Children's Health Insurance Program Medicare

News & Analysis as of

The Brave New World of Physician Medicare Payment: MACRA Makes Sweeping Changes

On November 14, 2016, CMS published its final rule implementing the physician payment provisions of the Medicare Access and CHIP Reauthorization Act (“MACRA”). The rule became effective January 1, 2017. Data collection from...more

ML Strategies 2017 Outlook: Health Care

If Congress chose to do nothing other than what it absolutely has to address, it would have three very consuming legislative policy issues on its plate in 2017: the various User Fee Acts (UFAs) reauthorization, the...more

Medicaid: Significant Changes Coming in 2017 and Beyond

With Congress back in session, attention in the health care policy universe is directed squarely at Washington, where Republicans in Congress and the Trump Administration are debating how to repeal and replace the Affordable...more

The New “Price” of U.S. Health Care: The Future of Value-based Reimbursement Under President-elect Trump and Tom Price

The total U.S. health care expenditure was $3.2 trillion in 2015, and is projected to grow to nearly $5.6 trillion by 2025. As our nation’s cost of care rises, both Democrats and Republicans recognize the overwhelming need to...more

The AHA’s Letter to Santa Claus

The American Hospital Association, after having been “nice” all year, penned its letter to Santa Claus with its wish list for Christmas. Its four page letter (actually addressed to President-Elect Donald Trump at 1717...more

Health Law Insights: November Newsletter

ALERT: "No Contract" Disclaimer in Employee Handbook Upheld by Illinois CourtAuthor: Employee handbooks have long been a trap for the unwary employer that desires merely to establish a set of rules and policies without...more

The U.S. Department of Health and Human Services Publishes Two Free Resources to Help Practices Navigate Healthcare IT

The U.S. Department of Health and Human Services (“HHS”), Office of the National Coordinator (“ONC”) has published two free online playbooks to assist healthcare providers navigate healthcare information technology (“IT”)....more

Trump Administration: Impact on Healthcare Policy

Republicans’ biggest issue will be what to do with the 20 million Americans who have gained coverage under the ACA. Congress reconvened this week for the first time since Donald Trump’s stunning victory, and just as his...more

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

CMS Finalizes New Rules for Bidders in Medicare DMEPOS Competitive Bidding Program, Revises DMEPOS Fee Schedule Update Policies

CMS has adopted a number of changes to its Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) policies for 2017, including new competitive bidding program (CBP) requirements and revisions to the...more

Washington Healthcare Update

This Week: Congress remains in recess, but members write letters on Mylan’s EpiPen…CBO says repealing Part B Demo would cost $395 million…CMS releases data on hospice utilization and finds spending and utilization vary in...more

Vermont to Launch a First-in-the-Nation All-Payer System for All Healthcare Providers

As recently reported by Modern Healthcare and other major healthcare news outlets, the Obama administration has granted tentative approval for Vermont to establish an all-payer reimbursement system. If granted final approval,...more

PTAC Announces Timeline for Submission of Physician-Focused Alternative Payment Model Proposals

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Physician-Focused Payment Model Technical Advisory Committee (PTAC) to provide recommendations on arrangements that meet the criteria for a...more

Lawmakers Join MedPAC in Speaking Out Against CMS Surgeon Data Collection Proposal

On September 16, 2016, approximately 112 congressional representatives submitted a letter to HHS Secretary Sylvia Matthews Burwell and CMS acting Administrator Andy Slavitt requesting that CMS not implement its proposal...more

Managing the Transition to Transformation: Quality and Payment Reform: Who Is Asking for What and Why?

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 care delivery...more

Will Physicians Accept CMS's Offer to "Pick Your Pace"?

The Acting CMS Administrator, Andy Slavitt, announced that CMS would propose new options for physician participation in the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)....more

CMS Seeks Input on “Evolution” of State Innovation Models Initiative, Including Potential Inclusion in MACRA Advanced Alternative...

CMS is soliciting public input on the “evolution” of its State Innovation Models (SIM) Initiative, which was launched in 2013 to accelerate state design and testing of multi-payer payment and delivery models to generate...more

Managing the Transition to Transformation: Corporate Governance and the Transition to Transformation

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 care delivery...more

CMS Lifts Temporary Moratorium on Emergency Ground Ambulance Suppliers but Extends and Expands Other Moratoria

On July 29, 2016, CMS announced that it is lifting a temporary moratorium on Medicare Part B, Medicaid, and Children's Health Insurance Program (CHIP) emergency ambulance suppliers, but extending and expanding similar...more

Manatt on Health Reform: Weekly Highlights - August 2016 #3

CMS’s risk adjustment program data signals an improving risk pool while the agency announces plans to modify the program; California enrolls 134,000 undocumented immigrant children into Medicaid; and Oregon approves increases...more

CMS Announces Changes to HHA/Ambulance Supplier Enrollment Moratoria, New Exception Process Demo

CMS has announced a number of changes to its temporary Medicare enrollment moratoria for certain provider types in select geographic areas as a mechanism to address fraud, waste, and abuse. First, CMS is extending for six...more

HHS Final Rule Extends Anti-Discrimination Protection to Transgender Patients

This past May, the Department of Health and Human Services (HHS) issued a final rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin,...more

CMS Extends and Expands Freezes on New Home Health Agencies in Four States

The Centers for Medicare and Medicaid Services (CMS) announced that, effective July 29, it extended and expanded temporary six-month moratoria on the enrollment of new Home Health Agencies (HHAs) statewide in Florida,...more

Health Update - July 2016

The Vulnerability of Healthcare Information - According to a report the Brookings Institute issued in May 2016, 23% of all data breaches occur in the healthcare industry. Nearly 90% of healthcare organizations had some...more

Could There Be A “Stark” Law Change?

There appears to be momentum on Capitol Hill in Washington, DC to modify and/or repeal the Ethics in Patient Referrals Act of 1989, more commonly known as the Stark Law, which was enacted to curb overutilization of certain...more

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