Hospitals Centers for Medicare & Medicaid Services

News & Analysis as of

CMS Posts Revised Application for Meaningful Use Hardship Exceptions

On January 22, CMS posted a revised application and instructions for a hardship exception from the Meaningful Use program penalties in 2015. Under the new, streamlined application process, which CMS says is a temporary...more

CMS Issues Guide on Avoiding Readmissions in Diverse Medicare Populations

The CMS Office of Minority Health has released a “Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries.” The guide highlights data indicating that racial and ethnic minority...more

CMS Releases Guide to Preventing Readmissions Among Racially and Ethnically Diverse Medicare Beneficiaries

On January 26, 2016, the CMS Office of Minority Health released a new Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries (Guide). The purpose of the Guide is to assist hospital...more

Outliers: CMS Explains its Reasoning for FY2004 Fixed Loss Threshold Calculation

In accordance with the order issued by the D.C. Circuit in District Hospital Partners, LP v. Burwell and related cases, on January 22, CMS issued an explanation of the methodology it used to calculate the fixed-loss threshold...more

CMS Announces DSH Allotments

CMS has published the final fiscal year (FY) 2013 and preliminary FY 2015 disproportionate share hospital (DSH) allotments, along with final FY 2013 and preliminary FY 2015 limitations on aggregate DSH payments that states...more

CMS Payment Initiatives Target Quality & Care Improvement - The Short Version

Like it or not, the Centers for Medicare & Medicaid Services (CMS) is expanding its strong commitment to focus on quality and care improvement as the basis for payment throughout the continuum of care. The final rule for the...more

CMS Publishes Clarification of FY 2004 Outlier Fixed-Loss Threshold As Required by Two Recent Federal Court Rulings

On January 22, 2016, CMS published an explanation of its FY 2004 outlier fixed-loss threshold rulemaking. The explanation was required by two 2015 federal court orders in cases brought by hospitals challenging the outlier...more

Manatt on Medicaid: CMS Approves California's Delivery System Reform Incentive Payment (DSRIP) Waiver Renewal

On December 30, 2015, the Centers for Medicare and Medicaid Services (CMS) approved California's request to renew its waiver under Section 1115 of the Social Security Act. A significant component of the waiver is the Delivery...more

Deadline Looms for EHR Hardship Exceptions

The Centers for Medicare & Medicaid (CMS) expect 209,000 health care providers to face Medicare payment reductions for failing the electronic health records (EHR) “meaningful use” requirements in 2014. CMS puts the estimated...more

Length of funded training: Initial Residency Period (IRP) issues

The payment rules for Medicare graduate medical education (GME) reimbursement inherently incentivize training during a resident's "initial residency period" (IRP), which is defined as the minimum accredited length for each...more

Whose Turn To Pay? New OIG Opinion Provides Clarity Regarding Payment of Radiology Transcription Fees

A new OIG opinion clarifies that providers are free to determine who will pay the transcription fees when separate parties perform the professional and technical components of a radiology exam. ...more

Washington Healthcare Update

This Week: The House is not in session this week... The Senate returns today... Committees in the Senate will hold hearings on co-ops and mental health... Vice President Biden will attend the World Economic Forum in...more

Stark Law Update

The Stark Law has been updated effective January 1, 2016 in ways that may affect your medical practice and hospital relationships. Among other things, these updates add two new exceptions to the referral prohibition, relax...more

A&B Healthcare Week in Review - January 2016

On January 5, 2016, the Office of Management and Budget (OMB) received for review a final rule from the Centers for Medicare & Medicaid Services (CMS) entitled Covered Outpatient Drugs (CMS-2345-F). The rule had previously...more

Final Stark Rule Changes Adopt New Exceptions For Hospitals and Significant Clarifications - Corridors January 2016

In the Medicare Fee Schedule Final Rule with Comment Period for calendar year 2016, the Centers for Medicare & Medicaid Services (CMS) adopted two new exceptions to the Stark physician self-referral law affecting hospitals,...more

CMS Initiatives Target Quality & Care Improvement - Corridors January 2016

Like it or not, the Centers for Medicare & Medicaid Services (CMS) is showing a strong commitment to moving forward with its focus on hospitals’ quality and care improvement as the basis for payment. In November, CMS...more

Corridors - January 2016 - News for North Carolina Hospitals

Final Stark Rule Changes Adopt New Exceptions For Hospitals and Significant Clarifications - In the Medicare Fee Schedule Final Rule with Comment Period for calendar year 2016, the Centers for Medicare & Medicaid...more

Catastrophe Averted…What’s Next for ICD-10?

If the October 1, 2015 ICD-10 transition buildup felt to you like Y2K all over again, then you are not alone. Although some hospitals have reported delays in payments, physician practices have not experienced delays in...more

GAO Recommends Payment Reform in Response to Increase in Hospital/Physician Consolidation

On December 18, 2015, the Government Accountability Office (GAO) released a report analyzing the increase in hospital/physician consolidation and a related increase in Medicare hospital outpatient spending. Finding that...more

Patient Access and Medicare Protection Act Signed Into Law; Includes Additional Medicare Reforms

On December 28, 2015, President Obama signed into law S. 2425, the Patient Access and Medicare Protection Act, which includes a number of Medicare provisions that were not included in the Consolidated Appropriations Act. ...more

Congress Passes End-of-Year Legislation

Last week, Congress passed three acts impacting the healthcare industry—a tax extenders bill titled Protecting Americans from Tax Hikes of 2015, an Omnibus spending bill titled the Consolidated Appropriations Act of 2016, and...more

Manatt on Health Reform: Weekly Highlights - December 2015 #4

HealthCare.gov enrolls 8.2 million; Manatt and RWJF release an open access dataset on Marketplace plans nationwide; Montana names administrator for its Medicaid expansion; and Michigan gets the green light in the nick of time...more

Also In The News - Health Headlines - December 2015 #2

CMS Releases HAC Data for FY 2016, Showing More Payment Reductions – On December 10, 2015, CMS published quality measure scores related to hospital-acquired conditions (HACs) for hospitals participating in the HAC Reduction...more

New Year, New Flexibility: Top 10 Takeaways from CMS Stark Law Final Rule

On November 16, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published the Calendar Year 2016 Physician Fee Schedule final rule with comment period, which includes a final rule (the “Final Rule”) that amends...more

Medicare Launches Its First Mandatory Bundled Payment Model for Joint Replacement Care – What You Need to Know to Get Ready

On November 24, 2015, the Centers for Medicare & Medicaid Services (CMS) published a significant final rule that will require hospitals in selected geographic areas to participate in a new Medicare Comprehensive Care for...more

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