News & Analysis as of

Health Insurance Medicare Shared Savings Program

Robinson+Cole Health Law Diagnosis

Key Changes to the Medicare Shared Savings Program

On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued changes to the Medicare Shared Savings Program to advance CMS’ broader strategy of growth, alignment, and equity. To improve the overall...more

Robinson+Cole Health Law Diagnosis

CMS Issues Final Rules Concerning the 2023 Outpatient Prospective Payment System Rates and Physician Fee Schedule

On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued final rules concerning the 2023 Hospital Outpatient Prospective Payment System (OPPS) payment rates and 2023 Medicare Physician Fee Schedule...more

K&L Gates LLP

COVID-19: K&L Gates Triage: Value-Based Payment Arrangements

K&L Gates LLP on

In this week’s episode, Limo Cherian, Carla Dewberry and Steven Pine discuss recent changes to value-based health care payment arrangements triggered by the current COVID-19 emergency. In particular, the presenters discuss...more

Foley & Lardner LLP

Healthcare Law Review: Overview of the U.S. Healthcare System

Foley & Lardner LLP on

The U.S. healthcare industry remains at a crossroads. The healthcare reform legislation passed under President Barack Obama in 2010, officially called the Patient Protection and Affordable Care Act (ACA) but widely referred...more

Verrill

CMS Issues Final Rule to ACOs: It’s Time to Take a Risk

Verrill on

Just before the holidays, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) that will overhaul the Medicare Shared Savings Program (“MSSP”). As of January 2018, the MSSP included 561...more

Pierce Atwood LLP

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

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

Polsinelli

DOJ-AmEx Case Could Have Ramifications for Health Care Providers

Polsinelli on

The U.S. Department of Justice's loss to American Express sends a message to health care providers: Steering, tiering, exclusive dealing and other contractual arrangements that appear to suppress competition in one part of...more

King & Spalding

CMS Issues Medicare Physician Fee Schedule Proposed Rule

King & Spalding on

On July 7, 2016, CMS issued a proposed rule that updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2017 (Proposed...more

Sheppard Mullin Richter & Hampton LLP

IRS Denial of Section 501(c)(3) Status for a Commercial ACO

The IRS recently released a ruling, Private Letter Ruling (“PLR”) 201615022, denying Section 501(c)(3) tax-exempt status to a “commercial” accountable care organization (“ACO”). This is the IRS’ first published guidance...more

Dickinson Wright

Healthcare Legal News: Volume 5, Number 1

Dickinson Wright on

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

Akerman LLP - Health Law Rx

A Quick Look at Healthcare Issues Expected to Make News in 2015

As we look into our crystal balls, we do not expect a lot of new issues in 2015. Rather, we believe that most of the significant issues will be a continuation of issues that arose in 2014 or earlier. ...more

Manatt, Phelps & Phillips, LLP

Health Update - July 2014

Avoiding the Regulatory Land Mines of Commercial ACOs - While providers are showing great interest in creating ACOs to participate in the Medicare Shared Savings Program (MSSP), they are showing even greater enthusiasm...more

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