On June 7, 2022, after months of written warnings, the U.S. Centers for Medicare & Medicaid Services (CMS) has levied its first fines nationwide on two affiliated Georgia hospitals for violations of CMS’ Hospital Price...more
On July 19, 2021 the Centers for Medicare and Medicaid Services (CMS), as part of proposed rule covering a variety of subjects, including Medicare Hospital Outpatient and Ambulatory Surgery Center PPS modifications, issued a...more
The Centers of Medicare and Medicaid Services (CMS) issued a Final Rule (the Rule) on April 29, 2021 extending and making various revisions to the Comprehensive Care for Joint Replacement Model (the CJR Model). The CJR Model...more
By letter dated April 13, 2021 (Letter), the Democrat and Republican leadership of the House Committee on Energy and Commerce and its Subcommittee on Health, wrote United States Health and Human Services Secretary, Xavier...more
On December 29, 2020, the United States Court of Appeals for the District of Columbia issued its opinion in American Hospital Association v. Azar (the Opinion) upholding the Hospital Transparency Regulation (the Rule) issued...more
1/13/2021
/ Administrative Procedure Act ,
Affordable Care Act ,
American Hospital Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Corrective Action Plans (CAPs) ,
Department of Health and Human Services (HHS) ,
First Amendment ,
Hospitals ,
New Regulations ,
New Rules ,
PHSA ,
Price Transparency ,
Public Disclosure ,
Secretary of HHS
On November 15, 2019, the Federal Government issued two rules: one in final form and one in proposed form, both designed to increase price transparency in health care. The rules follow on the Executive Order announced by...more
12/27/2019
/ Affordable Care Act ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Hospitals ,
Price Transparency ,
Proposed Rules
On July 10, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Center for Medicare & Medicaid Innovation (Innovation Center) released a much awaited proposal for a new bundled payment model for radiation...more
8/6/2019
/ Bundled Payments ,
Cancer ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Hospitals ,
Medicare ,
NPRM ,
Proposed Rules ,
Quality of Care Standards
In April, the IRS released a private letter ruling denying section 501(c)(3) status to an accountable care organization (“ACO”) that contracted with third-party payers outside of the Medicare Shared Savings Program (“MSSP”)....more
7/15/2016
/ 501(c)(3) ,
ACOs ,
Affordable Care Act ,
Exempt Organizations ,
Health Care Providers ,
Hospitals ,
IRS ,
Medicare Shared Savings Program ,
Physicians ,
Private Letter Rulings ,
Third-Party ,
Unrelated Business Income Tax
Approximately 800 hospitals in 67 Metropolitan Statistical Areas will begin mandatory participation in the Comprehensive Care for Joint Replacement (CJR) Model on April 1, 2016. The CJR bundled payment program applies to...more
Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more
11/3/2015
/ ACOs ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Fee-for-Service ,
Fraud and Abuse ,
Health Care Providers ,
Health Information Technologies ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Medicare ,
Medicare Shared Savings Program ,
OIG ,
Suppliers ,
Telehealth ,
Telemedicine ,
Value-Based Purchasing ,
Waivers
Cooperative Hospital Service Organizations (CHSOs) are organizations that are available for hospitals considering certain types of joint ventures with other hospitals. If the terms for their use strictly meet the regulatory...more
The financial situation for hospitals and health care organizations remains challenging. The accrediting agencies, Moody’s, Fitch, and S&P all have negative outlooks for the hospital industry. Hospitals are facing numerous...more
11/11/2014
/ Capital Requirements ,
Corporate Financing ,
Financing ,
Fitch ,
Funding ,
Health Care Providers ,
Hospitals ,
Moody's ,
Real Estate Investments ,
Recapitalization ,
S&P
The American Hospital Association (AHA) submitted a letter to the Centers for Medicare and Medicaid Services (CMS) on April 17, 2014, recommending modifications to the Medicare Shared Savings Program (MSSP) and the Pioneer...more
The environment for independent community hospitals is challenging. Government reimbursement reductions, technology enhancements and other capital demands, preparation for a changing health care system based on population...more