News & Analysis as of

Medicare

FY 2018 President’s Budget May Signal Challenges for Health Programs on the Horizon

by McDermott Will & Emery on

Eric Zimmerman, along with McDermott+Consulting Vice Presidents Adaeze Enekwechi and Piper Su, wrote this +Insights publication detailing the possible effects of the Trump Administration's 2018 budget on health programs and...more

The State AG Report Weekly Update

by Cozen O'Connor on

2018 Election Update- Michael Dougherty Announces Bid for Colorado Attorney General- Michael Dougherty formally announced his candidacy to become Colorado AG. Dougherty is the third Democrat to formally enter the...more

The American Health Care Act, the Sequel Receives Its CBO Grade

Perhaps the high fives in the Rose Garden of the White House a few weeks ago may have been a bit premature. On Wednesday, May 24, 2017, the non-partisan Congressional Budget Office (CBO) released its analysis of the revised...more

CMS Delays Start Date for Medicare Cardiac/Hip Fracture Episode Payment Model Until 2018; Parallel CJR Changes Also Pushed Back

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) is delaying until January 1, 2018 implementation of mandatory Medicare episode payment models (EPMs) for acute myocardial infarction, coronary artery bypass graft, and...more

Health Care Reform Weekly Roundup – Issue 2

Below are key health care reform developments from the week of May 15th: ACA Repeal Efforts. Efforts to repeal and replace the Affordable Care Act (ACA) continue despite slowing down as the House of Representatives’...more

Florida Federal District Court Denies Government’s Attempt To Submit Statement of Interest In False Claims Act Case Where...

by King & Spalding on

On April 26, 2017, the United States District Court for the Middle District of Florida denied the government’s motion for leave to submit a “statement of interest” in a False Claims Act (FCA) action in which the government...more

Medicare Claims Appeals Process - A Refresher

by Burr & Forman on

With the increased audit activity we are seeing among the alphabet soup of Medicare contractors— RACs, ZPICs, SMRCs, CERTs, etc.—now appears to be a good time for a refresher on the Medicare claims appeals process. Due to...more

The Opportunities and Challenges of Freestanding Emergency Departments

Following our blog post regarding the retail clinic movement, “Patient Check-Ups Before Checking Out: Partnering to Bring Health Care into the ‘One-Stop Shopping’ Sector” (April 19, 2017), we continue our examination of...more

Manatt on Health Reform: Weekly Highlights - May 2017 #4

The President's budget proposes over $600 billion in Medicaid cuts on top of major reductions anticipated in repeal and replace legislation; the Trump Administration asks the Court for more time to decide on cost-sharing...more

Capitol Hill Healthcare Update

by BakerHostetler on

Congress’s official budget scorekeepers this week will release analysis of the House-approved bill repealing most of the Affordable Care Act (ACA), and that data will inform Senate Republicans on a path for passing their...more

CMS Urged To Reverse Obama-Era Biosimilar Reimbursement Policy

A bipartisan congressional effort is underway to convince CMS to reverse its biosimilar reimbursement policy implemented under the Obama administration. We discussed the current reimbursement policy in a March 2016 blog post...more

Health Care Weekly Preview from ML Strategies – May 2017

We are half way through May – are we having fun yet? There is a lot of activity this week in addition to ongoing talks in the Senate regarding their version of the American Health Care Act. The reauthorization of FDA User...more

Health Care E-Note - May 2017

by Burr & Forman on

When a physician leaves a medical practice, especially if the physician stays in the area to compete against his/her former employer, the situation can become stressful and acrimonious. Please see full E-Note below for...more

Key Tax Changes in the American Health Care Act

by Dickinson Wright on

The American Health Care Act ("AHCA"), passed by the House of Representatives on May 4, 2017, repeals many of the taxes added by the Affordable Care Act ("ACA") and makes changes to other tax rules. Some of the notable...more

AHCA Would Affect Medicare, Too

Editor’s Note: While the American Health Care Act (AHCA)—the bill that would replace the Affordable Care Act—does not include explicit changes to Medicare, it could have a profound impact on the 11 million Medicare...more

The State AG Report Weekly Update

by Cozen O'Connor on

2018 AG Elections Update- Phil Weiser Announces Bid for Colorado Attorney General- Phil Weiser has formally registered his candidacy to become Colorado AG. Weiser, a Democrat, is the first candidate to formally...more

Revocation of Enrollment in the Medicare Program- A Powerful Weapon in Medicare’s Arsenal

by Burr & Forman on

In 2014, CMS issued a final rule related to 42 CFR 424.535, which gave CMS expanded authority to impose penalties on providers. Although the rule is several years old, the first version published in 2006, the rule has been...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

GAO: CMS, MACs Should Bolster Provider Education to Cut Improper Medicare Payments

by Reed Smith on

In 2016, an estimated $41.1 billion in improper Medicare fee-for-services payments were made to providers. The Centers for Medicare & Medicaid Services (CMS) believes that provider education plays an important role in...more

CMS Retroactively Revises DMEPOS Fee Schedule to Implement Cures Act

by Reed Smith on

CMS has announced revised Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule amounts for the period of July through December 2016, as required by the 21st Century Cures Act. By way...more

Nurse Anesthetists Sue Novitas Solutions and CMS Over Medicare Reimbursement Policy on Chronic Pain Management

by King & Spalding on

On April 11, 2017, the American Association of Nurse Anesthetists (AANA), an organization representing more than 50,000 Certified Registered Nurse Anesthetists (CRNAs), filed a complaint for declaratory and injunctive relief...more

The American Health Care Act: Summary of House-Passed Bill to Repeal and Replace Portions of the Affordable Care Act and Next...

Last week, the House took the first step to repealing and replacing the Affordable Care Act (ACA) by passing a bill titled “The American Health Care Act” (AHCA). On May 4, 2017, after numerous fits and starts over the past...more

Passed House AHCA Bill Contains Numerous Provisions Affecting Employers

by Holland & Knight LLP on

Holland & Knight originally issued this alert in March 2017 regarding the American Health Care Act (AHCA) as it stood on that date. This client alert provides an update on the AHCA as passed by the U.S. House of...more

Changes in MACRA Creating Complications in Healthcare

by Clark Hill PLC on

Healthcare is still buzzing about CMS’s Medicare physician two-track payment system, MACRA. The Merit-Based Incentive Payment System (MIPS) is a complex pay-for-performance system based on traditional fee-for-service (FFS)....more

Will the GOP's AHCA Repeal and Replace the ACA?

We promised to keep you up to date on the GOP majority's promise to repeal and replace the Affordable Care Act (the "ACA"). After reaching agreement on several amendments to the original House bill (described in our previous...more

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