On July 13, 2023, CMS published a proposed rule to update the payment policies, payment rates, and other provisions for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory...more
On August 2, 2021, CMS published the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule for federal fiscal year (FY) 2022. The final...more
8/10/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Long Term Care Facilities ,
Medicare ,
Medicare Advantage ,
Prospective Payment System (PPS) ,
Reporting Requirements ,
Vaccinations ,
Wage Index
Last week, the United States Court of Appeals for the Third Circuit held that prognoses of terminal illness submitted in support of hospice claims for reimbursement could be actionable false statements under the False Claims...more
On February 10, 2020, the White House unveiled its proposed budget (the Budget) for FY 2021, which would decrease funding for HHS by 10 percent. Medicare and Medicaid would bear the brunt of these cuts. For both programs...more
n November 1, 2019, CMS posted the final rule establishing the payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment System for calendar year (CY) 2020...more
11/15/2019
/ Ambulatory Surgery Centers ,
Appeals ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Lack of Authority ,
Medical Devices ,
Medicare ,
Off-Campus Departments ,
Outpatient Prospective Payment System (OPPS) ,
Payment Rates ,
Prescription Drugs ,
Price Transparency ,
Prior Authorization ,
Provider Payments ,
Rural Health Care Providers ,
Section 340B
On September 25, 2019, the United States Court of Appeals for the Eleventh Circuit affirmed a lower court’s decision to deny a motion for a preliminary injunction to stay the implementation of the new policy for allocating...more
10/4/2019
/ Amended Rules ,
Appeals ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Hospitals ,
Injunctive Relief ,
Likelihood of Success ,
Motion To Stay ,
Organ Transplant Centers ,
Preliminary Injunctions ,
Remand
In a ruling dated June 10, 2019, the United States Court of Appeals for the Fifth Circuit sided with Mississippi hospitals in a dispute over the calculation of the Medicare DSH payment. Forrest General Hospital v. Azar, No....more
On April 23, 2019, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for FY 2020 (the Proposed Rule), which will affect...more
4/30/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Graduate Medical Education ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Long Term Care Facilities ,
Medicare ,
Proposed Rules ,
Quality Payment Program (QPP) ,
Regulatory Requirements
Last week, CMS announced on its website that for cost reporting periods beginning on or after October 1, 2019, providers must comply with a so-called “longstanding” rule to claim reimbursement for crossover bad debts from the...more
For the first time in nearly a decade, the Advanced Medical Technology Association (AdvaMed) has updated its Code of Ethics on Interactions with Heath Care Professionals (HCPs) in the United States (the Code or the AdvaMed...more