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Physicians › Medicaid › Accountable Care Organizations

Ballard Spahr LLP

CMS and OIG Release Long-Awaited Stark Law and Anti-Kickback Statute Proposed Rules

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The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) recently released two proposed rules restructuring the Physician Self-Referral...more

Obermayer Rebmann Maxwell & Hippel LLP

TRANSPARENCY: Embracing CMS’s Push To Publicize Your Organization’s Performance

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The Centers for Medicare and Medicaid Services (CMS) is launching new value-based programs with great fervor as a central strategy to bend the healthcare cost curve. Value-based reimbursement models linked to achieving the...more

Dorsey & Whitney LLP

CMS’s New “Primary Cares Initiative” Places Primary Care at the Center of the Shift to Value-Based Care

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On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced two sweeping new payment innovation models under the Primary Cares Initiatives. The models will seek to incentivize primary care and other...more

Robinson+Cole Health Law Diagnosis

2019 Physician Fee Schedule Rule Review: Option to Extend MSSP Agreements for Currently-Expiring ACOs Finalized

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On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Physician Fee Schedule Final Rule (PFS Rule), which contains a number of significant substantive changes to Medicare payment practices...more

Verrill

No Summer Slump for CMS: Major Changes Proposed for the Medicare Shared Savings Program

Verrill on

On August 17, 2018, the Centers for Medicare & Medicaid Services (“CMS”) officially published a proposed rule (“Proposed Rule”) in the Federal Register that would significantly alter the Medicare Shared Savings Program...more

Sheppard Mullin Richter & Hampton LLP

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

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The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

Polsinelli

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

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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

Pierce Atwood LLP

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

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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

Holland & Knight LLP

CMS Finalizes Sweeping Changes to Medicare Physician Payments

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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

Pierce Atwood LLP

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

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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

Mintz - Health Care Viewpoints

CMS Releases MACRA Final Rule, Easing 2017 Reporting Requirements

Mintz - Health Care Viewpoints on

On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The final rule marks the most significant reform to our...more

Mintz - Health Care Viewpoints

Mintz Levin Health Care Qui Tam Update: Recent Developments & Unsealed Cases - September 2015

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Trends & Analysis - Since our last Qui Tam Update, we have identified 39 health-related False Claims Act (“FCA”) qui tam cases that have been unsealed. Of those cases...more

BakerHostetler

Clinically Integrated Networks: Privacy and Security Concerns with Sharing Data

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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

King & Spalding

CMS Issues CY 2016 Medicare Physician Fee Schedule Proposed Rule

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On July 8, 2015, CMS issued its annual proposed rule outlining payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) for CY 2016. In the proposed rule,...more

Foley & Lardner LLP

Beneficiary Assignment Under the MSSP Final Rule

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This is the fourth post in Health Care Law Today’s series on the final rule. This post addresses how CMS assigns beneficiaries to an ACO participating in the MSSP. In the MSSP ACO Final Rule, CMS finalized new...more

Morgan Lewis

CMS Releases 2016 Physician Fee Schedule

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Major changes to Stark law are ahead, including new exceptions for timeshare arrangements and employment of NPPs. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule on July 8 for the 2016...more

McGuireWoods LLP

Washington Healthcare Update

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This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more

Mintz - Health Care Viewpoints

HHS Payment and Delivery Reform Announcement Sets Priorities for Remainder of Obama Administration

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One week prior to the unveiling of the President’s first budget under a completely Republican-controlled Congress, the Department of Health and Human Services (HHS) made its most formal announcement yet on the Obama...more

Katten Muchin Rosenman LLP

Impact of Health Care Reform on Provider Liability

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In this presentation: - The Changing Healthcare Landscape - Key Features of an ACO/CIN - ACO Standards and Quality Metrics - Examples of Quality Standards - Impact on Board and Corporate...more

Saul Ewing Arnstein & Lehr LLP

How Physician Practices and Physicians Can Take Advantage of the Supreme Court's ACA Ruling

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The June 28th Supreme Court ruling to uphold the Patient Protection and Affordable Care Act ("ACA") removed some of the uncertainty surrounding the immediate short-term prospects for health care reform. Now that the debate...more

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