News & Analysis as of

Physician Medicare Reimbursements Accountable Care Organizations

The Financial Impact of MACRA – Uncertainty Reigns in a Recent Rand Corporation Study

With all the talk of the Affordable Care Act’s uncertain future, it is easy to forget about the Medicare Access and CHIP Reauthorization Act (“MACRA”), a bipartisan law passed by Congress in 2015 to change the way physicians...more

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

by Snell & Wilmer on

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

CMS Continues Efforts to Improve Patient Care, Spending, and Population Health

by Pierce Atwood LLP on

On November 2, 2016, the Centers for Medicare and Medicaid Services (CMS), released the 2017 Medicare Physician Fee Schedule (MPFS) final rule, which finalized a number of new policies designed to improve Medicare payment for...more

Making Sense of the MACRA Final Rule, Part 2 of 3: Alternative payment Models

by Polsinelli on

Many observers view the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a game changer for the delivery and payment of health care services. On Oct. 14, 2016 the Centers for Medicare & Medicaid Services...more

CMS Releases List of Additional Advanced APM’s and Announces Vermont’s All-Payer ACO

by Pierce Atwood LLP on

On the heels of the release of its final rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA), the Centers for Medicare and Medicaid Services (CMS) released its 2017 list of Advanced Alternative Payment...more

Making Sense of the MACRA Final Rule, Part 1 of 3: Essential Concepts

by Polsinelli on

On Oct. 14, the Centers for Medicare & Medicaid Services (CMS) published a final rule with comment period implementing the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The nearly 2,400 pages of...more

CMS Finalizes Sweeping Changes to Medicare Physician Payments

by Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Oct. 14, 2016, released the highly anticipated Final Rule implementing the Medicare physician payment reforms enacted as part of the Medicare Access and CHIP...more

CMS Finalizes New Medicare Quality Payment Program: "Flexibility" and "Pick Your Pace" Key Themes

by Pierce Atwood LLP on

After receiving roughly 4,000 comments to its proposed rule, the Centers for Medicare and Medicaid Services (CMS) on October 14, 2016 released its final rule for implementing the Medicare Access and CHIP Reauthorization Act...more

Washington Healthcare Update

by McGuireWoods LLP on

On Oct. 8, the House Republican caucus did not select a candidate for Speaker of the House and selection has been delayed. The current Speaker, John Boehner (R-OH), had announced that he would step down and retire from...more

Clinically Integrated Networks: Privacy and Security Concerns with Sharing Data

by BakerHostetler on

The Centers for Medicare & Medicaid Services (CMS) is changing reimbursement methodologies for healthcare providers from a fee-for-service model to a value-based model. Healthcare providers are responding to the changing...more

2014 Medicare ACO Results Released: CMS Asserts Success but Few ACOs Receive Payments

by Foley & Lardner LLP on

The Centers for Medicare and Medicaid Services (CMS) released, on August 25, 2015, the quality and financial performance results for Medicare Accountable Care Organizations for 2014. CMS touted that Medicare ACOs continued to...more

Medicare Shared Savings Program - 2015: What's Changed, What's New, and What's to Come?

by Baker Ober Health Law on

The most recent Shared Savings Program final rule, published in the Federal Register on June 9, 2015, finalizes a number of the revisions to the original November 2011 final rule that CMS proposed on December 8, 2014. In...more

“Next-Generation ACO” Model Is CMS’s Newest Effort to Encourage More ACO Risk

by Epstein Becker & Green on

On March 10, 2015, the Centers for Medicare & Medicaid Services’ (“CMS’s”) Center for Medicare and Medicaid Innovation (“Innovation Center”) announced a demonstration project incorporating new risk models for reimbursement of...more

Medicare Moves Strongly to Value Based Payment...A Tipping Point?

by Smith Anderson on

Over the last several years, doctors and other health-care professionals have worked to transform accountable care organizations (ACOs) from an academic idea into a meaningful presence in the health-care marketplace. Last...more

HHS Aims to Tie Most Medicare Reimbursements To Quality By 2018

Health and Human Services (HHS) Secretary Sylvia M. Burwell announced on January 26, 2015, specific goals and a timeline for shifting Medicare reimbursements from the traditional fee-for-service (FFS) model, to a quality or...more

Health Headlines: Also in the News - June 2014 #3

by King & Spalding on

MedPAC Recommends Short- and Long-Term ACO Changes – In a comment letter sent to CMS Administrator Marilyn Tavenner on June 16, 2014, the Medicare Payment Advisory Commission (MedPAC) outlined certain challenges associated...more

Birmingham Medical News: 2012 Health Care Year In Preview

by Burr & Forman on

The health care events of 2012 can be properly divided into "Before" and "After": Before the Supreme Court ruling on the Affordable Care Act and President Obama's re-election and After. Before these two events, the viability...more

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