Medicare

News & Analysis as of

MedPAC Votes on Medicare Payment Rate Sufficiency

On January 12, 2017, Medicare Payment Advisory Commission (MedPAC) members unanimously voted to maintain Medicare’s existing updates (i.e., maintain the increases Congress and the HHS Secretary have already established) to...more

What Is The Trump Pharmaceutical Policy?

Pharmaceutical stocks took a hit after President-elect Trump criticized the industry during his January 11, 2017 press conference. But he also expressed support for the domestic pharmaceutical industry. What is the Trump...more

Medicaid: Significant Changes Coming in 2017 and Beyond

With Congress back in session, attention in the health care policy universe is directed squarely at Washington, where Republicans in Congress and the Trump Administration are debating how to repeal and replace the Affordable...more

Texas Court Enjoins Enforcement of Regulation that Would Forbid Discrimination in Healthcare on the Basis of Gender Identity and...

As LGBTQ rights have taken center stage in political and social issues, FordHarrison has been following ground-breaking litigation related to LGBTQ rights and providing updates. In the latest decision, a federal judge in...more

Tennessee Health Services and Facilities Report: January 2017 Newsletter

The Tennessee Health Services and Development Agency ("HSDA") is responsible for regulating the health care industry in Tennessee through the Certificate of Need Program. A Certificate of Need ("CON") is a permit for the...more

Qualifications for Artificial Limb Suppliers, After Only 16 Years

Bill Clinton was President when Congress enacted a law requiring CMS to come up with qualifications for those who make or supply artificial limbs to Medicare patients. It was January 11, 2017, when CMS finally unveiled the...more

The MACRA Final Rule: In Search of the “Goldilocks” Model

The Medicare Access and CHIP Reauthorization Act (“MACRA”) Final Rule published late last year implements CMS’ new payment approach for physicians and other Medicare Part B eligible clinicians under the Merit-Based Incentive...more

Notes on Day 4 of the JPMorgan Healthcare Conference

Some interesting presentations on the last day of the JPMorgan Healthcare Conference that concentrated on common themes – the increasing importance of ancillary business line to bolster core business revenue and of filling in...more

Medicare Secondary Payer – A Lot Less Boring Now

We’ve previously written several posts (not recently) on Medicare secondary payer (“MSP”) issues – which we characterized as “boring.” The recent MSP decision, Humana Insurance Co. v. Paris Blank LLP, 2016 WL 2745297, 187 F....more

Birmingham Medical News: End in Sight for Medicare ALJ Backlog?

As providers who are currently undergoing a Medicare claims appeal know, there is a lengthy delay to having an appeal actually heard by an Administrative Law Judge (“ALJ”). Some estimates indicate that it will currently take...more

HHS Ordered To Eliminate Medicare Appeals Backlog By 2021

On January 4, 2017, the U.S. District Court for the District of Columbia rejected a request by the Secretary of HHS asking the court to reconsider its decision that requires HHS to eliminate the backlog of Medicare claims...more

OIG Interprets and Incorporates Statutory Exceptions to CMP Law

As of January 6, 2017, final rules published by the United States Department of Health and Human Services Office of the Inspector General (the “OIG”) implementing certain exceptions to the Civil Monetary Penalty law (“CMP”)...more

New Year, New Possibilities: OIG Final Rule Amends Beneficiary Inducement Rules

The Office of Inspector General (“OIG”) of the Department of Health and Human Services has issued a final rule (“Final Rule”) adding new safe harbors to the federal anti-kickback statute, amending existing safe harbors, and...more

The Old and the New – Day 3 Notes from the JPMorgan Healthcare Conference

Day 3 of the JPMorgan healthcare conference was one of striking contrasts between the old and the new. (And, by the way, the rain finally stopped for a day, but it will be back tomorrow to finish off the last day of the...more

Judge Denies HHS’s Request to Rescind Timeline to Eliminate the Medicare Appeals Backlog

On January 4, 2017, the court in the American Hospital Association (AHA) v. Burwell litigation denied HHS’s motion to reconsider, which means that HHS must comply with the court’s timeline to eliminate the Medicare appeals...more

Urban hospitals that established GME caps after 1996: Be careful with this compliance issue

If a teaching hospital meets certain regulatory requirements, the hospital is generally permitted to loan its cap slots to other hospitals through a Medicare GME affiliated group agreement. (See Sharing FTE Caps: Threshold...more

CMS to Host Call on Transitioning Physician Quality Reporting to MIPS (Jan. 24)

On January 24, 2017, CMS is hosting a call to discuss how to complete the final reporting period for the “legacy” Medicare physician quality reporting programs (Physician Quality Reporting System, Medicare Electronic Health...more

HHS OIG Revises Various Safe Harbors Related to Beneficiary Inducements

On Dec. 7, 2016, the U.S. Department of Health and Human Services’ (HHS’) Office of Inspector General (OIG) published a final rule revising federal Anti-Kickback Statute (AKS) safe harbors and the beneficiary inducement...more

CMS Corrects Final 2017 OPPS/ASC Rule, Results in Slight Payment Increase

CMS has published a notice correcting technical errors in its November 14, 2016 final rule with comment period updating the Medicare hospital outpatient prospective payment system (OPPS) and ambulatory surgical center payment...more

Looking Forward/Looking Backward – Day 1 Notes from the JPMorgan Healthcare Conference

A large amount of wind, much discussion about the U.S healthcare, and the public getting soaked again – if you were thinking about Washington, DC and the new Congress, you’re 3,000 miles away from the action. This is the week...more

Health Reform Outlook for 2017: A Year of Major Uncertainty

Fulfilling their promises, Congressional Republicans moved to repeal the Affordable Care Act (ACA) on the first day of the new Congress when Senate Budget Committee Chair Michael Enzi (R-WY) introduced “reconciliation...more

Repealing Obamacare Will Have Consequences for Medicare

One of President-elect’s Donald Trump's campaign promises was to repeal the Affordable Care Act (ACA), aka Obamacare, and Republicans in Congress have vowed to make repeal one of their first acts in the new term. While...more

New billing modifier required for services furnished at certain off-campus provider-based departments on or after January 1, 2017

Changes to Medicare billing and payment rules for services furnished at certain off-campus provider-based departments (PBDs) went into effect on January 1, 2017. Pursuant to the statutory “site-neutral” payment policy enacted...more

2016 Nerve-of-a-Burglar Award

Competition for the 2016 Nerve-of-a-Burglar Award was fierce, with health care providers constantly coming up with new and different ways to scam Medicare and Medicaid. Nevertheless, we have a clear winner: the Michigan...more

Capitol Hill Healthcare Update

A growing number of moderate and conservative Republicans in Congress are voicing concerns about the party’s strategy to repeal the Affordable Care Act (Act) in February but then wait months – and possibly even into 2018 –...more

2,633 Results
|
View per page
Page: of 106
Popular Topics

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.
×