Provider Payments

News & Analysis as of

Preparing for the Conversion to ICD-10

With the ICD-10 implementation date delayed once again until October 1, 2015, providers who were previously unprepared for the transition or had only begun their transition planning have an extra year to address the upcoming...more

CMS Proposes Significant Rate Cuts and Other Changes to Medicare Advantage and Prescription Drug Plans

The Advance Notice ("Advance Notice") of Methodological Changes for Calendar Year ("CY") 2015 for Medicare Advantage ("MA") Capitation Rates, Part C and Part D Payment Policies and 2015 Call Letter was released by the Centers...more

The ERISA Litigation Newsletter - February 2014

The employee benefits issues to be considered by the U.S. Supreme Court continue to be of great significance to plan sponsors and fiduciaries. This month we review the Court's employee benefit decisions from 2013 and also...more

Polsinelli Podcast - Health Care Payment Changes: From Service to Value [Video]

Healthcare is changing for consumers and providers under the Affordable Care Act. Less publicized is the way providers are now being paid and the way they will work together. In this week's Polsinelli "Inside Law," podcast,...more

CMS Announces New Payment Model for Maryland

On January 10, 2014, CMS announced that Maryland is shifting to the “the Maryland All-Payer Model,” a new payment model based on a CMS Innovation Center program that tests payment and delivery models. ...more

CMS Releases Proposed FFY 2014 SNF PPS Rule

CMS has released its proposed federal fiscal year (FFY) 2014 prospective payment system (PPS) rule for Medicare Skilled Nursing Facilities (SNFs). The rule projects a net increase in operating payments to SNFs in the amount...more

Exclusions: OIG Offers Relationship Counseling to Providers

On May 8, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued an updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs...more

New Metropolitan Areas Could Affect Medicare Payment, Regulations

The U.S. Office of Management and Budget recently announced new Metropolitan Areas based on revised standards and 2010 census data. If adopted by Medicare, which they typically are, these changes would affect many aspects of...more

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