Advantage program (MA or Part C) and Prescription Drug Benefit program (Part D) regulations, implementing...more

11/15/2018 / Centers for Medicare & Medicaid Services (CMS) , Medicaid , Medicare , Medicare Advantage , Medicare Part D

CMS Seeking Public Comment on Stark Law Burdens

The Centers for Medicare and Medicaid Services (CMS) is seeking public comment on the burdens imposed by the Stark Law. Specifically, on June 25, 2018, CMS published in the Federal Register a Request for Information (RFI) on...more

6/28/2018 / Centers for Medicare & Medicaid Services (CMS) , Medicaid , Medicare , Public Comment , Request For Information , Stark Law

CMS Seeks New Direction for Center for Medicare and Medicaid Innovation

On September 20, 2017, the Center for Medicare and Medicaid Innovation (“CMMI”) issued an informal Request for Information (“RFI”) seeking public feedback on “a new direction to promote patient-centered care and test...more

9/27/2017 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , CMMI , Medicaid , Medicare , Request For Information

Appeals Court Upholds Charity Care Patient Population Exclusion from DSH Payments

On May 9, 2017, the U.S. Court of Appeals for the District of Columbia Circuit affirmed a lower court ruling denying hospitals from including New Jersey Charity Care Program (NJCCP) patients in the hospitals’ disproportionate...more

6/5/2017 / 1115 Waivers , Appeals , Department of Health and Human Services (HHS) , DSH , Hospitals , Medicare , Social Security

HHS Announces Final Rule on Medicare Benefit Claim Appeals Process

On January 17, 2017, HHS published its final rule addressing modifications to the Medicare benefit claim appeals process. The final rule seeks to reduce the significant backlog of pending Medicare appeals and streamline the...more

2/6/2017 / Appeals , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Medicare , OMHA

HHS OIG Issues Report on Medicare’s 2-Midnight Rule

On December 19, 2016, the HHS OIG issued a report on Medicare’s 2-midnight rule titled “Vulnerabilities Remain Under Medicare 2-Midnight Hospital Policy.” The report reviews data from 2013 and 2014 and reaches several...more

1/4/2017 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Hospitals , Inpatient Prospective Payment System (IPPS) , Medicare , OIG , Two-Midnight Rule

CMS Delays Stricter Reviews of Medicare Home Care Claims

CMS recently announced a delay in the broad implementation of a stricter review program for Medicare home care claims that launched on a demonstration basis on August 3, 2016. CMS began the demonstration program to test...more

9/30/2016 / Centers for Medicare & Medicaid Services (CMS) , Demonstration Project , Health Care Providers , Hospice , Medicare

CMS Considers Delaying MACRA Start Date

On July 13, 2016, CMS Acting Administrator Andy Slavitt testified before the Senate Finance Committee regarding the possibility of a delay in implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). ...more

7/25/2016 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , Physician Payments , Physicians

Kiel Yager

King & Spalding

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