News & Analysis as of

Medicare Access and CHIP Reauthorization (MACRA)

Dealing with Disasters – Quality Payment Program Exception Available for MIPS-Participating Clinicians and Groups

by Polsinelli on

The Centers for Medicare & Medicaid Services (CMS) simplified the process for clinicians and other providers to seek the Quality Payment Program (QPP) Hardship exception by releasing an online application on Aug. 2....more

Health Care Weekly Preview from ML Strategies – September 2017

“It’s déjà vu all over again.” We’re back again this week for an important round of hearings in HELP and Finance where we will be paying close attention to the tone emanating from the hearings especially after Chairman...more

MACRA Update: How to Prepare for Changes in MIPS

As we reported last month, CMS’ proposed rule updating MACRA’s Quality Payment Program (“QPP”) for CY 2018 would extend and expand exceptions that would allow many practitioners to avoid participating in its Merit-based...more

Final Rule for MACRA's Second Year (2018) Expected in November 2017

by Baker Donelson on

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

Community Health Center Fund: A Minibus Rider

Over the past month, we provided additional details on the structure, funding, and evaluation of the Maternal, Infant, Early Childhood, Home Visiting (MIECHV) program and Medicare Therapy Caps. In this post we will go into...more

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

CMS Issues Final FY 2018 Medicare Hospice Payment Update

by Reed Smith on

CMS has finalized fiscal year (FY) 2018 Medicare hospice reimbursement rates and other updates to Medicare hospice policies. As mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS is increasing...more

Back to School Rules Recap: Hospital and Physician Cheat Sheet on What CMS Did This Summer

by BakerHostetler on

Summer was no vacation for the Centers for Medicare & Medicaid Services (CMS). The agency released a series of significant rules that signal the nature and pace of CMS Medicare payment and policy changes for hospitals and...more

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

MACRA Physician Payment Reform: Time to Take Stock of What Is Working and What Changes Are Needed

by Epstein Becker & Green on

In April 2015, Congress established a new framework for Medicare Part B physician payments through the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), which the Centers for Medicare & Medicaid...more

MACRA: Proposed Changes to the Merit-Based Incentive Payment System Track

by Polsinelli on

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule on the Medicare Quality Payment Program (QPP) in the Federal Register1 on June 30, 2017. This rule proposes the QPP program requirements for...more

CMS Finalizes 1% Update to Medicare IRF Rates for FY 2018; Payments to Rise by $75 Million

by Reed Smith on

CMS has finalized Medicare prospective payment system (PPS) rates for inpatient rehabilitation facility (IRF) services for fiscal year (FY) 2018, which begins October 1, 2017. CMS estimates that IRF PPS payments will increase...more

CMS Issues Final FY 2018 SNF PPS Update; Rates to Increase by 1%

by Reed Smith on

CMS has released its final rule to update Medicare skilled nursing facility (SNF) prospective payment system (PPS) rates and policies for FY 2018, which begins October 1, 2017. The final rule incorporates a 1% increase to SNF...more

MACRA Quality Payment Program Update

On June 20, 2017, CMS released its proposed rule updating MACRA’s Quality Payment Program (“QPP”) for CY 2018. At over 1,000 pages, the rule might not do much to simplify the already complex requirements of the QPP; however,...more

CMS Proposes QPP Revisions: The Paths for QPP Participation Continue to Evolve

by Baker Ober Health Law on

CMS recently proposed modified policies for continued implementation of the Quality Payment Program (QPP) in the 2017 Proposed Rule. Among other things, the Proposed Rule provides flexibility for clinicians in the second QPP...more

CMS Proposes Medicare Physician Fee Schedule Update for 2018

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) has published its proposed rule to update the Medicare physician fee schedule (PFS) for calendar year (CY) 2018. The proposed rule addresses numerous Medicare policies,...more

Health Care E-Note - July 2017

by Burr & Forman on

Everywhere you look these days, there seems to be another report of a cyberattack -- attacks which do not discriminate based on industry type, size of business, or impact. In other words, everyone is vulnerable. In fact, the...more

A Look Forward and Back: AHLA’s Annual Meeting

by Arnall Golden Gregory LLP on

On The American Health Lawyers Association (AHLA) held its Annual Meeting on June 24 - 28, 2017 in San Francisco, California. The meeting “[o]ffer[s] the most current information and analysis of myriad legal issues the health...more

CMS Proposes CY 2018 Quality Payment Program Policy Changes that Signal Intent to Reduce the Pace and Burdens of MACRA

by BakerHostetler on

On June 30, the Centers for Medicare & Medicaid Services (CMS) issued a much anticipated rule outlining proposed payment and policy changes to the new Medicare Part B Quality Payment Program (QPP) that was created by the...more

CMS Issues Proposed Rule to Increase Flexibility and Reduce Burden in the Second Year of MACRA’s Quality Payment Program

by Arnall Golden Gregory LLP on

On June 20, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule (CMS-5522-P) that would make changes to the second year requirements of the Medicare Access and CHIP Reauthorization Act of 2015...more

Meaningful Use and the Costs of Noncompliance

by Burr & Forman on

It is something of an understatement to note that the U.S. healthcare legal landscape is currently experiencing a degree of transition and uncertainty. There is no shortage of changes to discuss, debate, and, perhaps, grow...more

Payor Initiatives with Physicians and Payment Models In The Insurance Marketplace

by Locke Lord LLP on

Payment models that seek to reward physicians, hospitals and other health care providers for achieving certain quality and cost-saving goals, or “value-based purchasing” (VBP), are not new to the healthcare landscape,...more

Manatt on Health: July 2017

BCRA Implications: Affordability of Coverage - In making the case for repealing and replacing the Affordable Care Act (ACA), the president and congressional leadership have cited “rising premiums,” “unaffordable...more

CMS Proposes Changes to for Second Year of Medicare Physician Quality Payment Program

by Reed Smith on

CMS has proposed new regulations to continue implementing the “Quality Payment Program” (QPP)– the new Medicare physician fee schedule (MPFS) update framework mandated by the Medicare Access and CHIP Reauthorization Act of...more

A Cautious First Step From a Bold Administration: Proposed Rule on Clinician Quality-based Payments Incorporates Some, But Not...

by Faegre Baker Daniels on

On June 30, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule covering the second and future years of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program. The...more

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