News & Analysis as of

Final Rules Centers for Medicare & Medicaid Services

CMS Requires Participating Providers to Prepare for Emergencies

by Carlton Fields on

On March 24, 2017, the Centers for Medicare & Medicaid Services (CMS) released a memorandum encouraging participating providers to “seek out and participate in a full-scale, community-based exercise with their local and/or...more

Start Date Delayed for EPM, Cardiac Rehabilitation and CJR Episodes of Care

by Baker Ober Health Law on

CMS recently announced that the effective start dates for episodes of care under the Episode Payment Model (EPM), Cardiac Rehabilitation Incentive Payment Model (CR) and the revisions to the Comprehensive Care for Joint...more

Has the CMS Done an About Face as it Relates to Arbitration?

by Steptoe & Johnson PLLC on

Has the Centers for Medicare & Medicaid Services (CMS) abandoned its previously adopted Final Rule prohibiting mandatory nursing home arbitration?  The recent decision by the CMS to forego its Fifth Circuit appeal of the...more

CMS’ New Interpretations And Guidance Relating To The Rules Governing The Affordable Care Act

by Stoel Rives LLP on

While H.R. 1628, the American Health Care Act of 2017, the bill that seeks to repeal key provisions of the Patient Protection and Affordable Care Act (“PPACA”), passed the House on May 4, 2017, and is being considered by 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

Stabilizing the Exchanges: CMS Issues Final Rule

by Bass, Berry & Sims PLC on

On April 18, 2017, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a final rule (the "Final Rule") aimed at stabilizing the individual and small group health insurance markets...more

CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions

by McDermott Will & Emery on

CMS recently released a final rule with the goal of stabilizing Exchange markets for 2018. The agency also issued several significant guidance documents where CMS extended the deadlines for 2018 rate and Exchange qualified...more

CMS Give Clinical Labs Reporting Deadline Extension

by Dorsey & Whitney LLP on

Clinical laboratories have until May 30, 2017 to make required reports to the Centers for Medicare & Medicaid Services (“CMS”) regarding payment rates paid by private payors for certain diagnostic tests and the volume of such...more

CMS Delays Effective Date for Episode Payment Model (EPM) Final Rule

by King & Spalding on

CMS has announced that the effective date for the Final Rule for certain EPMs will be delayed until May 20, 2017. This is the second delay for the Final Rule. CMS previously pushed the effective date from February 18 to March...more

Medicare Mandatory Bundled Payments Rule: Minor Aspects Delayed, Others On-Schedule for July Implementation

by Polsinelli on

In a move the Centers for Medicare & Medicaid Services cites as a reaction to President Donald Trump's regulatory freeze, CMS announced that implementation of certain minor aspects of the final rule expanding Medicare...more

Health Care E-Note - Februaury 2017

by Burr & Forman on

Ransomware: A Reportable Breach? In the past several years, a huge increase has occurred in the number of electronic attacks in the United States using ransomware, a form of malware that targets and encrypts critical...more

HHS Finalizes Appeals Backlog Rule in Wake of Judicial Order

by Polsinelli on

The U.S. Department of Health and Human Services (HHS) released a Final Rule aimed at reducing and eventually eliminating the backlog of more than 650,000 claims currently awaiting adjudication by an administrative law judge...more

Nursing Home Arbitration Agreements: A Changing Landscape

by Fisher Phillips on

Because arbitration proceedings often offer a less costly and more efficient alternative to the burdens of protracted courtroom litigation, arbitration agreements are increasingly common in the nursing home industry. However,...more

CMS Issues Final Rule on New Medicare and Medicaid Conditions of Participation for Home Health Agencies

by Stinson Leonard Street on

The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule, 42 C.F.R. pt. 484, implementing significant changes to the conditions of participation (CoPs) that home health agencies (HHAs) must satisfy to...more

The Brave New World of Physician Medicare Payment: MACRA Makes Sweeping Changes

by Seyfarth Shaw LLP on

On November 14, 2016, CMS published its final rule implementing the physician payment provisions of the Medicare Access and CHIP Reauthorization Act (“MACRA”). The rule became effective January 1, 2017. Data collection from...more

CMS Finalizes Rule to Reduce Medicare Appeals Backlog

by Reed Smith on

In the face of growing scrutiny and now judicial pressure, the Centers for Medicare & Medicaid Services (CMS) published a final rule on January 17, 2017 implementing certain administrative and procedural actions in an effort...more

Jan. 31 Deadline: Off-Campus Provider-Based Relocations Requests

by Polsinelli on

For relocations that occurred between 11.2.15 and 12.31.16, providers must submit relocation requests by 1.31.2017. The CY 2017 OPPS Final Rule brought significant changes to the way Medicare reimburses hospitals for...more

2016 – Health Law Year in Review

We are pleased to present our annual review of developments in the field of health law. The year was marked by key changes in False Claims Act jurisprudence and Medicare payment policy. 2016 also brought with it focused...more

CMS Releases Final Rule Updating Home Health Agency Conditions of Participation­

by King & Spalding on

CMS issued a final rule, which was published in the Federal Register on January 13, 2017, intended to modernize the home health agency Conditions of Participation (CoPs). The rule, which goes into effect on July 13, 2017,...more

CMS Finalizes Revamped Home Health Agency Conditions of Participation

by Baker Ober Health Law on

CMS recently issued revamped home health agency (HHA) conditions of participation (CoPs), strengthening patient confidentiality, patient rights, quality assessment, care and performance standards. The final rule was published...more

The MACRA Final Rule: In Search of the “Goldilocks” Model

by Snell & Wilmer on

The Medicare Access and CHIP Reauthorization Act (“MACRA”) Final Rule published late last year implements CMS’ new payment approach for physicians and other Medicare Part B eligible clinicians under the Merit-Based Incentive...more

CMS Finalizes Testing of New Episode Payment Models and MSSP Track 1+ ACO

by Ropes & Gray LLP on

On January 3, 2017, CMS published a final rule addressing three care coordination models: - Cardiac care: CMS added two new cardiac care episode payment models (“EPMs”) for items and services furnished to patients...more

CMS Finalizes Mandatory Cardiac Care Bundled Payment Model and More

by Foley & Lardner LLP on

On December 20, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (the Final Rule) which includes three new mandatory episode-based payment programs for cardiac care, as well as the expansion of 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

OIG Finalizes CMP Regulations, Largely as Proposed

by Baker Ober Health Law on

On December 7, 2016, the Department of Health and Human Services, Office of Inspector General (OIG) finalized [PDF] its proposal to update the civil monetary penalty (CMP) regulations – namely, incorporate new CMP authorities...more

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