Centers for Medicare & Medicaid Services

News & Analysis as of

HHS Announces $840 Million Initiative to Improve Patient Care and Lower Healthcare Costs

Last week, the Department Health and Human Services (HHS) announced that it will invest $840 million over the next four years to support 150,000 clinicians through a combination of incentives, tools, and information to...more

CMS Unveils New Plan to Provide Infrastructure Capital to ACOs

The Center for Medicare & Medicaid Innovation introduced the ACO Investment Model, on October 15, 2014, through which CMS will provide newly-formed ACOs in rural and underserved areas access to capital necessary for...more

CMS Launches $840 Million “Transforming Clinical Practice Initiative”

On October 23, 2014, CMS announced it would begin accepting applications for its “Transforming Clinical Practice Initiative,” a four-year initiative authorized by the Affordable Care Act. The new Initiative is designed to...more

Outsourcing Ambulatory and Outpatient Services: What Hospitals Need to Know

We are in the midst of a trend involving the “outsourcing” of certain outpatient and ambulatory services by hospitals and health systems. These outsourcing transactions often involve partnerships with for-profit, specialty ...more

CMS Reopens the Medicare Payment Adjustment Hardship Exception Application Submission Period for Certain Providers and Hospitals

Centers for Medicare & Medicaid Services (CMS) recently announced the reopening of the submission period for hardship exception applications for eligible professionals and eligible hospitals that have been unable to fully...more

Manatt on Health Reform: Weekly Highlights: October 2014

This week, states’ Marketplaces are busy preparing for the 2015 Open Enrollment Period. Marketplaces are reviewing projected enrollment and renewal figures and releasing searchable databases for 2015 health plan rates, among...more

Health Headlines: Also in the News - October 2014 #3

CMS Allocates Additional Support for ACOs – On October 15, 2014, CMS announced that it will allocate up to $114 million towards 75 ACOs in order to encourage development in areas lacking the care models. CMS said that the...more

Deadline Approaching to Secure Health Plan Identifier (“HPID”)

Certain group health plans are required to obtain a 10-digit Health Plan Identifier ("HPID") from the Center for Medicare and Medicaid Services ("CMS") by November 5, 2014. Currently various users of the health care system...more

Internal Revenue Service Releases Notice Liberalizing the Private Business Use

On October 24, 2014, the Internal Revenue Service (“IRS”) released Notice 2014-67 (the “Notice”), providing guidance with respect to Accountable Care Organizations and their use of tax-exempt bond financed projects. The...more

Notice 2014-67 ?? Safe Harbors for ACOs and a New Management Contract Safe Harbor for Everyone

On Friday, Oct. 24, 2014, the Internal Revenue Service released interim guidance, Notice 2014-67, on whether a state or local government entity or an organization described in §501(c)(3) of the Internal Revenue Code of 1986,...more

$840 Million in Grants From Government Available to Providers

The Centers for Medicare & Medicaid Services (CMS) Innovation Center intends to award $840 million in grants to test methodologies to improve clinical practices and care. CMS's Transforming Clinical Practice Initiative (TCPI)...more

Health Care Update - October 2014 #4

In This Issue: - Ebola Response Taking a Multifaceted Approach - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional Initiatives - Other...more

Report Shows CMP Enforcement Actions On the Rise Against Part C and Part D Sponsors

A new report issued October 16, 2014 by the Medicare Parts C & D Oversight and Enforcement Group (MOEG) reveals that civil monetary penalty (CMP) enforcement actions in these two programs more than tripled from 2012 to 2013....more

Counting on Hospice Care? Try to Hang on Until 2017

Yesterday’s Washington Post “Business of Dying” article is a sobering account of how little information is available on the quality—or lack of quality—of hospice organizations. Almost no information on quality is available...more

$840 Million Available to Drive Practice Transformation

After a fairly quiet year in terms of new funding announcements, the Center for Medicare and Medicaid Innovation (CMMI) has released an $840 million solicitation that seeks to drive 150,000 clinicians toward delivering...more

IRS Releases Private Business Use Guidelines for ACO Participants

On Friday, October 24, 2014, the Internal Revenue Service (IRS) released Notice 2014-67, providing guidance regarding the circumstances under which participation by a hospital in an Accountable Care Organization (ACO) will...more

CMS Withdraws Medicare Secondary Payer Proposed Rule

The Office of Management and Budget (OMB) has withdrawn an Advanced Notice of Proposed Rulemaking (ANPRM) in which CMS planned to address how Medicare’s interest should be protected in situations where future medical costs...more

Health Law Pulse - October 2014

In This Issue: - CMS Updates Guidance on Hospital Governing Body and Medical Staff Conditions of Participation (CoPs) - DOL Announces Delay of Home Care Minimum Wage Enforcement - OIG Releases Special...more

CMS and OIG Extend Interim Final Rule Regarding Waivers of Fraud and Abuse Laws For ACOs

On October 17, 2014, CMS and OIG jointly published a notice extending the effectiveness of a November 2011 interim final rule establishing waivers that protect qualifying accountable care organizations (ACOs) from liability...more

Medicare Shared Saving Program Interim Final Rule Extended

On October 17, 2014, the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services, Office of Inspector General (OIG) published in the Federal Register (79 FR 62356 et seq) a notice...more

Blog: CMS Launches New Search Tool for Open Payments Database; Announces Disputed Payments Reporting Deadline

As we discussed here, the launch of the Centers for Medicare and Medicaid Services (CMS) Open Payments database on September 30, 2014 was met with a high level of criticism from industry, health care professionals, the media...more

Manatt on Health Reform: Weekly Highlights

Welcome to the first publication of the “Manatt on Health Reform: Weekly Highlights” newsletter. Many of you are familiar with the healthcare reform tracking efforts and weekly newsletters we produced for the KidsWell...more

Pioneer ACOs: Slowed Health Spending, Improved Quality and More Drop Outs?

The Centers for Medicare and Medicaid Services (CMS) recently released second year results on its Pioneer Accountable Care Organization (ACO) program. The Pioneer ACO program is CMS’ ambitious foray into the ACO space and a...more

CMS Provides for Greater MAC Involvement in ALJ Hearings

CMS recently issued Transmittal 543, Change Request 8501 in which it instructs Medicare Administrative Contractors (MACs) to, among other things, defend their medical review decisions through the Administrative Law Judge...more

Big Changes to Administrative Law Hearings for Medicare Providers

Effective October 27, 2014, the Medicare Program Integrity Manual (“Manual”) will require Medicare Administrative Contractors (“MACs”) to participate in administrative hearings concerning medical review decisions. ...more

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