Final Rules Centers for Medicare & Medicaid Services

News & Analysis as of

Health Care Update - August 2015

CMS Releases Final Payment Rules (IPPS, IRF, LTCHs, Hospice, and Psych): At the end of last week, the Centers for Medicare and Medicaid Services (CMS) released a set of final 2016 payment rules affecting acute care hospitals...more

CMS Issues FY 2016 IPPS and LTCH Final Rule

On July 31, 2015, CMS issued its final rule to update the fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective...more

MSSP Final Rule Provides Modification to Shared Savings Financial Arrangement

This is the fifth post in Health Care Law Today’s series on the final rule. The final Medicare Shared Savings Program (“MSSP”) rule released on June 4, 2015, contains a number of modifications to the financial...more

Beneficiary Assignment Under the MSSP Final Rule

This is the fourth post in Health Care Law Today’s series on the final rule. This post addresses how CMS assigns beneficiaries to an ACO participating in the MSSP. In the MSSP ACO Final Rule, CMS finalized new...more

CMS Issues Final Rule for Medicare Shared Savings Program

This month, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule (the “Final Rule”) regarding an update to the Medicare Shared Savings Program (the “Program”). The Final Rule will seek to enhance primary...more

Final Rule Will Give ACOs Participating in MSSP Access to More Data for More Beneficiaries

This is the third post in Health Care Law Today’s series on the final rule. This post addresses changes to sharing of beneficiary identifiable data. In its December 8, 2014 proposed rule revising the Medicare Shared...more

MSSP Final Rule ACO Eligibility Requirements, Application and Renewal Process

This is the second post in Health Care Law Today’s series on the final rule. This post addresses Eligibility Requirements, and the Application and the Renewal Process. ACO Eligibility Requirements - Under the...more

ACOs: The Next Generation of Coordination Care

An Overview of the Medicare Shared Savings Program/Accountable Care Organization Final Rules - The Centers for Medicare and Medicaid Services (CMS) recently released a final rule (Final Rule) that makes changes to the...more

ACOs: The Next Generation of Coordinated Care - An Overview of the Medicare Shared Savings Program/Accountable Care Organization...

The Centers for Medicare and Medicaid Services (CMS) recently released a final rule (Final Rule) that makes changes to the Medicare Shared Savings Program (MSSP). The Affordable Care Act (ACA) created the MSSP as one of...more

Medicare Shared Savings Program: Final Rule

Last week, the Centers for Medicare & Medicaid Services (CMS) released its Final Rule on the Medicare Shared Savings Program (MSSP). The Final Rule provides additional flexibility to accountable care organizations...more

CMS Releases Final Rule on Medicare Shared Savings Program

This is the first post in Health Care Law Today’s Series on the final rule. The Centers for Medicare and Medicaid Services (“CMS”) released a final rule, on June 4, 2015, addressing changes to its Medicare Shared Savings...more

CMS Issues Final ACO Rules: Key Legal Implications for Hospital & Health System ACOs

On June 4, 2015, the Centers for Medicare & Medicaid Services (CMS) released a final rule (Final Rule) containing changes to its Medicare Shared Savings Program (MSSP). Some of the changes codify informal guidance that the...more

CMS Releases Final Medicare Shared Savings Program Rule

On June 9, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published a Final Rule that provides substantial new flexibility for Medicare Shared Savings Program (“MSSP”) Accountable Care Organizations (“ACOs”)....more

Medicare Shared Savings Program: CMS Finalizes Changes Affecting All ACOs

On June 4, 2015, the Centers for Medicare & Medicaid Services (“CMS”), issued a final rule (the “Final Rule”) implementing changes to the Medicare Shared Savings Program (“MSSP”). The Final Rule addresses matters raised in a...more

CMS’ Long Awaited Final ACO Regulations for 2016 and Beyond: Major New Options and Plenty of Fine Tuning

Today, the Centers for Medicare and Medicaid Services (“CMS”) will publish final regulations (“Final Rule”) for its flagship pay-for-performance program, the Medicare Shared Savings Program, in the Federal Register. The Final...more

CMS Publishes Corrections to 2015 Medicare Physician Fee Schedule Final Rule

CMS has published corrections to its final 2015 Medicare physician fee schedule rule. Among other things, the rule reflects a previously-announced correction to the conversion factor for the first quarter of 2015 ($35.7547),...more

CMS Finalizes SMART Act MSP Appeals Provisions

The Centers for Medicare & Medicaid Services (CMS) has published a final rule that implements Medicare Secondary Payer (MSP) appeals provisions under the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act). ...more

CMS Publishes Final Rule Establishing Appeal Process for Applicable Plans in Medicare Secondary Payer Cases

On February 27, 2015, CMS published a final rule, effective April 28, 2015, to establish a formal, multilevel administrative appeals process for applicable plans against which Medicare Secondary Payer (MSP) recovery demands...more

CMS Publishes Corrections to OPPS and ASC Payment System for CY 2015

On February 24, 2015, CMS published corrections to the hospital outpatient prospective payment system (OPPS) and the ambulatory surgical center (ASC) payment system Final Rule that was published in the November 10, 2014...more

Medicare Advantage and Medicare Part D Changes for 2016 Released

On February 6, 2015, the Centers for Medicare & Medicaid Services (CMS) released a final rule regarding changes to Medicare Advantage and Medicare Part D to take effect in 2016. According to CMS, this final rule “implements...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

Strategizing to Operationalize the Medicare Advantage and Part D Final Rule

More than a year ago, the U.S. Centers for Medicare & Medicaid Services (CMS) proposed significant regulatory changes to the Medicare Advantage (MA) and Part D Programs, many of which were the subject of significant...more

CMS Finalizes Policy Rules For Medicare Parts C and D

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) released its final rules on policy and technical changes to the Medicare Advantage (MA) and Prescription Drug Benefit programs (Part D) for contract year...more

CMS Finalizes Changes to Medicare Advantage and Part D Programs

On February 6, 2015, CMS released a final rule revising certain requirements for the Medicare Advantage and Part D programs. The changes will be effective for Contract Year 2016. According to CMS, the final rule implements...more

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