News & Analysis as of

Hospitals Centers for Medicare & Medicaid Services

Provider Taxes: The Battle over Medicare's Treatment Continues

by Baker Ober Health Law on

For the better part of a decade, hospitals and CMS have fought over the extent to which hospitals may claim as reasonable costs the provider tax assessments levied on them by the individual states in which they operate. In...more

Medicare Proposes Continued Relief for Critical Access and Rural Hospitals Through 2-Year Moratorium on Direct Supervision...

by Dorsey & Whitney LLP on

On July 13, 2017, CMS released a proposed rule as part of its 2018 Outpatient Prospective Payment System proposals that is aimed at helping to reduce some of the burdens rural hospitals experience in recruiting physicians....more

New Medicare Proposals that Reduce Payment to Hospitals for 340B Drugs in 2018

by Dorsey & Whitney LLP on

On July 13, 2017, CMS released several proposed rules impacting health care, including the 2018 Outpatient Prospective Payment System (OPPS) proposed rule which, among other proposals, could have a significant impact on 340B...more

CMS Releases Proposed Rule for 2018 Physician Fee Schedule

by King & Spalding on

On July 13, 2017, CMS proposed a rule (Proposed Rule) updating payment policies and rates, as well as the quality provisions, for the Medicare Physician Fee Schedule (PFS). Among other provisions, the Proposed Rule reduces...more

Key funding issues for provider-operated allied health residency programs

by Dentons on

Medicare GME reimbursement is designed only to support the training of medical, dental and podiatric residents. The Medicare program does, however, provide separate funding to support certain programs that train nursing and...more

GAO Releases Report on Evaluation Methodology in Hospital Value-Based Purchasing Program

by King & Spalding on

On June 30, 2017, the Government Accountability Office (GAO) released a report on the Hospital Value-Based Purchasing (HVBP) program, which evaluates hospital performance on quality and efficiency measures, and provides...more

CMS Open Payments: A Look Behind the Curtain

by McGuireWoods LLP on

Compliance officers often lament that it is impossible to identify, assess and manage the compliance risks of financial relationships they know nothing about. Too often they are limited to relationships brought to their...more

Amendments to Illinois Hospital Licensing Act Align Illinois Law with CoPs

by McDermott Will & Emery on

On June 23, 2017, the Illinois register will publish a number of significant amendments to the rules and regulations promulgated under the Illinois Hospital Licensing Act (the Act), at 77 Ill. Admin. Code § 250 et seq. These...more

CMS Releases MACRA Proposed Rule for 2018

by Baker Ober Health Law on

On June 20, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled, "Medicare Program; CY 2018 Updates to the Quality Payment Program." CMS proposes changes for the second year (2018) of the...more

Mandatory Bundled Payments Delayed, CMS seeking comments

by 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

MedPAC Takes Anti-POD Stance in Report to Congress, Echoing an Increasingly Uniform Consensus

by Ropes & Gray LLP on

On June 15, 2017, the Medicare Payment Advisory Commission (MedPAC), a non-partisan group that advises Congress on Medicare policy, released its annual Report to the Congress on Medicare and the Health Care Delivery System...more

CMS finalizes additional delay for episodic payment programs

by Thompson Coburn LLP on

After earlier delays following the change in administration and leadership, the Centers for Medicare and Medicaid Services (CMS) has set the start date for cardiac episode payment models (EPMs) and revisions to the...more

Senate reintroduces resident rotator legislation, other GME-related Washington updates

by Dentons on

With the recent change of administration and a new congressional session beginning in 2017, medical education stakeholders have been watching closely for any signs on the political horizon regarding federal GME funding. Below...more

CMS changes the SRDP process effective June 1, 2017

by Thompson Coburn LLP on

If you are in the process of drafting a SRDP submission, you must use the new SRDP forms or risk CMS not accepting the disclosure into the protocol. Effective June 1, 2017, the Centers for Medicare and Medicaid Services’...more

Health Update - May 2017

Mapping the Healthcare M&A Landscape Under the New Administration - Editor’s Note: The healthcare M&A market continues to be among the most active sectors. In a recent webinar, Manatt examined how the policies and goals of...more

CMS Announces Solicitation for the Rural Community Hospital Demonstration Program

by King & Spalding on

CMS announced solicitation for applications for participation in the Rural Community Hospital Demonstration Program (Demonstration). In this request for applications, CMS is seeking information from interested hospitals...more

CMS Seeks Comments on Overhauling Hospital IPPS

by Baker Ober Health Law on

CMS is asking for feedback on how Medicare can make the health care delivery system simpler for patients and health care providers. This spring's Fiscal Year 2018 Hospital Inpatient Prospective Payment System (IPPS) and the...more

CMS Releases FY 2018 Hospital Inpatient Prospective Payment System Proposed Rule and Request for Information

by King & Spalding on

On April 14, 2017, CMS issued the annual Hospital Inpatient Prospective Payment System (IPPS) Rule for FY 2018 (the “Proposed Rule”) which will affect discharges on or after October 1, 2017. CMS estimates that IPPS operating...more

Ten Things Investors Need to Know About Value-Based Healthcare

by Ropes & Gray LLP on

This article highlights key business and legal issues related to value-based healthcare for investors considering opportunities in the healthcare industry. 1. Value-Based Arrangements Are Here to Stay Value-based...more

CMS Gamed System to Identify Hospitals Gaming System?

by Faegre Baker Daniels on

You can’t make this stuff up. When CMS conducted a study to identify hospitals that game the quality data reporting system, it used an approach that made the data reporting look better than it actually was. That bottom line...more

IPPS Proposed Rule Increases Hospital Payment; Solicits Ideas for Achieving Transparency, Relieving Administrative Burden

by BakerHostetler on

The Centers for Medicare & Medicaid Services (CMS) recently issued its proposed rule updating fiscal year (FY) 2018 payment policies and rates under the Medicare inpatient prospective payment system (IPPS). As highlighted...more

New teaching hospitals that started training residents before October 1, 2012, should verify their GME FTE cap calculations

by Dentons on

Due to potential inconsistencies in CMS's cap-setting calculation methodologies, new teaching hospitals that first started training residents after the 1996 cap-setting base year, but before October 1, 2012, are well-advised...more

CMS Proposes IPPS/LTCH Payment and Policy Changes for FY 2018; Requests Comments on Broader Policy Issues

by Reed Smith on

CMS has published its proposed rule to update the Medicare acute hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) for fiscal year (FY) 2018. CMS also...more

Medicare Two-Midnight Rule and Observation Status Updates

by Baker Ober Health Law on

What's new from Medicare in the areas of the Two-Midnight rule and observation services? CMS recently published updates to a Medicare manual reflecting clarifications to its Two-Midnight policy, a Medicare Quality Improvement...more

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

by 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

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