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Bundled Payments

Bundled Payments Out in the Cold? Another Delay for Mandatory Bundled Payment Models

by BakerHostetler on

This most recent delay raises questions concerning how the Trump administration intends to implement value-based payment in the Medicare program. The Centers for Medicare and Medicaid Services (CMS) has delayed again the...more

CMS Delays Implementation of New Payment Models (Again)

On March 21, 2017, the Centers for Medicare and Medicaid Services (“CMS”) published an interim final rule (“Interim Final Rule”) delaying (i) the effective date of several new Medicare payment models developed by the CMS...more

Delayed ETA for EPMs – CMS Delays New Bundled Payment Models

by Baker Ober Health Law on

On March 21, 2017, CMS issued the anticipated delay related to the new Episode Payment Model (EPM) bundled payment program regulations that were finalized in January. The rule, Advancing Care Coordination Through Episode...more

White House “Regulatory Freeze” Delays Implementation of Bundled Payment Models

by King & Spalding on

In the February 17, 2017 Federal Register, CMS announced that it will delay implementation of several bundled payment initiatives until March 21, 2017. The Advancing Care Coordination Through Episode Payment Models (EPMs),...more

Medicare Mandatory Bundled Payments Rule: Minor Aspects Delayed, Others On-Schedule for July Implementation

by Polsinelli on

In a move the Centers for Medicare & Medicaid Services cites as a reaction to President Donald Trump's regulatory freeze, CMS announced that implementation of certain minor aspects of the final rule expanding Medicare...more

New Bundled Payments Are a Go…For Now

by Baker Ober Health Law on

CMS issued a final rule on January 3, 2017, implementing three new episode payment models (EPMs) and a Cardiac Rehabilitation (CR) incentive payment model under the authority of the Center for Medicare & Medicaid Innovation...more

CMS Finalizes Mandatory Cardiac Care Bundled Payment Model and More

by Foley & Lardner LLP on

On December 20, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (the Final Rule) which includes three new mandatory episode-based payment programs for cardiac care, as well as the expansion of the...more

House Republicans Push Back on Medicare’s New Mandatory Bundled Payment Models

On July 25, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that promises to deliver coordinated, high-quality care for Medicare beneficiaries. The proposed rule (effective July 1, 2017)...more

Health Law Insights - Issue 12

by McCarter & English, LLP on

CMS Proposes Bundled Payments for Cardiac Care - In its most recent effort to hasten Medicare’s transformation from a fee-for-service payment model to a value-based payment model, the Centers for Medicare & Medicaid...more

CMS Proposes Sweeping 'Episode Payment Models' for Cardiac Care, Hip/Femur Fracture Cases, Plus Changes to 'Comprehensive Care for...

by Reed Smith on

Proposed Rule to Impact Hundreds of Hospitals and Post-Acute Providers - Building on the current mandatory Comprehensive Care for Joint Replacement (CJR) bundled payment initiative, the Centers for Medicare & Medicaid...more

Managing the Transition to Transformation: Implementing a CJR Collaborator Agreement

by McDermott Will & Emery on

Summary - McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and...more

CMS Proposes New Bundled Payment Models for Cardiac and Orthopedic Care

by King & Spalding on

On July 25, 2016, CMS posted a proposed rule that would create three new Medicare Parts A and B episode payment models for patients admitted for care for a heart attack, bypass surgery or surgical hip/femur fracture treatment...more

CMS Expands Mandatory Bundled Payments to Cardiac Care

by Foley & Lardner LLP on

On Monday July 25, 2016, CMS proposed new models that expand mandatory participation in bundled payments and continue CMS’s initiative to shift Medicare payments from fee for service to alternative payment models. Coming just...more

CMS Unveils New Mandatory Medicare Bundled Payment Models for Cardiac & Hip Fracture Cases, Plus Proposed Refinements to CJR...

by Reed Smith on

On July 25, 2016, CMS announced ambitious, multi-pronged plans to expand mandatory Medicare coordinated care/bundled payment programs, promote the use of cardiac rehabilitation services, refine current Comprehensive Care for...more

Expansion of Clinical Services at Assisted Living Sites – The New Paradigm

by Foley & Lardner LLP on

As payment reforms, such as bundled payments and Accountable Care Organizations (ACOs), drive further provider collaboration to achieve lower costs with enhanced outcomes, post- acute providers, especially assisted living...more

Also In The News - Health Headlines - April 2016

by King & Spalding on

CMS Extends Participation in Bundled Payments for Care Improvement by Two Years – CMS has offered awardees the opportunity to extend participation in Models 2, 3, and 4 of the Bundled Payments for Care Improvement program...more

At The Intersection of New Bundled Payment Programs and New Discharge Rules: Private Equity Opportunities

by Foley & Lardner LLP on

Recently, CMS has promulgated new bundled payment rules for Comprehensive Joint Replacement(CJR) that require the mandatory participation of approximately 800 hospitals across the US. This bundle includes not only the...more

All Right Stop, Collaborate and Listen! CMS Is Back with Its Brand New Invention, Preparing for CJR Gainsharing

by Baker Ober Health Law on

Understandably, there is anticipation surrounding the April 1st start date for CMS’s newest bundled payment program, the Comprehensive Care for Joint Replacement (CJR) program. As participant hospitals consider gainsharing...more

Comprehensive Joint Replacement Bundled Payment Program Begins April 1st

by Foley & Lardner LLP on

Approximately 800 hospitals in 67 Metropolitan Statistical Areas will begin mandatory participation in the Comprehensive Care for Joint Replacement (CJR) Model on April 1, 2016. The CJR bundled payment program applies to...more

3 Things to Consider When Dealing with Bundled Payments to Providers

by Dickinson Wright on

The Centers for Medicare & Medicaid Services (CMS) has traditionally paid health care providers separately for each of the individual services they furnish to beneficiaries for a single illness or course of treatment. This...more

Final ACA Medicaid Drug Pricing Rule Published: Changes to 5i, Bundling, RCP and Other Provisions Leave a Lot for Manufacturers to...

by King & Spalding on

On Thursday, January 21, the Centers for Medicare & Medicaid Services (CMS or “the Agency”) published its long-awaited final rule with comment period implementing the Medicaid pricing and reimbursement provisions of the...more

Day Three Notes – JP Morgan Healthcare Conference, San Francisco

On January 13, 2016, conference sessions surfaced interesting questions and approaches regarding the post-acute sector, bundled payment, emergency medicine and anesthesia. Post-Acute Focus: With more and more focus on...more

[Event] Preparing for the Comprehensive Care Joint Replacement Program - Jan. 5th, 6th, & 7th - Seattle, Portland, Los Angeles

by Davis Wright Tremaine LLP on

Please join Davis Wright Tremaine partners Bob Homchick and Adam Romney, and associate Kyle Gotchy for a briefing regarding the final rule for the Comprehensive Care Joint Replacement (CJR) Program. They will discuss the...more

Medicare Launches Its First Mandatory Bundled Payment Model for Joint Replacement Care – What You Need to Know to Get Ready

by Reed Smith on

On November 24, 2015, the Centers for Medicare & Medicaid Services (CMS) published a significant final rule that will require hospitals in selected geographic areas to participate in a new Medicare Comprehensive Care for...more

CMS Finalizes Bundled Payment Program for Hip and Knee Replacements

by King & Spalding on

On November 16, 2015, CMS finalized the Comprehensive Care for Joint Replacement (CJR) model. Starting April 1, 2016, certain hospitals will receive retrospective bundled payments for lower extremity joint replacement (LEJR)...more

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