News & Analysis as of

Hospitals Bundled Payments

Foley Hoag LLP

BPCI Advanced Model Extended with Pricing Changes

Foley Hoag LLP on

On October 13, 2022, CMS announced it will extend the Bundled Payments for Care Improvement Advanced Model (BPCI Advanced) for two years, with the opportunity for new entities to join the model beginning in 2024. CMS also...more

King & Spalding

CMS Extends CJR Model for Another Three Performance Years with Changes

King & Spalding on

On April 29, 2021, CMS issued a final rule extending the Comprehensive Care for Joint Replacement (CJR) bundled-payment model for an additional three performance years (the Final Rule). Originally slated to end September 30,...more

Foley & Lardner LLP

Transformative Health Care System Affiliations: A Growing Trend

Foley & Lardner LLP on

We continue to see activity in the hospital and health care system affiliation space. While few actually believe that the “Medicare for All” proposals will garner the support of a majority of the American people and are...more

Foley & Lardner LLP

Radiation Oncology: What You Need to Know About the Long Awaited Bundled Payment Proposal

Foley & Lardner LLP on

On July 10, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Center for Medicare & Medicaid Innovation (Innovation Center) released a much awaited proposal for a new bundled payment model for radiation...more

Holland & Knight LLP

Over 1,500 Medicare Providers Sign Up for BPCI Advanced

Holland & Knight LLP on

Centers for Medicare & Medicaid Services (CMS) has published the list of 832 Acute Care Hospitals and 715 Physician Group Practices which will be participating in the Bundled Payments for Care Improvement – Advanced (BPCI...more

Baker Donelson

Maryland All-Payer Model's Progression to Total Cost of Care: Alignment Strategies for Stakeholders in New Cost Paradigm

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The State of Maryland is unique in its historical experimentation with rate setting and global budgets for hospitals, and that experimentation continues with the Maryland Total Cost of Care Model (TCOC). Beginning January...more

Baker Donelson

BPCI Advanced – CMS Offers a Familiar Program with a New Twist

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The Centers for Medicare & Medicaid Services (CMS) is launching BPCI Advanced – the successor program to the Bundled Payments for Care Improvement Initiative. Providers that like the current BPCI program, or simply missed the...more

Tucker Arensberg, P.C.

CMS Announces Bundled Payments Care Improvement Model

Tucker Arensberg, P.C. on

On January 11, 2018, CMS announced a new voluntary episode payment model (bundled payments for care improvement advanced–BPCI Advanced) that will test a new iteration of bundled payment for the following thirty-two (32)...more

Baker Donelson

What's Next Now that Mandatory EPM and Cardiac Rehabilitation Payment Models Have Been Terminated?

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CMS released its Final Rule canceling the Episode Payment Model (EPM) and Cardiac Rehabilitation Incentive Payment Model (CR Incentive Payment Model). This was an expected result following August's proposed rule to cancel...more

Baker Donelson

CMS Requests Industry Feedback on "New Direction" for the Innovation Center

Baker Donelson on

CMS is seeking comments through a Request for Information (RFI) on a "new direction" for the CMS Innovation Center. The RFI includes focus areas identified by CMS, but the RFI welcomes all stakeholder input on "additional...more

Robinson+Cole Health Law Diagnosis

CMS Proposes to Cancel EPM and CR Bundled Payment Programs and to Reduce Mandatory Participation in CJR Model

The Centers for Medicare and Medicaid Services (CMS) recently published a proposed rule (Proposed Rule) to scale back its mandatory bundled payment programs. Under the Proposed Rule, CMS would cancel the episode payment...more

Mintz - Health Care Viewpoints

Hospitals and Others Respond to “Red Tape Relief Project” Requests

Last week, a number of health care industry associations sent letters to Congress detailing ways in which the government could relieve them of the burdens associated with “red tape.” The letters are in response to the first...more

Sheppard Mullin Richter & Hampton LLP

CMS Aims to Nix Obama-Era Payment Models

In a proposed rule published Tuesday, August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its intention to roll back a handful of payment models introduced under the Obama Administration. If...more

Baker Donelson

CMS Cancels EPM and Cardiac Rehabilitation Incentive Program While Revising CJR in New Proposed Rule

Baker Donelson on

After initially delaying the implementation of Episode Payment Models (EPMs) earlier this year, CMS issued a Proposed Rule on August 17 that proposes to cancel all EPMs and the Cardiac Rehabilitation Incentive Program (CR)...more

Mintz - Health Care Viewpoints

CMS Proposes to Cancel Bundled Payment and Incentive Models

The U.S. Centers for Medicare & Medicaid Services (CMS) published a proposed rule last week regarding the cancellation of three bundled payment models and an incentive payment model while also reducing the scope of a third...more

Polsinelli

CMS Proposal Terminates and Revises Mandatory Bundled Payment Models

Polsinelli on

On August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule which would cancel the Episode Payment Models (EPMs) and the Cardiac Rehabilitation (CR) incentive payment model, each of which...more

Carlton Fields

Mandatory Bundled Payments Delayed, CMS seeking comments

Carlton Fields on

CMS Administrator, Seema Verma, and Secretary of Health and Human Services Secretary, Tom Price delayed implementation of the Comprehensive Care for Joint Replacement (“CJR”) program via an interim final rule. See CMS – 5519...more

BakerHostetler

Bundled Payments Out in the Cold? Another Delay for Mandatory Bundled Payment Models

BakerHostetler on

This most recent delay raises questions concerning how the Trump administration intends to implement value-based payment in the Medicare program. The Centers for Medicare and Medicaid Services (CMS) has delayed again the...more

Baker Donelson

Delayed ETA for EPMs – CMS Delays New Bundled Payment Models

Baker Donelson on

On March 21, 2017, CMS issued the anticipated delay related to the new Episode Payment Model (EPM) bundled payment program regulations that were finalized in January. The rule, Advancing Care Coordination Through Episode...more

King & Spalding

White House “Regulatory Freeze” Delays Implementation of Bundled Payment Models

King & Spalding on

In the February 17, 2017 Federal Register, CMS announced that it will delay implementation of several bundled payment initiatives until March 21, 2017. The Advancing Care Coordination Through Episode Payment Models (EPMs),...more

Baker Donelson

New Bundled Payments Are a Go…For Now

Baker Donelson on

CMS issued a final rule on January 3, 2017, implementing three new episode payment models (EPMs) and a Cardiac Rehabilitation (CR) incentive payment model under the authority of the Center for Medicare & Medicaid Innovation...more

Sheppard Mullin Richter & Hampton LLP

House Republicans Push Back on Medicare’s New Mandatory Bundled Payment Models

On July 25, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that promises to deliver coordinated, high-quality care for Medicare beneficiaries. The proposed rule (effective July 1, 2017)...more

King & Spalding

CMS Proposes New Bundled Payment Models for Cardiac and Orthopedic Care

King & Spalding on

On July 25, 2016, CMS posted a proposed rule that would create three new Medicare Parts A and B episode payment models for patients admitted for care for a heart attack, bypass surgery or surgical hip/femur fracture treatment...more

Foley & Lardner LLP

CMS Expands Mandatory Bundled Payments to Cardiac Care

Foley & Lardner LLP on

On Monday July 25, 2016, CMS proposed new models that expand mandatory participation in bundled payments and continue CMS’s initiative to shift Medicare payments from fee for service to alternative payment models. Coming just...more

Foley & Lardner LLP

Expansion of Clinical Services at Assisted Living Sites – The New Paradigm

Foley & Lardner LLP on

As payment reforms, such as bundled payments and Accountable Care Organizations (ACOs), drive further provider collaboration to achieve lower costs with enhanced outcomes, post- acute providers, especially assisted living...more

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