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Benchmarks Centers for Medicare & Medicaid Services (CMS)

Benesch

CMS announces Policy Changes and Updates for the CKCC Model - Any KCE PY 2024 Risk Option selections must be submitted by April...

Benesch on

We encourage all CKCC Model participants to review these updates carefully and take necessary actions to ensure compliance with the deadlines for KCE CKCC Model Performance Year 2024 Risk Option selections....more

Health Care Compliance Association (HCCA)

Defensibility of a fair market value analysis

Fair market value (FMV) is a pinnacle issue with respect to healthcare regulatory compliance and compensation agreements. This article will analyze the issues related to an FMV defensibility analysis of compensation...more

Benesch

Dialysis & Nephrology Digest - March 2023

Benesch on

Correction to our January 31, 2023 newsletter article, “Dialysis Provider Satellite Healthcare Reports Data Breach Affecting Nearly 100k Patients”: Media Statement, Satellite Healthcare - In January 2023, Satellite...more

Baker Donelson

CMS Revises Medicare Shared Savings Program's Performance Benchmarking Methodology to Encourage Continued Participation by Current...

Baker Donelson on

On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year 2023 Physician Fee Schedule (PFS) Final Rule, which includes changes to the Medicare Shared Savings Program (MSSP), the nation's...more

Baker Donelson

Proposed Updates to the Medicare Shared Savings Program's Performance Benchmarking Methodology

Baker Donelson on

On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) proposed rule that includes changes to the Medicare Shared Savings Program (MSSP) to advance...more

Manatt, Phelps & Phillips, LLP

Implementing a Statewide Healthcare Cost Benchmark

Editor’s Note: Seeking methods to better understand and control healthcare costs, many states are taking a careful look at a state-defined spending target, or “benchmarking” model, that originated in Massachusetts and has...more

Manatt, Phelps & Phillips, LLP

Implementing a Statewide Healthcare Cost Benchmark: How Oregon and Other States Can Build on the Massachusetts Model

State interest in healthcare cost containment has grown dramatically since Massachusetts enacted the nation’s first cost benchmarking program in 2012. At that time, most states were focused on coverage expansion through the...more

Verrill

CMS Issues Final Rule to ACOs: It’s Time to Take a Risk

Verrill on

Just before the holidays, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) that will overhaul the Medicare Shared Savings Program (“MSSP”). As of January 2018, the MSSP included 561...more

Verrill

No Summer Slump for CMS: Major Changes Proposed for the Medicare Shared Savings Program

Verrill on

On August 17, 2018, the Centers for Medicare & Medicaid Services (“CMS”) officially published a proposed rule (“Proposed Rule”) in the Federal Register that would significantly alter the Medicare Shared Savings Program...more

Bradley Arant Boult Cummings LLP

CMS Proposes Redesign of Medicare Shared Savings Program - Healthcare Alert

On August 9, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would redesign the Medicare Shared Savings Program (MSSP). The proposed changes would accelerate the risks associated with...more

Mintz - Health Care Viewpoints

CMS Proposes to Overhaul the Medicare Shared Savings Program

On August 9, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to overhaul the Medicare Shared Savings Program (MSSP). The proposal, titled “Pathways to Success,” would make significant changes...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes Massive Changes to ACO Program – Pushing Providers to Accept Downside Risk

On Thursday, August 9, 2018, the Centers for Medicare & Medicaid Services (“CMS”) published a Proposed Rule (the “Proposed Rule”) regarding the Medicare Shared Savings Program (“MSSP”) for Accountable Care Organizations...more

K&L Gates LLP

K&L Gates Triage: A New Proposed Pathway for the Medicare Shared Savings Program Part 1, in a 2-Part Series

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The Centers for Medicare & Medicaid Services (“CMS”) recently proposed a major redesign of its Medicare Shared Savings Program (“MSSP”) under a new plan it calls “Pathways to Success.” In this Part I of a two-part series on...more

King & Spalding

Also In The News - Health Headlines - October 2016

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CMS Releases 2017 Final Rule For ESRD Prospective Payment System – On October 28, 2016, CMS released the final rule for the End-Stage Renal Disease (ERSD) Prospective Payment System (PPS) that updates and makes revisions to...more

King & Spalding

CMS Releases Final Shared Savings Program Rule

King & Spalding on

On June 6, 2016, CMS issued a final rule (Final Rule) establishing a phased approach for incorporating regional FFS expenditures into calculations for resetting, adjusting, and updating Accountable Care Organizations’ (ACOs’)...more

K&L Gates LLP

CMS Issues a New Medicare Shared Savings Program Proposed Rule and Aims to Encourage Existing Accountable Care Organizations to...

K&L Gates LLP on

On February 3, 2016, the Centers for Medicare and Medicaid Services (“CMS”) issued a new proposed rule that makes a number of revisions to the Medicare Shared Savings Program (“MSSP”). Several of the proposed changes create...more

Parker Poe Adams & Bernstein LLP

Proposed Changes to Methodology to Update ACO Benchmarks

The Medicare Shared Savings Program provides financial rewards to Accountable Care Organizations (ACO’s) that successfully manage overall health care costs for a defined population of beneficiaries while meeting quality of...more

Baker Donelson

2-Midnight Rule Updates

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- CMS Adopts Change to Benchmark and Shift in Enforcement - CMS Explains Reasoning Behind 0.2% Payment Reduction CMS has published discussions of the 2-midnight rule in two recent Federal Register publications. In the...more

Baker Donelson

Medicare Shared Savings Program - 2015: What's Changed, What's New, and What's to Come?

Baker Donelson on

The most recent Shared Savings Program final rule, published in the Federal Register on June 9, 2015, finalizes a number of the revisions to the original November 2011 final rule that CMS proposed on December 8, 2014. In...more

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