Centers for Medicare & Medicaid Services

News & Analysis as of

Hospital Text Messaging Rules Placed on Hold by Joint Commission

The Joint Commission, which accredits hospitals and other health care organizations, hit pause on its prior May 2016 announcement to allow secure text messaging in hospitals and other health care organizations. The use of...more

Projected Decline of Americans Lacking Health Insurance Over Next Decade

The CMS Office of the Actuary recently released a report estimating that the percentage of Americans lacking health insurance will decline over the next decade. The actuary’s office predicts that in 2025, 8 percent of the...more

CMS’ Web Portal: Final Rule 21 CFR § 411.39 Promises Quick and Efficient Conditional Payment Resolution for Those Able to Abide by...

The Centers for Medicare & Medicaid Services (CMS) has published its long-awaited final rule entitled “Medicare Program: Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal.” From the outset of...more

Manatt on Medicaid: Monthly Expansion Recap, July 2016

Alaska - Legislative Council Drops Medicaid Expansion Lawsuit - The joint legislative council that sued Governor Bill Walker (I) over his executive order expanding Medicaid voted to drop its lawsuit after Superior...more

Transparency's Opaque Beginning: CMS Starts Implementing ACA Transparency Requirements

Based on QHP Certification instructions issued on July 22, 2016, the Centers for Medicare and Medicaid Services (CMS) will collect administrative and performance data from health insurers that participate in the federally-run...more

Manatt on Health Reform: Weekly Highlights - July 2016 #4

CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more

HHS Proposes Rules to Eliminate Backlog … in 5 Years

On June 28, 2016, the U.S. Department of Health and Human Services (HHS) released a series of regulatory changes in the Notice of Proposed Rule Making (NPRM) designed to curtail the massive backlog of Medicare claim appeals....more

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

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

CMS Hosts Call on Potential Future Changes to Open Payments/Sunshine Act Reporting Requirements (Aug. 2)

On August 2, 2016, CMS is hosting a Special Open Door Forum Call on potential future changes to Open Payments/Physician Payments Sunshine Act requirements for reporting payments and transfers of value made by drug and device...more

CMS Issues Final Rule on Overhaul of Clinical Diagnostic Laboratory Test Payment System

On June 17, 2016, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (the “Final Rule”) that makes significant changes to Medicare reimbursement for clinical diagnostic laboratory tests (“CDLTs”)....more

New Medicare Enrollment Requirements for MA Providers

In Depth - The Medicare Physician Fee Schedule proposed rule released by the Centers for Medicare & Medicaid Services (CMS) on July 7, 2016, (the Proposed Rule) requires certain providers and suppliers furnishing health...more

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

CMS Releases the 2016 OPPS Proposed Rule

On July 15, CMS published its proposed policy changes, quality provisions, and payment rates for 2017 as they relate to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC)...more

Summary of Major Provisions in the Proposed 2017 Physician Fee Schedule

The proposed Physician Fee Schedule for 2017 (PFS) includes several changes covering a litany of topics spanning from telehealth services to expanding the Diabetes Prevention Program Model. The following is a high-level...more

More (MACRA) Data Analysis, Please

On July 1, CMS finalized new MACRA rules that significantly expand how qualified data entities will be allowed to share or sell analyses of Medicare and private claims data to providers, insurers, employers, and others who,...more

CMS Announces Second Round of TCPI Support Grants

On June 10, the Center for Medicare and Medicaid Services (CMS) committed $10 million over the next three years to fund a second round of the Support and Alignment Networks under the Transforming Clinical Practice Initiative...more

Provider-Based Status Post-BBA: CMS Offers Limited Answers, Requests More Feedback

For those in the hospital industry hoping for additional clarity regarding the operation and billing of provider-based departments (PBDs), the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule provides some...more

Bankruptcy Courts Lack Subject Matter Jurisdiction Over Medicare Issues, Eleventh Circuit Rules

In a detailed opinion that likely constitutes the last word on the matter, the Eleventh Circuit recently held in Fla. Agency for Health Care Administration v. Bayou Shores SNF, LLC that bankruptcy courts lack jurisdiction...more

Two-Midnight Rule Update

Medicare and Medicaid Services (CMS) on August 19, 2013, the two-midnight rule provided that an inpatient admission generally would only be payable under Medicare Part A if: (1) the admitting practitioner had an expectation,...more

The "Primary Care Exception"—a limited opportunity for billing without in-person supervision of residents

In most circumstances, the Centers for Medicare & Medicaid Services (CMS) will not allow billing or payment under the Medicare Physician Fee Schedule (PFS) for services furnished by interns and residents within the scope of...more

CMS Releases Final Rule to Implement Major Changes in Medicare Clinical Laboratory Payment Policy

On June 23, 2016, the Centers for Medicare and Medicaid Services (CMS) published a long-awaited final rule making major changes in the way Medicare will pay for clinical diagnostic laboratory tests (CDLTs). The changes were...more

Senate Finance Committee Report Concludes Stark Law Change Is Necessary to Drive Health Care Reform

In its report, Why Stark, Why Now? [PDF], released June 30, 2016, the Senate Committee on Finance outlines suggested changes to the physician self-referral law, 42 U.S.C. § 1395nn, (the Stark law) in order to facilitate and...more

Integration of Technology Into Health Care Delivery

The integration of technology into health care delivery is exploding throughout the health industry landscape. Commentators speculating on the implications of the information revolution’s penetration of the health care...more

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

Massachusetts’s Marketplace eliminates cost-sharing for addiction treatment in subsidized QHPs; Montana cuts its uninsurance rate in half; and a Kaiser report identifies the 50 most costly drugs for Medicaid....more

CMS Releases Details on Site-Neutral Payment Provision under Bipartisan Budget Act

On July 6, the Centers for Medicare and Medicaid Services (“CMS”) released the Medicare hospital outpatient prospective payment system (“OPPS”) and the Medicare ambulatory surgical center (“ASC”) payment system proposed rule...more

2,595 Results
|
View per page
Page: of 104
JD Supra Readers' Choice 2016 Awards

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.
×