Centers for Medicare & Medicaid Services Hospitals

News & Analysis as of

Disruptive, Aged & Impaired Physicians Legal Updates

In This Presentation: - What is Disruptive/Impaired Behavior? - Main Impediments to Addressing Unprofessional Behavior - Components of Successful Policies - A Legal Perspective - Joint Commission and...more

Injury Prevention: CMS Updates: What Must Go Into Your Bylaws

In This Presentation: - Hospital Governing Board - Do physicians have to serve on boards? - How must board consult with the organized medical staff if physicians are not on the board? - Hospital...more

Insurer Wrongfully Passed Sequestration Cuts Through to Providers

A Pennsylvania judge found, on May 6, 2015, that a Medicare Advantage Plan had no right under its participation agreements to pass CMS sequestration reductions through to participating providers. Judge R. Stanton Wettick Jr....more

GAO Report on Oversight of Medicaid Payments to Hospitals

The Government Accountability Office (GAO) has released a report entitled “Medicaid: CMS Oversight of Provider Payments Is Hampered by Limited Data and Unclear Policy.” The report examines how state Medicaid payments to...more

CMS Official Offers Views on Hospital Co-Location

On May 5, 2015, the American Health Lawyers Association hosted a webinar during which a CMS representative gave his views on certain hospital co-location issues. The webinar largely focused on hospital compliance with the...more

CMS Call: Medicare Acute Care Quality and Reporting Programs (May 12)

On May 12, 2015, CMS is hosting a call that will provide an overview of all Medicare hospital inpatient quality reporting and value-based purchasing programs. Specifically, the call will cover: the Hospital Inpatient Quality...more

CMS Releases Proposed IPPS Rule

On April 17, 2015, CMS released a copy of its proposed changes and updates to the Medicare inpatient prospective payment system (IPPS) for fiscal year 2016. The official version appears in the April 30th Federal Register, and...more

MACRA Brings Modifications to the Recovery Audit Program

This is the second K&L Gates Health Care Client Alert discussing the “Medicare Access and CHIP Reauthorization Act of 2015” (MACRA), signed into law by President Barack Obama on April 16, 2015. This alert focuses on...more

Challenge to DSH Adjustment Estimates Barred by Statute

In a decision issued on March 31, the United States District Court for the District of Columbia dismissed a challenge by Florida Health Sciences Center, Inc., also known as Tampa General Hospital, to the calculation of its...more

New CMS Ruling on DSH Appeals for FY 2004 and Earlier

It’s a measure of the backlog in DSH (for Disproportionate Share Hospital) payment appeals that CMS is still issuing rulings for appeals applicable to treatment of patients before October 1, 2004. On April 24 CMS issued...more

Health Care Enforcement: The Impact on Private Equity Investments [Video]

Brian Platton provides an overview of enforcement trends that private equity investors should be aware of before entering into the health care space....more

Washington Healthcare Update

This Week: Energy and Commerce Health Subcommittee Explores Post-Acute Bundling…CMS Releases First-ever Hospital Compare Star Ratings…Fiscal Year 2016 Proposed Inpatient and Long-term Care Hospital Policy and Payment Changes....more

CMS Proposes Updates to EHR Meaningful Use Rules

CMS published a proposed rule on April 15, 2015 that would modify the Medicare and Medicaid Electronic Health Record (EHR) Incentive program to reduce complexity, simplify reporting requirements, and align Stage 1 and Stage 2...more

Also In The News - Health Headlines - April 2015 #3

OIG Releases Joint Compliance Guidance for Hospital – In a first-of-its-kind collaboration, the HHS Office of Inspector General (OIG) has released a new guidance document, “Practical Guidance for Health Care Governing Boards...more

CMS Issues First Hospital Compare Star Ratings

CMS is now posting star ratings on Hospital Compare to help consumers assess hospital performance related to patient experience of care. The Hospital Compare star ratings are based on data from the Hospital Consumer...more

Beyond SGR – MACRA Provides Additional Payment Provisions and Offsets

This is the second post in our continuing series on the Medicare Access and CHIP Reauthorization Act (MACRA). Pub.L. No: 114-10. In addition to repealing the Sustainable Growth Rate (SGR), which was covered in our April 20th...more

CMS Issues FY 2016 IPPS and LTCH Proposed Rule

On April 17, 2015, CMS released a proposed rule (Proposed Rule) to update the fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital...more

CMS Issues Proposed Modifications to Meaningful Use Rule

On Friday, April 10, 2015, CMS issued a proposed rule containing several important modifications to the Medicare and Medicaid EHR Incentive Programs. Among the most notable proposals is to move eligible hospitals from a...more

Federal Trade Commission and Department of Justice Hold Joint Workshop on Payment Models and Competition Within the Health Care...

On February 24-25, 2015, the Federal Trade Commission (“FTC”) and Antitrust Division of the Department of Justice (“DOJ”) co-hosted a second public workshop as part of the “Examining Health Care Competition” series to study...more

Also In The News - Health Headlines - March 2015 #5

CMS Announces Billing Changes for Certain Inpatient-Only Procedures – Effective April 1, 2015, CMS will allow payment for Inpatient-Only procedures provided in an outpatient setting on the date of the inpatient admission, or...more

CMS Releases Stage 3 Meaningful Use Proposed Rule

The Centers for Medicare & Medicaid Services (“CMS”) released the Stage 3 proposed rule to the Medicare and Medicaid Electronic Health Records Incentive Programs (“Proposed Rule”) on March 20, 2015. To provide context,...more

Washington Update: Meaningful Use Stage 3 and 2015 Voluntary EHR Certification Criteria Proposed

On Monday, March 23, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) issued a notice of proposed rulemaking for Stage 3 Meaningful Use of Electronic Health...more

HHS Publishes Proposed Stage 3 EHR Incentive Program, Health IT Certification Rules

On March 30, 2015, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule on Stage 3 meaningful use criteria, which focus on the advanced use of Electronic Health Record (EHR) technology to promote...more

Placing Medicare Beneficiaries Into "Observation Status" - Recent Second Circuit Decision Casts Doubt on Lawfulness of CMS...

The trend toward placing more Medicare beneficiaries into observation status in the hospital has come under increasing attack by patient advocates. Such patients are considered outpatients reimbursed by Medicare Part B rather...more

HHS Releases Two Healthcare Information Technology Proposed Rules

On March 20, 2015, CMS and the HHS Office of the National Coordinator for Health Information Technology (ONC) released proposed rules regarding Stage 3 of the Medicare and Medicaid Electronic Health Records (EHRs) Incentive...more

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