News & Analysis as of

Health Law Alert: CMS Modifications to Meaningful Use Rule Gives Providers a Welcome Reprieve

On September 4, the Centers for Medicare & Medicaid Services (CMS) published a Final Rule that made several helpful changes to the meaningful use requirements for the Electronic Health Record (EHR) Incentive Program. Among...more

Final Meaningful Use Rule: CMS Loosens its Grip

The Centers for Medicare & Medicaid Services (“CMS”) finalized a rule on August 29th which should give providers some breathing room in complying with meaningful use requirements for the Electronic Health Record (“EHR”)...more

CMS Waves Partial White Flag in Appeals of Payment Status Denials

For the last several years, hospitals, on the one hand, and the Centers for Medicare and Medicaid Services and its contractors (collectively, CMS), on the other, have been engaged in a spirited dispute over claims denials for...more

CMS Issues Final Rule on Hospice Wage Index and Payment Rate Update for FY 2015

On August 4, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule updating the hospice wage index and payment rate for Fiscal Year (FY) 2015 and adopting a number of payment reforms addressing concerns...more

CMS, ONC Adopt EHR Standards Flexibility for Eligible Providers; Delay Start of Stage 3

On August 29, 2014, CMS and the Office of the National Coordinator for Health IT (ONC) issued a final rule adopting the agencies’ proposal to grant flexibility for eligible providers regarding which edition of certified EHR...more

CMS Publishes FY 2015 Final IPPS Rule

On August 4, 2014, CMS posted its final changes and updates to the Medicare Inpatient Prospective Payment System (IPPS) that apply for fiscal year (FY) 2015, effective October 1, 2014. Below are some of the highlights of the...more

Health Headlines: Also in the News - August 2014

Hospital IPPS Final Rule Not Yet Released – As of the time this edition of Health Headlines was sent to press, CMS has not yet released the hospital inpatient prospective payment system (IPPS) final rule for FY 2015....more

New ICD-10 Compliance Date Set for October 1, 2015

On July 31, 2014, CMS issued a final rule moving the ICD-10 compliance date from October 1, 2014 to October 1, 2015, and requiring HIPAA covered entities to continue to use ICD-9 through September 30, 2015. The final rule...more

Health Care Reform Implementation Update

Congress begins its summer recess this week, but last week legislators were busy holding hearings on management issues regarding HealthCare.gov, introducing legislation to increase payments to primary care doctors under...more

Most Recent Final Deadline for ICD-10 Implementation is October 1

It’s been a while since CMS set a new “final” deadline for implementation of ICD-10—the greatly expanded medical coding system. So last Thursday CMS issued a new final rule setting October 1, 2015, as the final date for...more

The Probe and Educate Process For The Two-Midnight Rule

On August 2, 2013, the Centers for Medicare and Medicaid Services (“CMS”) released the final rule for the 2014 Medicare Inpatient Prospective Payment System (“IPPS”), effective October 1, 2013.[1] Introduced in the IPPS...more

CMS Proposes Changes to Physician Payments Sunshine Act Implementing Regulations

On July 3, 2014, the Centers for Medicare and Medicaid Services (CMS) released four proposed changes for comment to the implementing regulations for the Physician Payments Sunshine Act. The proposed changes would amend the...more

CMS's Final Exchange and Insurance Market Standards Impact Qualified Health Plan Filings for 2015 and Beyond

On May 16, 2014, the Centers for Medicare & Medicaid Services ("CMS") released a final rule titled "Patient Protection and Affordable Care Act; Exchange and Insurance Market Standards for 2015 and Beyond" ("Final Rule")...more

Cloudy Skies Ahead for Providers? CMS’ Release of Medicare Billing Data Combined with Physician Payment Sunshine Act Data May...

In February 2013, we reported (on our Healthcare Law Blog) that the Centers for Medicare and Medicaid Services (CMS) announced the final rule for the Physician Payments Sunshine Act. In the interest of providing more...more

No More He-Said-She-Said: Revised Regulations Allow CMS to Request Records Information Directly from any Person or Entity Involved...

The Centers for Medicare & Medicaid Services (CMS) on May 19, 2014, adopted a final rule that significantly revised Medicare Advantage (MA) and Part D prescription drug benefit program regulations (the “Final Rule”). One of...more

CMS Announces Final Regulatory Changes to Medicare Advantage and Part D

- CMS issues final Medicare Advantage and Part D regulatory changes after a controversial proposed rule was announced earlier this year. - New requirements for the reporting and return of Medicare Advantage and Part D...more

CMS updates hospital conditions of participation for the medical staff and governing body

On May 12, 2014, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule updating the hospital conditions of participation related to the medical staff and the governing body (“Final Rule”). Specifically,...more

CMS Changes to Medicare Advantage and Prescription Drug Benefit Programs for Contract Year 2015

On May 19, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule, published in the Federal Register on May 23, 2014, that sets forth changes to requirements for Medicare Advantage (“MA”) and...more

CMS Issues Pared-Down Final Rule on Medicare Part D and Medicare Advantage

CMS recently issued a Final Rule with respect to the Medicare Part D and Medicare Advantage programs (the “Final Rule”) implementing certain Affordable Care Act provisions. The Final Rule follows a January 10, 2014 Notice of...more

CMS Scaled Back Changes to the Medicare Part D Prescription Drug and Medicare Advantage Programs, but Some Important Revisions...

On May 19, 2014, the Centers for Medicare & Medicaid Services ("CMS") released a final rule ("Final Rule") completing changes to the Medicare Program's outpatient prescription drug benefit ("Part D") program and the Medicare...more

CMS Final Rule Eliminates Outdated, Unnecessary Regulations

On May 7, 2014, CMS issued CMS-3267-F, which finalizes reforms to various regulatory provisions that CMS identified as unnecessary, obsolete, or excessively burdensome. CMS estimates that these changes will save affected...more

Rule Overhaul to Save Health Industry Up To $640 Million, Medicare Says

On May 7, 2014, the U.S. Centers for Medicare & Medicaid Services (CMS) issued a long-awaited final rule in response to President Obama’s Executive Order (EO) 13563, “Improving Regulation and Regulatory Review,” which set as...more

Health Headlines: Also in the News - May 2014

CMS Proposes Payment Changes for Hospice Providers, SNFs, IRFs and Inpatient Psych Facilities – Last week, CMS issued proposed rules that would make certain payment and policy changes to the payment systems for...more

Health Care Reform Implementation Update - February 26, 2014

Though Congress was in recess this past week, congressional staff was hard at work continuing to consider ways to prevent a cut to Medicare providers’ payment rates that will be triggered by the sustainable growth rate...more

Lab Results on Demand: CLIA/HIPAA Amendment Increases Patient Access

A new final rule (the “Final Rule”) from the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, and the Office for Civil Rights (collectively, the “Agencies”) gives patients and their...more

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