News & Analysis as of

Medicare Access and CHIP Reauthorization (MACRA) Centers for Medicare & Medicaid Services (CMS)

Holland & Knight LLP

HHS Is Primed to Enforce Information Blocking Conduct

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The U.S. Department of Health and Human Services (HHS) continued its commitment to timely and full access to health records on June 24, 2024, through the finalization of its information blocking disincentives rule for...more

McDermott+

McDermottPlus Check-Up: June 23, 2023

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Congress was in session for a final week of legislative business before the two-week Independence Day recess. The House brought a small-business-focused healthcare bill to the floor, approving it along party lines....more

McDermott+

CMS Releases Proposed Rule: Medicaid and CHIP Managed Care Access, Finance, and Quality

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The proposed rule would make transparency-related updates to state directed payments (SDPs). It would also require states to submit an annual payment analysis that compares managed care plans’ payment rates for routine...more

Holland & Knight LLP

CMS Issues 2023 Medicare Physician Fee Schedule Final Rule

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The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Final Rule on Nov. 1, 2022, which impacts Medicare Part B payments starting on Jan. 1, 2023....more

Holland & Knight LLP

Holland & Knight Health Dose: September 13, 2022

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Holland & Knight Health Dose Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

King & Spalding

CMS Announces CMMI Milestones and Updates

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CMS recently announced updates and milestones for several programs run by the Center for Medicare and Medicaid Innovation (CMMI). CMMI is the internal CMS agency responsible for developing and testing new health care payment...more

McGuireWoods Consulting

Washington Healthcare Update May 2019 #2

This week in Washington: House to hold hearings on PFAS contamination and exposure, the maternal mortality crisis and single-payer issues....more

Sheppard Mullin Richter & Hampton LLP

Overview of Proposed Rule from the Centers for Medicare & Medicaid Services Regarding Interoperability and Patient Access to Data

On March 4, 2019, the Centers for Medicare & Medicaid Services (“CMS”) published a wide-ranging proposed rule (“Proposed Rule”) with the intent to “move the health care ecosystem in the direction of interoperability” in...more

Baker Donelson

OIG October 2018 Work Plan Update

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The OIG added five new items to its Work Plan in the October 2018 update: (1) childcare provider compliance with criminal background check requirements; (2) early results from Opioid State Targeted Response Grants; (3)...more

Sheppard Mullin Richter & Hampton LLP

The Merit-Based Incentive Payment System’s Targeted Review Deadline is Upon Us: Physicians, Groups, and other Clinicians have...

The Centers for Medicare & Medicaid Services (CMS) recently announced that it has several “prevailing concerns” regarding the accuracy of the 2017 Merit-Based Incentive Payment System (MIPS) scoring data that was used to set...more

Holland & Knight LLP

CMS Proposes Major ACO Overhaul

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On Aug. 9, 2018, Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would update the Medicare Shared Savings Program (MSSP). Called "Pathways to Success," the proposal significantly alters the...more

Foley & Lardner LLP

Health Care Policy Newsletter - July 2018 #3

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Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health Care policy news and legislation. *Please note that we...more

Bass, Berry & Sims PLC

Stark Under the Microscope: Congress and HHS Examine Reform of the Stark Law for a Value-Based System

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On July 17, 2018, the U.S. House of Representatives' Ways and Means Committee Subcommittee on Health ("Subcommittee") expressed its commitment to modernizing the Stark Law during a hearing in which industry and government...more

Foley & Lardner LLP

New Demonstration Program Would Reward Clinicians for Accepting Risk in Medicare Advantage

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CMS recently announced that it wants to launch a new demonstration program, the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration. If approved and adopted as a demonstration project, the MAQI...more

McDermott Will & Emery

CMS Opens Module for MA Plans to Report MACRA Other Payer Advanced APM Information

The other payer advanced alternative payment model (APM) option is intended to give eligible clinicians an additional option to meet MACRA’s escalating participation thresholds to qualify for the 5 percent advanced APM bonus....more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes “Wind Down” Plan for Federal Exchanges

Despite the Trump Administration’s unsuccessful attempts to fully repeal and replace the Affordable Care Act (the “ACA”), the Administration has continued to target the ACA. In the Administration’s latest salvo, the Centers...more

Mintz - Health Care Viewpoints

MedPAC Recommends Significant Changes to MACRA

In March, the Medicare Payment Advisory Commission (MedPAC) released its biannual report to Congress on matters affecting the Medicare program. MedPAC is an independent congressional agency that advises Congress on issues...more

Foley & Lardner LLP

6 Key Takeaways for Providers on BPCI-Advanced (Value-Based Medicare Payment)

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Despite some initial difficulty in gaining momentum, the use of value-based payment methodologies will likely increase across all provider niches. This change is partly a function of cost savings driven by margin compression...more

Mintz - Health Care Viewpoints

CMS to Begin Issuing New Medicare Cards Next Month

Last week, the Centers for Medicare & Medicaid Services (CMS) announced that new Medicare cards would be issued starting next month. As we previously reported, the government has been planning to revamp the card to reduce...more

McGuireWoods LLP

New Medicare Cards to Debut in April 2018

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In an effort to “prevent fraud, fight identity theft, and keep taxpayer dollars safe,” the Centers for Medicare and Medicaid Services (CMS) is issuing new Medicare cards to Medicare enrollees beginning in April 2018. This...more

K&L Gates LLP

K&L Gates Triage: Triage in 2018: Health Care Topics to Watch in the New Year

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We expect 2018 to be another year of rapid change within the health care industry. In this episode, Mary Beth Johnston highlights some of the key topics that the health care practice group will monitor in the coming year,...more

Baker Donelson

Key Health Care Provisions of Bipartisan Budget Act of 2018

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The wide-reaching Bipartisan Budget Act of 2018 (BBA), passed by Congress and signed by the President on February 9, 2018, extends and modifies dozens of health care programs, including extending funding for two years for...more

Pierce Atwood LLP

Update On New Medicare Cards And The Transition To The Medicare Beneficiary Identifier

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In an effort to combat identity theft and prevent fraud as well as to comply with the provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, the Centers for Medicare and Medicaid Services (CMS) will...more

Akin Gump Strauss Hauer & Feld LLP

Congress Makes Key Changes to Medicare Physician Payment Programs as Part of Short-Term Government Funding Bill

• Congress amended current law to prevent CMS from applying the “MIPS” payment adjustment to separately billed items like drugs and biologics, which will drastically reduce the total amount of payment adjustments to clinical...more

Mintz - Health Care Viewpoints

CMS Releases Advance Notice and Call Letter for Medicare Advantage and Part D

Late last week, CMS released the Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2019 draft Call Letter (Advance Notice...more

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