Centers for Medicare & Medicaid Services

News & Analysis as of

Final Rule Implementing MACRA

On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released its final rule (the “Final Rule”) implementing the Medicare Access and Children’s Health Insurance Program (CHIP) Authorization Act of 2015...more

The MACRA Final Rule: 10 Things You Need to Know

The Centers of Medicare and Medicaid Services (CMS) released the much-anticipated Medicare Access and CHIP Reauthorization Act (MACRA) final rule this month. The rule makes extensive changes to traditional Medicare Part B...more

What a Trump Administration Could Mean for the 340B Drug Program

A Republican White House and a Republican-run Congress could bring significant changes to the 340B Drug Pricing Program (“the 340B program”). Many in Washington believe that the new administration and Republicans in Congress...more

House Passes 21st Century Cures Act

On November 30, 2016, the House of Representatives passed the 21st Century Cures Act, a bill intended to modernize health care delivery and speed up and improve medical research and innovations by removing bureaucratic...more

CMS Re-Finalizes Stark Law Limitations for Per-Click Rental Charges

As part of its November 15, 2016, Calendar Year 2017 Physician Fee Schedule final rule, the Centers for Medicare and Medicaid Services (CMS) updated and clarified its ban on the use of per-unit of service (i.e., “per-click”)...more

President-elect Trump Nominates Representative Tom Price, M.D. as HHS Secretary and Seema Verma as CMS Administrator

President-elect Trump stated that Rep. Price, an orthopedic surgeon, six-term Member of Congress, and Chairman of the Budget Committee, “has earned a reputation for being a tireless problem solver and the go-to expert on...more

Manatt on Health Reform: Weekly Highlights - December 2016

President-elect Trump taps prominent conservatives with strong anti-ACA views for his healthcare transition team; House v. Burwell proceedings on cost-sharing reductions for Marketplace plans are delayed until the new...more

The Digital Download - Alston & Bird’s Privacy & Data Security Newsletter – November 2016

Updates on the EU: German DPA Publishes First Privacy Shield Guidelines, Requires German-Law Contracts for Transfers. On June 7, 2016, the European Commission adopted the EU-U.S. Privacy Shield. One question that many...more

CMS Releases 2017 Medicare DMEPOS and Clinical Lab Fee Schedules

CMS has announced 2017 Medicare fee schedule rates for durable medical equipment (DME) prosthetic orthotics and supplies (DMEPOS) furnished in non-competitive bidding areas. The calendar year 2017 DMEPOS update factor is 0.7...more

Telemedicine for All, As Lame Duck Session Winds Down

Even with the federal legislators poised to head home at the end of the week, two significant telehealth measures continue to work their way through the House and Senate, further evidence that telehealth services have become...more

Federal Court Enjoins CMS Regulation Banning Arbitration of Nursing Home Disputes

The United States District Court for the Northern District of Mississippi issued a preliminary injunction barring the scheduled November 28, 2016, implementation of a Center for Medicare and Medicaid Services (“CMS”)...more

CMS Releases Plan for Expanded Monitoring of Medicare Advantage and Part D Appeals and Grievances

In Depth - The Centers for Medicare & Medicaid Services (CMS) recently announced that it will monitor—beginning in January 2017—Part C and D appeals timeliness on an industry-wide basis. Under this initiative, all...more

Practical Considerations for Medical Practices Considering Converting Their Vascular Access Centers Into Medicare-Certified...

On November 2, 2016 the Centers for Medicare & Medicaid Services (CMS) released the 2017 Medicare Physician Fee Schedule (MPFS) Final Rule. Although the impact of the Final Rule on nephrology reimbursement is projected to be...more

CMS Releases List of Potential Quality and Efficiency Reporting Measures

On November 22, 2016, CMS published its annual list of quality and efficiency measures under consideration for adoption through the rulemaking process. CMS is considering approximately 100 measures for incorporation into...more

Resistance Is Futile: CMS Gets Serious About Antibiotic-Resistant Bacteria

Antibiotics and similar drugs, known more broadly as antimicrobial agents, are an instrumental weapon in the healthcare armory, rendering once-lethal infections treatable, and dramatically reducing instances of sepsis and...more

New POS Code for Telehealth Distant Site Providers

A new Place of Services or POS code for Telehealth services (POS 02) will go into effect on January 1, 2017. The descriptor for the code, which is for use by the physician or other clinician furnishing telehealth services...more

Manatt on Medicaid: Monthly Expansion Recap - December 2016

Post-Election Reactions and Activity in the States - Arizona: Former Governor Voices Support for Medicaid Expansion - Former Governor Jan Brewer (R), who served from 2009 to 2015, is encouraging President-elect...more

Capitol Hill Healthcare Update

After months of debate and partisan wrangling, the House on Wednesday voted 392-26 to pass the “21st Century Cures” bill designed to accelerate the development of new drugs and medical devices as well as increase federal...more

Health Law Insights: November Newsletter

ALERT: "No Contract" Disclaimer in Employee Handbook Upheld by Illinois CourtAuthor: Employee handbooks have long been a trap for the unwary employer that desires merely to establish a set of rules and policies without...more

Manatt on Health Reform: Weekly Highlights - November 2016 #5

The incoming Trump Administration selects HHS and CMS leadership; Alaska moves forward with its proposed 1332 waiver for its ACA reinsurance program; and a new Manatt Health report considers the role of Medicaid supplemental...more

CMS Issues Final Rule on Off-Campus Hospital Department Reimbursement

As of January 1, 2017, hospitals will receive lower Medicare reimbursement for items and services provided at certain off-campus provider-based facilities. This Alert provides an overview of the new reimbursement framework...more

Could Possible Healthcare Repeal Efforts Extend to Physician Payments Under Medicare?

Now that the 2016 presidential election is over, many patients are asking whether Congress will repeal the Affordable Care Act (ACA), or parts of the legislation. Yet, many doctors are asking (or should be asking) whether...more

The Future of the Medicare Part B Payment Demo under a Republican-held Congress

There has been much controversy over the Medicare Part B payment demonstration proposed by the Center for Medicare and Medicaid Innovation (CMMI) in March 2016. As we await the release of the final rule, the fate of this...more

Long-Term Care Facilities: Recent Developments on Use of Arbitration Agreements

Three cases making their way through the courts demonstrate that the question of arbitration clauses in long-term care (LTC) facility admission agreements is an active and developing area of the law....more

OPPS Provider-Based Final Rule — A More Practical Approach From CMS

CMS recently finalized sweeping changes to the way Medicare pays hospitals for services furnished in “new” off-campus provider-based departments (referred to as “off-campus PBDs”). CMS revealed the changes on November 1...more

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