Physician Fee Schedule

News & Analysis as of

Health Care E-Note - January 2016

The 2016 Medicare Physician Fee Schedule Final Rule ("Final Rule") contains recent changes to the Federal Stark Law, the majority of which took effect on January 1, 2016. The issuance of the Final Rule on November 16, 2015...more

Important Changes for Physicians from the 2016 Medicare Physician Fee Schedule: Part I (Stark Changes)

On November 16, 2015 the Centers for Medicare and Medicaid Services (CMS) published the final Medicare Physician Fee Schedule (Final MPFS). The Final MPFS addresses changes to the physician fee schedule and related policies,...more

Stark Law Update

The Stark Law has been updated effective January 1, 2016 in ways that may affect your medical practice and hospital relationships. Among other things, these updates add two new exceptions to the referral prohibition, relax...more

Recent Changes to the Stark Law Provide Added Flexibility

The 2016 Medicare Physician Fee Schedule Final Rule ("Final Rule") contains recent changes to the Federal Stark Law, the majority of which took effect on January 1, 2016. The issuance of the Final Rule on November 16, 2015...more

Introducing Stark Phase V

On November 16, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published the most significant changes to the physician self-referral law (“Stark Law”) regulations since 2008. Currently being referred to as...more

Health Law Pulse - January 2016

CHANGES TO STARK LAW, NEW ADVANCE CARE PAYMENTS INCLUDED IN 2016 PHYSICIAN FEE SCHEDULE - The Centers for Medicare & Medicaid Services (CMS) recently published a final rule (Final Rule) regarding physician payment...more

CMS Seeks Comments on Draft Physician Fee Schedule Quality Measure Development Plan

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to develop quality measures that will apply to Medicare payments to physicians when new Merit-based Incentive Payment System (MIPS) and Medicare...more

Patient Access and Medicare Protection Act Signed Into Law; Includes Additional Medicare Reforms

On December 28, 2015, President Obama signed into law S. 2425, the Patient Access and Medicare Protection Act, which includes a number of Medicare provisions that were not included in the Consolidated Appropriations Act. ...more

New Year, New Flexibility: Top 10 Takeaways from CMS Stark Law Final Rule

On November 16, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published the Calendar Year 2016 Physician Fee Schedule final rule with comment period, which includes a final rule (the “Final Rule”) that amends...more

Don’t Mail That Overpayment Disclosure Just Yet: Implications of CMS’ Final Rule Expanding the Writing, Signature and Holdover...

The Centers for Medicare and Medicaid Services (CMS) on Nov. 16, 20151 published the calendar year 2016 physician fee schedule final rule, fundamentally reducing the burden on entities seeking to demonstrate compliance with...more

Stark Updates Included in Final 2016 Physician Fee Schedule

With the final Medicare physician fee schedule (PFS) for 2016, the Centers for Medicare and Medicaid Services (CMS) has made a series of updates to the Stark physician self-referral regulations. The final rule is largely...more

CMS Finalizes Major Changes and Clarification to the Stark Law Regulations

Introduction - Since the passage of the Physician Self-Referral Act, also known as the “Stark Law,” health care providers have had to learn to work within and adjust to certain statutory and regulatory exceptions in...more

Recent Provider-Based Legislative Changes: Any GME Implications?

On November 2, 2015, President Obama signed into law the Bipartisan Budget Act of 2015, among other things, making changes to Medicare reimbursement for outpatient services furnished in off-campus provider-based departments...more

CMS Issues Final Payment Rules for Physicians and Hospitals

On October 30, 2015, the U.S. Department of Health and Human Services (HHS) released several final rules related to physician and hospital Medicare payments for 2016. Specifically, HHS’s Centers for Medicare and Medicaid...more

CMS Finalizes Stark Law Changes in CY 2016 Medicare Physician Fee Schedule Final Rule

This past July, on the heels of a decision in which a judge for the U.S. Court of Appeals for the Fourth Circuit characterized the federal physician self-referral prohibition commonly known as the “Stark Law” as, “even for...more

Budget Law Moves Towards Site-Neutral Medicare Payments; Join Foley for a Discussion on November 13

The recently enacted Bipartisan Budget Act (P. L. 114-74) included a provision that will significantly alter the future of hospital-based outpatient care. The provision, Section 603, will exclude from Medicare’s...more

CMS Issues CY 2016 Medicare Physician Fee Schedule Final Rule

On October 30, 2015, CMS released the CY 2016 Medicare Physician Fee Schedule (PFS) Final Rule updating payment policies, payment rates, and quality provisions for services furnished under the PFS on or after January 1, 2016....more

Budget Act Significantly Impacts Provider-Based Facility Reimbursement

On November 2, President Obama signed into the law the Bipartisan Budget Act of 2015 (the “Act”), which contains language that will significantly change how hospital-based outpatient care is reimbursed....more

Beyond residency: How the Medicare program treats fellowship training

Teaching hospitals are often responsible for the clinical training of three different categories of trainees: - Interns, or trainees in their first year of residency training - Residents, or trainees who have...more

Budget Deal Alters Reimbursement to Off-Campus Hospital-Owned Facilities

On November 2, 2015, President Obama signed into law H.R. 1314, the Bipartisan Budget Act of 2015 (the "Act"), which significantly changes Medicare reimbursement for off-campus hospital services. The Act, which Congress...more

Budget Deal Limits Payment to New Off-Campus Hospital Outpatient Departments

On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015 (the “Act”) into law. The Act, widely hailed as a rare act of bipartisan cooperation, raises the federal debt ceiling and sets federal spending...more

Budget Deal to Limit Provider-Based Status, Extend Sequestration

On October 28 and 30, 2015, the U.S. House of Representatives and U.S. Senate approved the Bipartisan Budget Act of 2015 (the Act)—a measure designed to raise the limit on Federal borrowing that would also have significant...more

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

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

Congress Take Step Toward Site-Neutral Medicare Payments in Bipartisan Budget Act of 2015

On October 28, 2015, the U.S. House of Representatives approved legislation that, if enacted, would, among other things, substantially alter how and how much Medicare pays for outpatient services furnished by hospitals. The...more

Budget Bill Aims to Kill Any New Off-Campus Provider-Based Facilities

Legislation being drafted as part of a budget deal between members of Congress and the White House includes language that will significantly alter the future of hospital-based outpatient care. The “discussion draft” of the...more

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