News & Analysis as of

Children's Health Insurance Program (CHIP) Physicians

Cozen O'Connor

CMS Issues Final Rule Impacting Prior Authorization Process

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Last week CMS issued its final rule “CMS Interoperability and Prior Authorization” (CMS-0057-F), unchanged from its proposed rule in 2022, which addresses prior authorizations. Prior authorization, a “utilization management”...more

McDermott+

House Holds Hearing on MACRA Challenges, but Meaningful Reform is Unlikely

McDermott+ on

On June 22, 2023, the US House of Representatives Committee on Energy and Commerce Subcommittee on Oversight and Investigations held a hearing titled “MACRA Checkup: Assessing Implementation and Challenges that Remain for...more

Manatt, Phelps & Phillips, LLP

[Webinar] Prenatal Vaccines in Medicaid & CHIP: Current State Payment Rates and Strategies to Increase Access - June 8th, 2:00 pm...

Prenatal vaccines provide important protection for pregnant women and newborns against communicable diseases such as whooping cough and influenza. However, fewer than one out of four pregnant women receives all federally...more

Health Care Compliance Association (HCCA)

Healthcare compliance in a post-pandemic world

On January 31, 2020, pursuant to Section 319 of the Public Health Service Act, the secretary of the U.S. Department of Health & Human Services (HHS) determined that a public health emergency (PHE) exists due to the soaring...more

Holland & Knight LLP

Holland & Knight Health Dose: October 11, 2022

Holland & Knight LLP on

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include ... ...more

Mintz - Health Care Viewpoints

California Passes New Law Requiring Physicians and their Employers to Notify Patients about the Open Payments Database

A new California law (AB 1278) will require physicians and their employers to provide patients with several forms of notices about the Open Payments database, starting January 1, 2023. The law is intended to increase...more

Baker Donelson

Medicare Revocation Consequences Worsened – Further Reenrollment Restrictions

Baker Donelson on

CMS recently finalized the most significant changes to enrollment since the 2006 enrollment rules were initially adopted. Overview of the New Rule - In its "Program Integrity Enhancements to the Provider Enrollment...more

Verrill

Keep Medicare Enrollment Information Correct and Current or Suffer Consequences

Verrill on

While most providers understand the need to bill Medicare correctly, many often fail to recognize the potentially disastrous results of not keeping Medicare informed of your correct and up-to-date practice information. A...more

McDermott Will & Emery

CMS Final Rule Strengthens Integrity of Medicare Provider Enrollment Process

McDermott Will & Emery on

On September 10, 2019, the US Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) expanding Medicare, Medicaid and Children’s Health Insurance Program...more

Obermayer Rebmann Maxwell & Hippel LLP

TRANSPARENCY: Embracing CMS’s Push To Publicize Your Organization’s Performance

The Centers for Medicare and Medicaid Services (CMS) is launching new value-based programs with great fervor as a central strategy to bend the healthcare cost curve. Value-based reimbursement models linked to achieving the...more

Baker Donelson

OIG July 2018 Work Plan Update

Baker Donelson on

The OIG added six new items to its Work Plan in the July 2018 update. Areas addressed include HHS cybersecurity vulnerabilities, increased payments for transfer claims with outliers, oversight of funds for Access Increases in...more

BakerHostetler

Capitol Hill Healthcare Update

BakerHostetler on

HOUSE OKs DOZENS OF OPIOID-RELATED BILLS; MORE VOTES SCHEDULED - The House last week approved 38 bills that lawmakers hope will stem the opioid epidemic, and it scheduled votes this week on at least a dozen more....more

Foley & Lardner LLP

Making a “Tele-Difference” by Using Telemedicine to Aid Medically Vulnerable Populations

Foley & Lardner LLP on

More than 74 million individuals are enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). Another 28 million are currently uninsured. Due to the repeal of the individual mandate (the requirement under the...more

Akin Gump Strauss Hauer & Feld LLP

Congress Makes Key Changes to Medicare Physician Payment Programs as Part of Short-Term Government Funding Bill

• Congress amended current law to prevent CMS from applying the “MIPS” payment adjustment to separately billed items like drugs and biologics, which will drastically reduce the total amount of payment adjustments to clinical...more

Holland & Knight LLP

House, Senate Proposals to Extend Funding for the Federal Government

Holland & Knight LLP on

Congress moved one step closer to avoiding a government shutdown on Feb. 6, voting overwhelmingly (245-182) to pass a short-term, GOP-backed government funding bill (text; section-by-section) that would keep the federal...more

Holland & Knight LLP

CMS Proposes New Voluntary Bundled Payment Model

Holland & Knight LLP on

On January 9, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary bundled-payment demonstration program, also known as Bundled Payments for Care Improvement (BPCI) Advanced. The new model will test...more

Alston & Bird

Alston & Bird Healthcare Week in Review

Alston & Bird on

On December 11, 2017, the Food and Drug Administration (FDA) issued a guidance entitled, Product Name Placement, Size, and Prominence in Promotional Labeling and Advertisements. The guidance clarifies the requirements for...more

Seyfarth Shaw LLP

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

Seyfarth Shaw LLP on

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

Roetzel & Andress

Health Law Insights: November Newsletter

Roetzel & Andress on

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

Sheppard Mullin Richter & Hampton LLP

“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

King & Spalding

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

King & Spalding on

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

McDermott Will & Emery

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

McDermott Will & Emery on

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

Baker Donelson

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

Baker Donelson on

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

McDermott Will & Emery

CMS’s Final Medicaid Rule Tweaks the Proposed Rules Related to Marketing, Physician Incentive Arrangements and Long-term Care

McDermott Will & Emery on

On April 25, 2016, the Centers for Medicare & Medicaid Services (CMS), released the Medicaid managed care final rule entitled, “Medicaid and Children’s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP...more

Manatt, Phelps & Phillips, LLP

Legal Issues Associated with Multi-Provider Alternative Payment Model

Since the passage of the Affordable Care Act (ACA), both federal and state policies have promoted the adoption of alternative payment models (APMs), providing financial incentives for groups of providers to improve care...more

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