News & Analysis as of

Centers for Medicare & Medicaid Services

CMS Urged To Reverse Obama-Era Biosimilar Reimbursement Policy

A bipartisan congressional effort is underway to convince CMS to reverse its biosimilar reimbursement policy implemented under the Obama administration. We discussed the current reimbursement policy in a March 2016 blog post...more

CMS Proposes Rule to Update Prospective Payment Rates for Inpatient Rehabilitation Facilities

by King & Spalding on

CMS recently proposed a rule that it estimates would increase payment to inpatient rehabilitation facilities (IRFs) by $80 million during fiscal year (FY) 2018 (discharges occurring between October 1, 2017 and September 30,...more

CMS Proposes Rule to Update the Hospice Wage Index and Payment Rates and Discusses Hospice Quality Reporting Requirements

by King & Spalding on

On April 27, 2017, CMS released a proposed rule (the Proposed Rule) that would update the hospice wage index, payment rates and cap amount for fiscal year (FY) 2018. It also provides an update with respect to quality...more

CMS Releases the Proposed Part D DIR Reporting Requirements for 2016

Yesterday, CMS released the Proposed Part D DIR (Direct and Indirect Remuneration) Reporting Requirements for 2016 and postponed the 2016 DIR Reporting deadline....more

CMS Proposes to Eliminate Therapy-Driven SNF Reimbursement

by Baker Ober Health Law on

It should come as no surprise to anyone working with skilled nursing facilities (SNFs) that CMS has been exploring ways to adjust its current payment model to reduce or eliminate skilled therapy utilization as the primary...more

Manatt on Health Reform: Weekly Highlights - May 2017 #3

Governors pen bipartisan letter to Congress urging five-year extension of funding for the Children's Health Insurance Program (CHIP); new analyses find Medicaid funding cuts under the AHCA would disproportionately affect...more

Supreme Court Applies FAA Preemption to Contract Formation

The Supreme Court held that the Federal Arbitration Act preempts state law governing contract formation where a state rule discriminates against arbitration, a holding with broad implications for state-court decisions that...more

CMS Proposes 1% Update to Medicare IRF PPS Payments for FY 2018

by Reed Smith on

CMS has published a proposed rule to establish FY 2018 Medicare prospective payment system (PPS) rates for inpatient rehabilitation facility (IRF) services. CMS estimates that IRF PPS payments would increase by 1.0% overall...more

CMS Announces Solicitation for the Rural Community Hospital Demonstration Program

by King & Spalding on

CMS announced solicitation for applications for participation in the Rural Community Hospital Demonstration Program (Demonstration). In this request for applications, CMS is seeking information from interested hospitals...more

Deemed Providers Beware: IPPS Rule Proposes Publicizing Accreditation Survey Results

by Baker Ober Health Law on

The veil of secrecy may soon be lifted from the reports of accreditation organizations like The Joint Commission if a proposal in the April 28, 2017 Inpatient Prospective Payment System (IPPS) Proposed Rule is finalized. As...more

Revocation of Enrollment in the Medicare Program- A Powerful Weapon in Medicare’s Arsenal

by Burr & Forman on

In 2014, CMS issued a final rule related to 42 CFR 424.535, which gave CMS expanded authority to impose penalties on providers. Although the rule is several years old, the first version published in 2006, the rule has been...more

CMS Gives States Three More Years to Comply with HCBS Rules

by Reed Smith on

CMS has announced that states may take an additional three years — until March 17, 2022 — to demonstrate compliance with the Medicaid home and community based services (HCBS) settings criteria established in a January 16,...more

CMS Seeks Comments on Overhauling Hospital IPPS

by Baker Ober Health Law on

CMS is asking for feedback on how Medicare can make the health care delivery system simpler for patients and health care providers. This spring's Fiscal Year 2018 Hospital Inpatient Prospective Payment System (IPPS) and the...more

GAO Encourages More CMS Collaboration with States on Medicaid Program Integrity Efforts

by Reed Smith on

The Government Accounting Office (GAO) has had ongoing concerns about the integrity of the Medicaid program due to its size, diversity, and recent rapid growth as a result of the Affordable Care Act. It is the second largest...more

GAO: CMS, MACs Should Bolster Provider Education to Cut Improper Medicare Payments

by Reed Smith on

In 2016, an estimated $41.1 billion in improper Medicare fee-for-services payments were made to providers. The Centers for Medicare & Medicaid Services (CMS) believes that provider education plays an important role in...more

Telehealth/Remote Patient Monitoring Rarely Used in Federal Health Programs, but Innovative Programs May Provide Boost, GAO...

by Reed Smith on

The GAO recently reported that fewer than 1% of Medicare and Department of Defense (DOD) beneficiaries and 12% of Veteran’s Administration (VA) beneficiaries utilized telehealth and remote patient monitoring services, even...more

CMS Retroactively Revises DMEPOS Fee Schedule to Implement Cures Act

by Reed Smith on

CMS has announced revised Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule amounts for the period of July through December 2016, as required by the 21st Century Cures Act. By way...more

Health Care Provider Insights - Introductory Edition

by Wilson Elser on

Welcome to the introductory edition of Health Care Provider Insights. We are practice management consultants, providing legal and business management advice and assistance to physicians and dentists (health care...more

Nurse Anesthetists Sue Novitas Solutions and CMS Over Medicare Reimbursement Policy on Chronic Pain Management

by King & Spalding on

On April 11, 2017, the American Association of Nurse Anesthetists (AANA), an organization representing more than 50,000 Certified Registered Nurse Anesthetists (CRNAs), filed a complaint for declaratory and injunctive relief...more

"Double Dip" Effectively Approved by Center for Medicare and Medicaid Services

by Hogan Lovells on

Last week the Centers for Medicare and Medicaid Services (CMS) issued Release No. 104 to Manufacturers and Release No. 180, which invalidated earlier agency releases addressing the treatment under the Medicaid drug rebate...more

Changes in MACRA Creating Complications in Healthcare

by Clark Hill PLC on

Healthcare is still buzzing about CMS’s Medicare physician two-track payment system, MACRA. The Merit-Based Incentive Payment System (MIPS) is a complex pay-for-performance system based on traditional fee-for-service (FFS)....more

CMS Issues New Rules Aimed at Improving Health Benefit Exchange Participation

by King & Spalding on

Even as President Trump and Congress work toward repealing some or all of the Affordable Care Act (ACA), CMS announced a final rule aimed at market stabilization of the Health Benefit Exchanges that are the cornerstone of the...more

Center For Medicare And Medicaid Services Proposes Delay Of Implementation Of New Home Health Agency Rules

by Roetzel & Andress on

On January 13, 2017, the Center for Medicare and Medicaid Services (CMS) issued a final rule relating to a series of changes for conditions to participation in Medicare and Medicaid by home health agencies (HHAs). At the time...more

CMS Releases FY 2018 Hospital Inpatient Prospective Payment System Proposed Rule and Request for Information

by King & Spalding on

On April 14, 2017, CMS issued the annual Hospital Inpatient Prospective Payment System (IPPS) Rule for FY 2018 (the “Proposed Rule”) which will affect discharges on or after October 1, 2017. CMS estimates that IPPS operating...more

Ten Things Investors Need to Know About Value-Based Healthcare

by Ropes & Gray LLP on

This article highlights key business and legal issues related to value-based healthcare for investors considering opportunities in the healthcare industry. 1. Value-Based Arrangements Are Here to Stay Value-based...more

3,232 Results
|
View per page
Page: of 130
Cybersecurity

"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 using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
*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.
Feedback? Tell us what you think of the new jdsupra.com!