News & Analysis as of

Health Care Providers Centers for Medicare & Medicaid Services Healthcare

Feb. 13 Deadline Looms for Provider-Based Departments Seeking Mid-Build Exception

by Polsinelli on

A new section of the 21st Century Cures Act provides much-needed relief for hospitals with an off-campus provider-based department (off-campus PBD) that was mid-build or under development as of November 2, 2015 (the Mid-Build...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

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

Health Care E-Note - January 2017

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

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

Joint Commission Confirms Ban on Texting of Patient Care Orders

After briefly considering a reversal of its prohibition on texting orders, The Joint Commission (TJC), in consultation with the Centers for Medicare & Medicaid Services (CMS), announced last month that its ban would continue...more

Healthcare Law Update: December 2016

by Holland & Knight LLP on

Prompt Payment Discounts Not an Anti-Kickback Statute Violation - In United States of Am. et al. ex rel. Ruscher v. Omnicare, No. 15-20629, 2016 WL 6407128 (5th Cir. Oct. 28, 2016), the court of appeals affirmed summary...more

21st Century Cures: Required Exploration of Telehealth Solutions

by McDermott Will & Emery on

President Obama signed the 21st Century Cures Act on December 13, 2016. The act encourages biomedical research investment and facilitates innovation review and approval processes, but also serves as a vehicle for a wide...more

2016 Health Care Year in Review

by Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

The MACRA Final Rule: 10 Things You Need to Know

by Carlton Fields on

The Centers of Medicare and Medicaid Services (CMS) released the much-anticipated Medicare Access and CHIP Reauthorization Act (MACRA) final rule this month. The rule makes extensive changes to traditional Medicare Part B...more

Could Possible Healthcare Repeal Efforts Extend to Physician Payments Under Medicare?

by Barley Snyder on

Now that the 2016 presidential election is over, many patients are asking whether Congress will repeal the Affordable Care Act (ACA), or parts of the legislation. Yet, many doctors are asking (or should be asking) whether...more

OPPS Provider-Based Final Rule — A More Practical Approach From CMS

by Polsinelli on

CMS recently finalized sweeping changes to the way Medicare pays hospitals for services furnished in “new” off-campus provider-based departments (referred to as “off-campus PBDs”). CMS revealed the changes on November 1...more

CMS Continues Efforts to Improve Patient Care, Spending, and Population Health

by Pierce Atwood LLP on

On November 2, 2016, the Centers for Medicare and Medicaid Services (CMS), released the 2017 Medicare Physician Fee Schedule (MPFS) final rule, which finalized a number of new policies designed to improve Medicare payment for...more

Now is the Time to Prepare for MACRA: 2017 Will Bring Major Changes to Physician Medicare Reimbursement

by Akerman LLP - Health Law Rx on

MACRA (the Medicare Access and CHIP Reauthorization Act of 2015) is bi-partisan legislation that was enacted to change Medicare reimbursement from being based on the current system of volume of services provided to...more

Federal Judge Blocks CMS Rule Banning Arbitration In Nursing Home Disputes

by King & Spalding on

In September, CMS announced a final rule that bans pre-dispute binding arbitration agreements related to care received in long-term care facilities. Among other things, the rule preserves the right of patients and their...more

Mississippi District Court Halts Implementation of New CMS Rule Banning Use of Arbitration Agreements in Long-Term Care Facilities

by Reminger Co., LPA on

Anyone familiar with long-term care litigation knows that the number of disputes regarding the use and enforcement of arbitration agreements in the context of assisted living/nursing home admissions has risen sharply over the...more

2017 OPPS Final Rule: Payment to Off-Campus Provider-Based Departments

by Stinson Leonard Street on

On November 1, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the 2017 Medicare Outpatient Prospective Payment System (OPPS) Final Rule. One aspect of this rule is the implementation of payment decreases for...more

Federal Court Blocks CMS Ban on Pre-Dispute Nursing Home Arbitration Agreements Pending Legal Challenge: What the Ruling Means for...

Earlier this week, a federal court enjoined the federal Centers for Medicare and Medicaid Services (“CMS”) from enforcing a rule, promulgated on September 28, 2016, which barred pre-dispute arbitration agreements between...more

Federal Court Enjoins U.S. Agency’s Nursing Home Arbitration Agreement Ban

by Ballard Spahr LLP on

The Centers for Medicare and Medicaid Services (CMS), an agency within the U.S. Health and Human Services Department, recently issued a final rule prohibiting nursing homes and other long-term care facilities from utilizing...more

Making Sense of the MACRA Final Rule – Part 3 of 3: Merit Based Payment Incentive System (MIPS)

by Polsinelli on

The Centers for Medicare & Medicaid Services (CMS) recently released its final rule with comment period implementing the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Among its numerous changes,...more

Proposed Rule to Strengthen State Medicaid Fraud Control Units

by Polsinelli on

A recently published proposed rule expands the functions and responsibilities of state Medicaid Fraud Control Units (MFCUs). The rule was issued by the Centers for Medicare and Medicaid Services (CMS) and the Office of...more

Making Sense of the MACRA Final Rule, Part 2 of 3: Alternative payment Models

by Polsinelli on

Many observers view the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a game changer for the delivery and payment of health care services. On Oct. 14, 2016 the Centers for Medicare & Medicaid Services...more

Manatt on Health Reform: Weekly Highlights - November 2016

Minnesota’s Governor and legislators propose financial assistance options for on- and off-Marketplace individual coverage; Vermont receives final federal approval for the country’s first all-payer ACO model; and a report...more

CMS Releases List of Additional Advanced APM’s and Announces Vermont’s All-Payer ACO

by Pierce Atwood LLP on

On the heels of the release of its final rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA), the Centers for Medicare and Medicaid Services (CMS) released its 2017 list of Advanced Alternative Payment...more

Making Sense of the MACRA Final Rule, Part 1 of 3: Essential Concepts

by Polsinelli on

On Oct. 14, the Centers for Medicare & Medicaid Services (CMS) published a final rule with comment period implementing the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The nearly 2,400 pages of...more

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