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Centers for Medicare & Medicaid Services Reporting Requirements

CMS Releases the Final Medicare Part D DIR Reporting Requirements for 2016

On Friday, June 23, 2017, CMS released the Final Medicare Part D DIR Reporting Requirements for 2016. Part D sponsors may begin submitting their DIR information on June 30, 2017 and must finish their submissions by the end of...more

Ch-Ch-Ch-Ch-Changes: Reporting Requirements for Updating Your CMS Provider Enrollment

by BakerHostetler on

With the possibility of significant penalties for improperly reported transactions, it is important to understand how certain changes necessitate specific reporting. Is your organization considering a stock transfer, a...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

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

Upcoming Cost Report Filings for FYE 12/31/2016 Subject to More Stringent Rules Prohibiting Payment of Items that Are not Claimed...

by King & Spalding on

The CY 2016 OPPS Final Rule, issued on October 30, 2015, instituted new cost reporting rules prohibiting MACs from paying items that a provider has not claimed or protested on its as-filed cost report. Importantly, these...more

Just Under the Wire, CMS Announces 60-Day Extension of PAMA Clinical Lab Reporting Deadline

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) has just announced that it is extending until May 30, 2017 the deadline for certain clinical laboratories to report to CMS private payor reimbursement information. As...more

Massachusetts Department of Public Health – Final Hospital Licensure Regulations

The Massachusetts Department of Public Health (DPH) has promulgated final Hospital Licensure Regulations. Approved by unanimous vote of the Massachusetts Public Health Council (PHC) on March 8, 2017, DPH anticipates that the...more

Client Alert/Reminder: Form W-2 Reporting Due / Disclosure Due to CMS for Medicare Part D

by Fraser Trebilcock on

UPCOMING DEADLINES: {1) FORM W-2 REPORTING; AND (2) MEDICARE PART D NOTICES TO CMS - Reminder: Form W-2 Reporting on Aggregate Cost of Employer Sponsored Coverage - Unless subject to an exemption,...more

Burr Alert: New Requirements of Participation for Skilled Nursing Facilities

by Burr & Forman on

On October 4, 2016, The Centers for Medicare and Medicaid Services (“CMS”) released the final rules regarding the requirements of participation for skilled nursing facilities. One of the most significant changes to the...more

Final Rule Implements Quality Payment Program under MACRA

by Baker Ober Health Law on

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

CMS Issues Alert Updating and Clarifying Mandatory Reporting Thresholds for Certain Liability Insurance Settlements, Judgments,...

by King & Spalding on

On December 12, 2016, CMS issued a Technical Alert that announced a change in reporting requirements for several different types of settlements with total payment obligation to claimant (TPOC) dates on or after January 1,...more

CMS Releases List of Potential Quality and Efficiency Reporting Measures

by King & Spalding on

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

CMS Delays Expanding Medicaid Rebate Program, Price Reporting Requirements to Territories Until 2020

by Reed Smith on

CMS has announced that it is delaying until April 1, 2020 its controversial change in the definitions of “States” and “United States” included in the February 1, 2016 Medicaid covered outpatient drug final rule with comment...more

CMS to Host November 2 Call on Clinical Diagnostic Lab Test Payment System Data Reporting

by Reed Smith on

CMS is hosting an educational call on November 2, 2016 to discuss reporting obligations under the June 23, 2016 Clinical Diagnostic Test Payment System final rule. As previously reported, under the Protecting Access to...more

Catching Up With the Times: CMS Reforms Long-Term Care Facility Requirements Part III

by Polsinelli on

On October 4, the Centers for Medicare and Medicaid Services (CMS) published the biggest overhaul to federal long-term care regulations since 1991, and impacted facilities can immediately take steps to ensure they’re prepared...more

CMS Releases MACRA Final Rule, Easing 2017 Reporting Requirements

On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The final rule marks the most significant reform to our...more

“Pick Your Pace” for MACRA Rollout (But Don’t Be Too Slow)

by Snell & Wilmer on

CMS Acting Administrator Andy Slavitt recently announced that CMS would provide new physician reporting options for the first year of the MACRA program starting January 1, 2017. In response to concerns about the MACRA...more

CMS Posts PAMA Clinical Lab Fee Schedule Data Reporting Template and User Guide

by Reed Smith on

In order to assist the clinical laboratory community in meeting new Medicare reporting requirements under the Protecting Access to Medicare Act of 2014 (PAMA), CMS has posted a Clinical Laboratory Fee Schedule Data Reporting...more

Risk Adjustment Update: CMS and the states react to insurer exits

by Dentons on

The close of 2016 will mark the end of the third full year that the Affordable Care Act (ACA) has been fully implemented. Data is available for the first two "reporting years," 2014 and 2015, for which health insurers and...more

Game-Changing PAMA Rule Sets off Major Payment Shifts for Lab Tests

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) recently published a major final rule that will base Medicare clinical laboratory fee schedule (CLFS) reimbursement on private insurance payment amounts, as required by the...more

CMS Proposes OPPS Reimbursement Adjustments: What Hospital Outpatient Providers Need to Know

by Polsinelli on

In early July, the Centers for Medicare & Medicaid Services (CMS) proposed Hospital Outpatient Prospective Payment System (OPPS) reimbursement rule changes that will impact reimbursement payment amounts and requirements for...more

CMS Hosts Call on Potential Future Changes to Open Payments/Sunshine Act Reporting Requirements (Aug. 2)

by Reed Smith on

On August 2, 2016, CMS is hosting a Special Open Door Forum Call on potential future changes to Open Payments/Physician Payments Sunshine Act requirements for reporting payments and transfers of value made by drug and device...more

CMS Finalizes Plan to Expand Medicare/Private Claims Data Available for Care Improvement

by Reed Smith on

CMS has published a final rule to allow organizations approved as “qualified entities” to confidentially share or sell analyses of Medicare and private-sector claims data to providers, employers, and other groups who can use...more

CMS Posts Open Payment Data – $7.52 Billion in 2015

by Tucker Arensberg, P.C. on

CMS published the 2015 Open Payment Data on June 30, 2015. CMS has presented tables in its press release showing the highest paid specialties and highest paying companies. ...more

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