Albert Shay on Medicare

CMS Proposes Additional Revisions to the 60-Day Rule

The Centers for Medicare & Medicaid Services has issued its Calendar Year 2025 Medicare Physician Fee Schedule Proposed Rule, scheduled for publication in the Federal Register on July 31, 2024. In response to industry...more

7/25/2024 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Physician Fee Schedule , Physicians

OIG Approves Consultant’s Provision of Gift Cards to Physician Practices

The US Department of Health and Human Services Office of Inspector General (OIG) published favorable Advisory Opinion No. 23-15 on January 3, which concluded that a consultant’s proposal to provide gift cards to existing...more

1/19/2024 / Anti-Kickback Statute , Client Referrals , Department of Health and Human Services (HHS) , Gift-Cards , Health Care Providers , Medicare , OIG , Physicians

How the End of the PHE Will Impact the Healthcare Industry

The Biden administration announced on January 30, 2023 that the COVID-19 Public Health Emergency (PHE) would officially end on May 11, 2023. The PHE declaration, which first was issued by the Secretary of the US Department of...more

5/11/2023 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Emergency Use Authorization (EUA) , Food and Drug Administration (FDA) , Life Sciences , Medicare , OCR , Public Health Emergency , Telehealth

CMS Releases Physician Fee Schedule Proposed Rule, Continuing Emphasis on Equity and Value-Based Care

The Centers for Medicare & Medicaid Services on July 7 released its proposed rule for the Medicare physician fee schedule for Calendar Year 2023. Among other updates, the proposed rule contains significant programmatic...more

7/12/2022 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Shared Savings Program , Physician Fee Schedule , Physicians , Proposed Rules

DC Circuit Court: CMS Rule on Drug Pricing Disclosure Exceeds Statutory Authority

In an informative decision for challenging rules that portend government overreach, the US Court of Appeals for the District of Columbia Circuit upholds the invalidation of the Centers for Medicare and Medicare Services’ drug...more

6/22/2020 / Centers for Medicare & Medicaid Services (CMS) , Disclosure Requirements , Drug Pricing , Medicare , Pharmaceutical Industry , Prescription Drugs , Transparency

CMS Publishes Six Proposed Medicare Payment Rules: What It All Means

Key themes emerging from the hundreds of pages of proposed Medicare payment and policy rules impacting hospitals and post-acute providers include encouraging price transparency, promoting exchange of healthcare data, and...more

5/14/2018 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Hospitals , Inpatient Prospective Payment System (IPPS) , Medicare

Senate Finance Committee Examines Repeal of the Stark Law

A new report suggests that the Stark law is obsolete in new payment models. On June 30, the US Senate Committee on Finance (the Committee) released the report Why Stark, Why Now? Suggestions to Improve the Stark Law to...more

7/7/2016 / Affordable Care Act , AHLA , Alternative Payment Models (APM) , Anti-Kickback Statute , Civil Monetary Penalty , False Claims Act (FCA) , Fraud Abuse and Waste , Health Care Providers , Legislative Agendas , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , Physicians , Repeal , Stark Law

CMS Releases 2016 Physician Fee Schedule

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

7/10/2015 / ACOs , Alternative Payment Models (APM) , Centers for Medicare & Medicaid Services (CMS) , Client Referrals , Comment Period , Exceptions , FQHC , Healthcare , Hospitals , Medicaid , Medicare , Physician Fee Schedule , Physicians , Proposed Regulation , Rural Health Care Providers , Stark Law

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