Fee-for-Service

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Also In The News - Health Headlines - May 2015

New Medicare Prescription Drug Cost Data Available – On April 30, 2015, CMS announced the availability of new, privacy-protected data on Medicare Part D prescription drugs prescribed by physicians and other health care...more

Physicians Finally Get Permanent Medicare Payment Solution

On April 16, 2015, President Obama signed into law a permanent sustainable growth rate (“SGR”) fix. The Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”) eliminates the Medicare SGR methodology, which has been...more

Locke Lord QuickStudy: Doc Fix Statute Contains a Lot More than SGR Repeal

On April 16, 2015, the President signed the Medicare Access and CHIP Reauthorization Act of 2015, commonly known as the “Doc Fix.” As has been extensively reported, the Act repeals the Sustainable Growth Rate or (SGR)...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

Important Recommendations from the MedPAC March Report to Congress, Part Two

Tuesday’s post discussed the recommendations of the Medicare Payment Advisory Commission (“MedPAC” or the “Commission”) with regard to fee-for-service (“FFS”) payment systems. ...more

Important Recommendations from the MedPAC March Report to Congress, Part One

Each March, the Medicare Payment Advisory Commission (“MedPAC” or the “Commission”) is tasked with reporting to Congress on the current state of the Medicare fee-for-service (“FFS”) payment systems, the Medicare Advantage...more

CMS Launches Health Care Payment Learning and Action Network

On March 25, 2015, CMS formally launched the Health Care Payment Learning and Action Network, a public-private partnership intended to support HHS’s goal of moving Medicare and the broader health industry from a...more

New NC Senate Bill Proposes 4-6 MCOs!! And the Creation of ARPLOs!!

Senate Bill 568 was filed today!!! It is a bill that you should follow! SB 568 reads: “It is the intent of the General Assembly to transform the State’s health care purchasing methods from a traditional fee-for-service...more

MedPAC Report to Congress on Medicare Policy

The Medicare Payment Advisory Commission (MedPAC) has released its annual recommendations to Congress on Medicare policies, including Medicare fee-for-service (FFS) payment updates and a status report on the Medicare...more

CMS Invites Stakeholders to Join "Health Care Payment Learning and Action Network" to Promote Alternative Payment Models

As previously reported, CMS has established a public-private partnership, the Health Care Payment Learning and Action Network, to support HHS’s goal of moving Medicare and the broader health industry from a FFS model towards...more

GAO Report Highlights Improper Medicare/Medicaid Payments

Despite the efforts of the Department of Health and Human Services (HHS) to combat fraud and contain costs in federal healthcare programs, Medicare’s fee-for-service program (Parts A and B) and Medicaid were two of the top...more

HHS Announces Next Generation ACO Model of Payment

On Tuesday, March 10, 2015, the U.S. Department of Health and Human Services ("HHS") announced the introduction of the Next Generation Accountable Care Organization ("ACO") Model of payment and care delivery. ACOs...more

Medicare Advantage Insurers May See Positive Growth in 2016 Despite CMS’ 0.95% Payment Rate Cut Announcement

The Centers for Medicare and Medicaid Services (CMS) proposed a 0.95 percent decrease in Medicare Advantage payment rates for 2016 in its Advance Notice and Draft Call Letter released on February 20, 2015. Medicare Advantage...more

Washington Healthcare Update

This Week: Upcoming Hearing: HHS Sec. Burwell Appearing Before E&C Committee on FY2016 Budget... CMS Issues 2016 Payment and Policy Updates for Medicare Health and Drug Plans... CMS Releases Improved Rating System for Nursing...more

Health Care E-Note - February 2015

In This Issue: - HIPAA Privacy During Emergency Situations - Probationary Medicaid RCOs – How Do Physicians Respond Without Subjecting Themselves to Potential Criminal And Civil Liability? - Big Data...more

Health Law Pulse - February 2015

On January 23, 2015, the United States Department of Labor (DOL) filed a notice of appeal with the United States Court of Appeals for the District of Columbia (District Court) challenging two rulings in the case of Home Care...more

Healthcare Legal News: Volume 5, Number 1

CMS ANNOUNCES NEW RULES THAT MAKE OWNER DOCTORS LIABLE FOR ALL PRACTICE MEDICARE DEBTS - Even after they leave the Practice. CMS announced its final rules on "Medicare Provider Oversight" on December 3, 2014....more

Say Ah! FTC and DOJ to Host Second Workshop on “Examining Health Care Competition”

On February 24-25, 2015, the FTC and the U.S. Department of Justice will host their second workshop on “Examining Health Care Competition.” The workshop will take place in Washington, D.C., and will focus on recent...more

CMS Extends Moratoria on Enrollment of New Providers and Suppliers in Six Locales

Last week, CMS announced that it has extended temporary moratoria on the enrollment of new ambulance suppliers and home health agencies within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania,...more

HHS Identifies Specific Goals to Move Toward Paying for Quality of Care

On January 26, 2015, the U.S. Department of Health and Human Services (HHS) announced a new initiative to shift Medicare reimbursements from volume to value using new payment methodologies for physicians and hospitals. Such a...more

New Rule on Medicare Reimbursement for Chronic Care Management Services

In November 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a final regulation with changes intended to ensure Medicare’s payment system “reflect[s] changes in medical practice and the relative value of...more

HHS Aggressive Goals for Value Based Payments

In a brief article published last week in the New England Journal of Medicine, Sylvia Burwell, the U.S. Secretary of Health and Human Services (HHS), summarily set forth HHS's efforts for improving the U.S. health care...more

HHS Announces First Timeline For Medicare Pay Reforms

On Monday, January 26, 2015, the Department of Health and Human Services ("HHS") announced a timeline for moving physicians and hospitals into new payment systems and tying Medicare reimbursements to quality of care....more

HHS Payment and Delivery Reform Announcement Sets Priorities for Remainder of Obama Administration

One week prior to the unveiling of the President’s first budget under a completely Republican-controlled Congress, the Department of Health and Human Services (HHS) made its most formal announcement yet on the Obama...more

Health Headlines: Also in the News - January 2015 #3

ALSO IN THE NEWS - HHS Publishes Goals on Alternative Payment Models with Continued Focus on Quality – In its continued efforts to base Medicare payments on quality over quantity, this morning HHS made public its goal...more

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