Centers for Medicare & Medicaid Services Medicare

News & Analysis as of

CMS Proposes CY 2017 Update to Medicare Home Health PPS Rates

CMS has released its proposed rule to update the Medicare home health prospective payment system (HH PPS) for 2017. CMS estimates that the policies in the proposed rule would reduce overall Medicare payments to home health...more

CMS Issues Final Rule on ACOs Participating in the Medicare Shared Savings Program

The Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (the “Final Rule”) for accountable care organizations (“ACOs”) participating in the Medicare Shared Savings Program (“MSSP”) on June 6, 2016. In the...more

CMS to Slash Medicare DMEPOS Rates on July 1, 2016

CMS has released the July 1, 2016 update to Medicare durable medical equipment (DME) prosthetic orthotics and supplies (DMEPOS) fee schedule amounts in non-competitive bidding areas, reflecting full implementation of...more

CMS Steps Up Efforts to Recover Overpayments from Providers/Suppliers Sharing TINs

CMS has just announced that it has enhanced its financial accounting system to allow it to recover Medicare payments made to a provider or supplier that shares the same Tax Identification Number (TIN) with a provider or...more

CMS Overhauls Clinical Laboratory Fee Schedule with Long-anticipated Final Rule

On June 17, 2016, CMS released a long-anticipated final rule revising the Medicare payment system for clinical diagnostic laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS) (the Final Rule). In 2018,...more

New ACO Rule: Continued CMS Efforts to Promote Program Participation

On June 6, 2016, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (the “Final Rule”) for accountable care organizations (“ACOs”) participating in the Medicare Shared Savings Program (“MSSP”). The Final...more

CMS Finalizes Changes to Medicare Clinical Lab Test Payment Policy, Pushes Back Effective Date to 2018

On June 23, 2016, the Centers for Medicare & Medicaid Services (CMS) is publishing a major final rule to base Medicare clinical laboratory fee schedule (CLFS) reimbursement on private insurance payment amounts, as required by...more

Senate Passes Legislation to Delay Pending Medicare DMEPOS Fee Schedule Cuts Based on Competitive Bidding Prices

As previously reported, the Affordable Care Act mandates that CMS use pricing information from the durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program (CBP) to adjust...more

CMS Announces Pre-Claim Review Demonstration for Medicare Home Health Services

CMS has announced a new three-year Medicare “pre-claim review” demonstration for home health services in five states — Illinois, Florida, Texas, Michigan, and Massachusetts — with “high incidences of fraud and improper...more

Managing the Transition to Transformation: Is Your Organization Ready for the Shift to Alternative and Quality-Based Payment...

For many decades, at least since the passage of the Health Maintenance Organization Act of 1973, there have been reform efforts focused on moving the United States health care system away from fee-for-service (FFS)...more

Understanding the Implications of MACRA, MIPS and APMs

On May 9, 2016, the Centers for Medicare & Medicaid Services (CMS) published a notice of proposed rulemaking to implement the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Although the...more

MedPAC Issues Recommendations on Medicare Drug, Post-Acute Care, and Other Payment Policies

MedPAC has released its June 2016 Report to the Congress on Medicare and the Health Care Delivery System. The report includes recommendations for a number of Medicare policy reforms and analyses of various health care market...more

OIG Identifies Continued Vulnerabilities in Medicare Provider-Based Facility Payment Policy

A new OIG report examines CMS’s oversight of Medicare billing by provider-based facilities – that is, facilities that operate under the ownership, administrative, and financial control of a hospital and meet other...more

CMS Finalizes Changes to Medicare Shared Savings Program/ACO Benchmark Rebasing Rules

CMS has published a final rule that revises the methodology CMS uses to measure the performance of accountable care organizations (ACOs) in the Medicare Shared Savings Program. According to CMS, the changes are intended to...more

All About APMs: What Will It Take for Physicians to Earn the APM Bonus Under MACRA?

On May 9, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule addressing the implementation of physician payment reforms included in the Medicare Access and CHIP Reauthorization Act of 2015...more

At Long Last, CMS Issues Final Rule for Lab Fee Schedule Changes

Last Friday afternoon CMS released its eagerly anticipated final rule (the Final Rule) implementing the Protecting Access to Medicare Act of 2014 (PAMA), which, together with the Final Rule, will make sweeping changes to the...more

APMs, MIPS, and the Final MSSP Rule - The Journey from Volume to Value-Based Reimbursement Continues

Since the Affordable Care Act was enacted, many providers have been shifting away from traditional fee-for-service, volume-based reimbursement models to payment mechanisms that take a data-driven approach to managing patients...more

Update on Medicare Part B Drug Pricing Model

On March 11, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to establish a nationwide demonstration regarding payment for outpatient drugs covered under Medicare Part B. This proposal was reported...more

GAO Issues Recommendations To Improve Medicare Appeals Backlog

On June 9, 2016, the Government Accountability Office (GAO) publicly released a report published May 10, 2016, regarding the continuing challenges surrounding the backlog of the administrative appeals process for Medicare...more

CMS Finally Publishes the Final Rule on Returning Medicare Overpayments

On February 12, 2016, six years after the passage of the Affordable Care Act (ACA), CMS published the final rule with respect to returning self-identified overpayments. The ACA established a requirement that any person...more

New Rules for ACOs in the MSSP

CMS issued a final rule, published in the Federal Register on Friday, June 10, 2016, updating how the performance of ACOs participating in the Medicare Shared Savings Program (MSSP) is measured and compensated. This rule is...more

MACRA will change the way you practice

A recent rule proposed by the Centers for Medicare and Medicaid Services (CMS) will bring far-reaching changes to payment models for physicians and other clinicians (including nurse practitioners, physician assistants,...more

CMS Releases Final Shared Savings Program Rule

On June 6, 2016, CMS issued a final rule (Final Rule) establishing a phased approach for incorporating regional FFS expenditures into calculations for resetting, adjusting, and updating Accountable Care Organizations’ (ACOs’)...more

MIPS Performance Scoring: Understanding How CMS Proposes to Calculate Performance Is Key to Preparing for MIPS Participation

On May 9, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule addressing the implementation of physician payment reforms included in the Medicare Access and CHIP Reauthorization Act of 2015...more

MedPAC Opposes Medicare FY2017 Payment Increases for SNFs and Pushes for Payment Reform

The Medicare Payment Advisory Commission (MedPAC) issued a letter on May 25, 2016, commenting on the Centers for Medicare & Medicaid Services’ (CMS) proposed rule relating to payment updates for skilled nursing facilities...more

1,243 Results
|
View per page
Page: of 50
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.
×