Catherine Stern

Catherine Stern

King & Spalding

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CMS Extends Timeline to Finalize Updated Medicare Rules for Hospitals to June 2020

In 2016, CMS issued a proposed rule to update the requirements that hospitals and critical access hospitals must meet to participate in Medicare and Medicaid programs....more

6/12/2019  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicaid , Medicare , Proposed Rules , Time Extensions

Major Changes to the Medicare Shared Savings Program Impact Current and Prospective ACOs

CMS issued final rules on December 21, 2018, that were published in the December 31, 2018 Federal Register (ACO Final Rules), adopting major changes to the Medicare Shared Savings Program (MSSP) which impact currently...more

1/2/2019  /  ACOs , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Shared Savings Program

OIG Report Alleges that Telehealth Claims Did Not Meet Medicare Requirements

OIG recently issued a report in April 2018 titled, “CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements,” in which it claims to have found that CMS improperly paid practitioners in 31 of 100...more

4/25/2018  /  Centers for Medicare & Medicaid Services (CMS) , Medicare , OIG , Telehealth

CMS Announces Plans to Expand Settlement Options to Decrease Medicare Appeals Backlog

On November 3, 2017, CMS announced that it plans to implement two appeals settlement initiatives designed to decrease the backlog of Medicare appeals pending at the Medicare Appeals Council (MAC) of the Department Appeals...more

11/27/2017  /  Administrative Backlogs , Appeals , Centers for Medicare & Medicaid Services (CMS) , Medicare , Medicare Appeals Council , OMHA

Senate Finance Committee May Tackle Medicare Appeals Backlog

According to Kimberly Brandt, Chief Oversight Counsel for the Senate Finance Committee’s majority staff, the Senate Finance Committee could reintroduce the Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of...more

4/17/2017  /  Administrative Law Judge (ALJ) , Medicare , OMHA , Stark Law

CMS Proposes New Bundled Payment Models for Cardiac and Orthopedic Care

On July 25, 2016, CMS posted a proposed rule that would create three new Medicare Parts A and B episode payment models for patients admitted for care for a heart attack, bypass surgery or surgical hip/femur fracture treatment...more

8/3/2016  /  Alternative Payment Models (APM) , Bundled Payments , Centers for Medicare & Medicaid Services (CMS) , Hospitals , Medicare , Medicare Access and CHIP Reauthorization (MACRA) , Medicare Part A , Medicare Part B , Payment Systems
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