CMS, Healthcare | JD Supra Law News

CMS Issues Final MLR Rule for Medicare Advantage and Part D Programs

by Roy M. Albert, Susan Berson | Mintz Levin - Health Law on 5/22/2013

Last week, CMS published a final rule implementing the ACA’s medical loss ratio (“MLR”) requirements that will apply to the Medicare Advantage (Part C) and prescription drug (Part D) programs beginning in contract year 2014. ...more

Enterprise Risk Management: The benefits of online policy and procedure management systems

by NAVEX Global on 5/22/2013

ABSTRACT - Operational inefficiencies, sub-optimal patient care, financial losses and missing or ineffective sanctions for non-compliance are all potential outcomes that can stem from passive policy and procedure management....more

CMS Announces $1 Billion in Funding for Innovation Grants

by King & Spalding on 5/21/2013

On May 15, 2013, CMS released a funding opportunity announcement for round two of the Health Care Innovation Awards. The grants are administered by the CMS Innovation Center, which is authorized by the Affordable Care Act to...more

Health Care Reform Update -- May 20th, 2013

by Joseph P. Hammang, Alexander Hecht, Abby Matousek, Jeremy Rabinovitz | Mintz Levin - Health Law on 5/21/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

Capital Thinking Updates - May 16, 2013

by Amy Davenport, Tanya DeRivi, Alexis Early, Eugenia Edwards, Jared Fleisher, Norma Krayem, Karen Kudelko, Matthew Kulkin, Jessica Monahan, Amy Budner Smith, Stacy Swanson, Joseph Urso, more +Sarah Vilms, Kristin Wells, Pam Welsh | Patton Boggs LLP on 5/21/2013

In This Issue: - General Legislative - Agriculture and Food - Budget and Appropriations - Cybersecurity - Defense - Education - Energy - Environment - Financial Services - Health...more

NOIs Due Soon to Apply for 2014 ACO Program

by Sarah E. Swank | Ober|Kaler on 5/20/2013

The Medicare Shared Savings Program (MSSP) for accountable care organizations (ACOs) established under the Affordable Care Act is about to kick-off its second year with a new round of applications for the January 1, 2014...more

CMS Proposes New Standard for Hospital Inpatient Admissions

by Leslie Demaree Goldsmith | Ober|Kaler on 5/17/2013

As part of its proposed inpatient prospective payment systems (IPPS) rule for FY 2014, CMS introduced a new standard for determining whether an inpatient admission to an acute care hospital is appropriate. Specifically, CMS...more

Bringing Sunlight to Healthcare Pricing: The CMS Release of Hospital Charge Data

by Robert Wolin | BakerHostetler on 5/17/2013

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337 Medicare hospitals for 100 of the most common inpatient diagnosis related...more

Health Care Reform Implementation Update - May 15, 2013

by Mark Alderman | Cozen O'Connor on 5/16/2013

Last week the Senate agreed to vote on Marilyn Tavenner’s nomination to lead the Centers for Medicare and Medicaid Services (CMS); the Department of Health and Human Services (HHS) announced an initiative that will give...more

Updated OIG Bulletin on Effect of Exclusion from Federal Health Care Programs

by Thompson Coburn LLP on 5/15/2013

On May 8, 2013, the U.S. Department of Health & Human Services, Office of Inspector General (“OIG”), issued an updated “Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs”...more

Health Care Reform Update -- May 13, 2013

by Joseph P. Hammang, Alexander Hecht, Abby Matousek, Jeremy Rabinovitz | Mintz Levin - Health Law on 5/15/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

OIG Revises Special Advisory Bulletin on Exclusions

by Howard Young | Morgan Lewis on 5/10/2013

OIG continues its aggressive interpretation of scope and effect of exclusion from participation in Federal health care programs and clarifies several open questions....more

Health Care Reform Update -- May 6, 2013

by Joseph P. Hammang, Alexander Hecht, Abby Matousek, Jeremy Rabinovitz | Mintz Levin - Health Law on 5/8/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups Scheduled....more

Capital Infusion: Private Equity Update - May 2013

by Sean Clancy, Adam Connatser, Lindsay Faine, Jon Finger, Rani Hauth Guerra, J. Atwood Jeter, Robert Johnston III, Amy Kaufman, David McLean, Ryan Mitchell, George Schutzer, Akash Sethi | Patton Boggs LLP on 5/8/2013

In This Issue: - DIGGING DEEPER: A Guide to Health Care Regulatory Due Diligence in Private Equity Deals 1 - Policy Spotlight: Affordable Care Act 6 - Case Spotlight: Best Practices in Down-Round Financings &...more

CMS Proposes Increase in Payments for SNFs in FY 2014

by King & Spalding on 5/7/2013

On May 1, 2013, CMS issued a proposed rule that would update payment rates under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2014. The proposal would increase aggregate...more

Health Care Reform Implementation Update - May 6, 2013

by Mark Alderman | Cozen O'Connor on 5/7/2013

Last week the Centers for Medicare & Medicaid Services (CMS) issued new proposed regulations on FY 2014 payment updates and regulatory policy changes for inpatient and long term care hospitals, skilled nursing facilitates,...more

Recent Court Decisions Affecting DSH Percentage Calculations May Impact Participation in the 340B Drug Discount Program

by Christine Morse | Ober|Kaler on 5/3/2013

A number of recent developments affecting the Disproportionate Share Hospital (DSH) percentage calculation methodologies will likely have significant impact on 340B covered entities. DSH hospitals that participate in the 340B...more

Self-Audit Results Found Sufficient to Sustain False Claims Act Complaint

by Robert Mazer | Ober|Kaler on 5/2/2013

District Court Finds That Medical Group’s Failure to Further Investigate Audit Results May Violate Requirement to Return Overpayments - Background - Internal audits of third-party payment claims – frequently...more

CMS Releases Proposed Inpatient Payment Regulation

by King & Spalding on 5/2/2013

On April 26, 2013, CMS released the proposed 2014 payment schedule for inpatient stays at general acute care and long-term care hospitals. In addition to the annual adjustment to payment rates, the proposed rule also reduces...more

CMS Proposes Prospective Payment System Update Rules for Inpatient and Long Term Care Hospitals

by Colin Roskey | Cozen O'Connor on 5/2/2013

On Friday, April 26, the Centers for Medicare and Medicaid Services (CMS) issued a crucial payment system rule that proposes updated rates and regulatory policies for inpatient hospitals (including inpatient psychiatric...more

CMS Releases Proposed FFY 2014 IPPS Rule

by Mark A. Stanley | Ober|Kaler on 5/2/2013

CMS has released its proposed federal fiscal year (FFY) 2014 prospective payment system (PPS) rule for inpatient stays in acute care and long-term care hospitals (LTCHs). The rule projects a net increase in operating payments...more

CMS Issues Proposed Changes to LTCH Payment Rates and Other Payment Policies for Fiscal Year 2014

by Paul Pitts | Reed Smith on 5/2/2013

On April 26, 2013, the Centers for Medicare & Medicaid Services (“CMS”) released the proposed update to the Medicare long-term acute care hospital prospective payment system (“LTCH PPS”) policies and payment rates for fiscal...more

Health Care Reform Update -- April 29, 2013

by Mintz Levin - Health Law on 5/1/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

Affordable Care Act: Navigators Get Clarified and Standardized in CMS's Latest Proposed Rule

by Baker, Donelson, Bearman, Caldwell &... on 5/1/2013

On Friday, April 5, 2013, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (45 CFR Part 155) that clarifies and implements standards for providers of consumer-related assistance under the...more

Hospitals Prevail in Effort to Include Pennsylvania GA Days in the Medicare DSH Calculation

by Gregory Fliszar, Mark Gallant | Cozen O'Connor on 5/1/2013

Two of Mercy Health System’s hospitals (Nazareth Hospital and the former St. Agnes Medical Center) successfully challenged, before Judge Ludwig of the U.S. District Court for the Eastern District of Pennsylvania, the...more

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Centers for Medicare & Medicaid Services › Healthcare

CMS Issues Final MLR Rule for Medicare Advantage and Part D Programs

Enterprise Risk Management: The benefits of online policy and procedure management systems

CMS Announces $1 Billion in Funding for Innovation Grants

Health Care Reform Update -- May 20th, 2013

Capital Thinking Updates - May 16, 2013

NOIs Due Soon to Apply for 2014 ACO Program

CMS Proposes New Standard for Hospital Inpatient Admissions

Bringing Sunlight to Healthcare Pricing: The CMS Release of Hospital Charge Data

Health Care Reform Implementation Update - May 15, 2013

Updated OIG Bulletin on Effect of Exclusion from Federal Health Care Programs

Health Care Reform Update -- May 13, 2013

OIG Revises Special Advisory Bulletin on Exclusions

Health Care Reform Update -- May 6, 2013

Capital Infusion: Private Equity Update - May 2013

CMS Proposes Increase in Payments for SNFs in FY 2014

Health Care Reform Implementation Update - May 6, 2013

Recent Court Decisions Affecting DSH Percentage Calculations May Impact Participation in the 340B Drug Discount Program

Self-Audit Results Found Sufficient to Sustain False Claims Act Complaint

CMS Releases Proposed Inpatient Payment Regulation

CMS Proposes Prospective Payment System Update Rules for Inpatient and Long Term Care Hospitals

CMS Releases Proposed FFY 2014 IPPS Rule

CMS Issues Proposed Changes to LTCH Payment Rates and Other Payment Policies for Fiscal Year 2014

Health Care Reform Update -- April 29, 2013

Affordable Care Act: Navigators Get Clarified and Standardized in CMS's Latest Proposed Rule

Hospitals Prevail in Effort to Include Pennsylvania GA Days in the Medicare DSH Calculation

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