News & Analysis as of

Obama Administration Centers for Medicare & Medicaid Services

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

CMS Considering 6-Month Delay of Obama Administration Home Health COP Rule

by Reed Smith on

As previously reported, in January 2017 the Obama Administration finalized major changes to the conditions of participation (CoPs) that home health agencies (HHAs) must meet to participate in Medicare and Medicaid. The rule...more

The New “Price” of U.S. Health Care: The Future of Value-based Reimbursement Under President-elect Trump and Tom Price

by Carlton Fields on

The total U.S. health care expenditure was $3.2 trillion in 2015, and is projected to grow to nearly $5.6 trillion by 2025. As our nation’s cost of care rises, both Democrats and Republicans recognize the overwhelming need to...more

If Obamacare’s Days are Numbered, What’s Next? Trumpcare.

by Snell & Wilmer on

The Affordable Care Act has withstood 62 repeal attempts by the House of Representatives and several challenges brought to the U.S. Supreme Court. Now, with Donald Trump as President and a new Republican-led House and...more

The Washington Report

by Baker Donelson on

In Washington, the Government Relations and Public Policy Group focuses on serving our clients by helping to design and implement government relations and public policy strategies. As part of that effort, we have launched a...more

Obama Administration Releases FY 2017 Budget Proposal with Extensive Medicare & Medicaid Funding and Program Integrity Provisions

by Reed Smith on

On February 9, 2016, the Obama Administration released its proposed fiscal year (FY) 2017 budget, which contains significant Medicare and Medicaid reimbursement and program integrity legislative proposals – including $419...more

Medicare and Medicaid Drug Policy Provisions in the Obama Administration’s Proposed FY 2017 Budget

by Reed Smith on

The Obama Administration’s proposed fiscal year (FY) 2017 budget, released on February 9, 2016, includes a number of legislative proposals that would revise Medicare and Medicaid policies to achieve budget savings and make...more

Obama Administration Proposes 2017 ACA Marketplace Plan Benefit and Payment Parameters

by Reed Smith on

On December 2, 2015, CMS is publishing its annual proposed Notice of Benefit and Payment Parameters, which would govern participation in the Affordable Care Act (ACA) Health Insurance Marketplaces for 2017. The wide-ranging...more

Reimbursement Change for Off-Campus Provider-Based Clinics, Physician Offices, and Ambulatory Surgical Centers

by Stinson Leonard Street on

On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015, a two-year budget deal with a key provision affecting hospitals and other health care providers. Effective January 1, 2017, the Act decreases the...more

Provider-Based Status: A Quiet Casualty of the Bipartisan Budget Act

by Polsinelli on

Without fanfare or any significant discussion, the Bipartisan Budget Act (Act) contains the first legislative action related to provider-based status—and it is a sweeping action with negative financial consequences to many...more

Health Care Update - July 2015 #3

ACA Repeal Votes Continue: As part of a rare Senate Sunday session to consider a bill to replenish the highway trust fund for six years, Majority Leader Mitch McConnell (R-KY) brought up an amendment to repeal the ACA—in...more

Health Care Update - July 2015 #2

Congress Slowly Works on Budget Reconciliation; ACA Reform Proposals Still Up in the Air - The FY 2016 budget resolution, which was agreed to by Congress this past April, included broad reconciliation instructions...more

Delivery System Reform 2.0: Scaling Alternative Payment Models is the New Normal

For some health care providers, a pair of recent announcements made by the Obama Administration to implement mandatory alternative payment models (APMs) for home health value-based purchasing and bundled payments for hip and...more

Energy & Commerce Committee Hearing on Administration's Approval of Medicaid Demonstrations

by Reed Smith on

On June 24, 2015, the House Energy and Commerce Health Subcommittee is holding a hearing to examine the Obama Administration’s approval of Medicaid demonstration projects. According to a background memo, the panel will focus...more

Manatt on Health Reform: Weekly Highlights - June 2015 #3

With the King v. Burwell ruling expected by the end of the month, Congressional Republicans continue to offer contingency plans in the event of a ruling for the plaintiffs; and the Mississippi Insurance Commissioner proposes...more

Health Care Update - October 2014 #3

In This Issue: - Policymakers Scrambling to Contain Ebola Crises - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional Initiatives -...more

Health Care Update - July 2014 #2

In This Issue: - Obama Administration Ramps up Efforts to Reduce Medicaid Spending - Senators Press Gilead on Sovaldi - Implementation of the Affordable Care Act - Other Federal Regulatory...more

COBRA Coverage Too Expensive? Consider ACA Coverage Instead, Obama Administration Says

On Friday, the Obama administration announced a proposed rule (the “Proposed Rule”) that will require that notices sent to workers regarding Consolidated Omnibus Budget Reconciliation Act (“COBRA”) health insurance coverage...more

Health Care Reform Implementation Update

by Cozen O'Connor on

This week, the Centers for Medicare and Medicaid Services (CMS) announced that in May Jonathan Blum would be leaving his post as Deputy Administrator for CMS and Danielle Moon who leads CMS’ Medicare Advantage division would...more

CMS Releases Unprecedented Amount Of Medicare Billing Information, Increasing Risk Related To Fraud Lawsuits

On April 9, 2014, the Center for Medicare and Medicaid Services ("CMS"), a branch of the Department of Health and Human Services ("HHS"), released data showing utilization, payments, and submitted charges for services and...more

Health Care Reform Implementation Update - April 21, 2014

by Cozen O'Connor on

On April 14, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) reported their findings that show a smaller rise in insurance premium costs under the Affordable Care Act (ACA) than previously...more

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