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Stark and AKS Rules Cross the Finish Line of HHS Regulatory Sprint

With a bold finish, the Department of Health and Human Services (HHS) crossed the finish line of its race to modernize and clarify the regulations interpreting the federal physician self-referral law (Stark) and anti-kickback...more

CMS Abruptly Ends Part B Advance Payments, Announces Intent to Reevaluate Part A Accelerated Payment Program

The Centers for Medicare & Medicaid Services (CMS) announced on Sunday that it immediately is suspending its Advance Payment Program to Part B suppliers and reevaluating all pending and new applications under the Part A...more

CMS COVID-19 Interim Final Rule Issued With Retroactive March 1 Effective Date

The Centers for Medicare & Medicaid Services (CMS) released an interim final rule, Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (April 6), that makes...more

CMS Issues Stark Law Waivers for COVID-19 Purposes

To enable healthcare entities to address the unique and exigent circumstances created by the COVID-19 public health emergency, the secretary of the Department of Health and Human Services (HHS) issued waivers of sanctions...more

CMS Announces COVID-19 Exceptions and Extensions for Medicare Quality Reporting Programs

The Centers for Medicare & Medicaid Services (CMS) announced on March 22, 2020 that it is granting reporting exceptions and extensions for measure reporting and data submission in Medicare quality reporting programs in...more

The Race to Modernize Stark and the AKS: Unpacking the Value-based Proposals in HHS Regulatory Sprint Rulemaking

The U.S. Department of Health & Human Services (HHS) made great strides in its race to modernize and clarify the regulations interpreting the federal physician self-referral law (Stark), Anti-Kickback Statute (AKS) and...more

Back to School Rules Recap: Hospital and Physician Cheat Sheet on What CMS Did This Summer

Summer was no vacation for the Centers for Medicare & Medicaid Services (CMS). The agency released a series of significant rules that signal the nature and pace of CMS Medicare payment and policy changes for hospitals and...more

CMS Proposes CY 2018 Quality Payment Program Policy Changes that Signal Intent to Reduce the Pace and Burdens of MACRA

On June 30, the Centers for Medicare & Medicaid Services (CMS) issued a much anticipated rule outlining proposed payment and policy changes to the new Medicare Part B Quality Payment Program (QPP) that was created by the...more

Bundled Payments Out in the Cold? Another Delay for Mandatory Bundled Payment Models

This most recent delay raises questions concerning how the Trump administration intends to implement value-based payment in the Medicare program. The Centers for Medicare and Medicaid Services (CMS) has delayed again the...more

Bundles, MACRA and the Trump Regulatory Freeze

In the final months of the Obama administration, CMS released rules of significant import to healthcare providers, including a final rule explaining how the Quality Payment Program mandated by the Medicare Access and CHIP...more

CMS Finalizes Mandatory Cardiac and Joint Bundles … But Their Future is Uncertain

When Tom Price assumes the top post at the U.S. Department of Health and Human Services (HHS) later this month (subject to Senate confirmation), the ink will barely be dry on a final rule issued by the Centers for Medicare &...more

21st Century Cures: Not Just a Biomed Bill

The 21st Century Cures Act signed into law on December 13, 2016 is gaining significant attention as landmark legislation promoting medical innovation. But the massive Cures Act goes much further and includes some relief...more

The Wait is Over: CMS Delivers Post-BBA Provider-Based Policies in Final 2017 OPPS

Now that the rule is out, work to implement the BBA changes begins in earnest. CMS commemorated the one-year anniversary of the Bipartisan Budget Act of 2015 (BBA) with the traditional gift of paper, offering...more

Making Sense of MACRA

The countdown has begun for the momentous Part B payment reforms created by the Medicare Access and Chip Reauthorization Act of 2015 (MACRA). On October 14, 2016, CMS released a final rule explaining, in nearly 2,400 pages,...more

Year of the Bundle: CMS Proposes New Mandatory Cardiac Bundles and Expansion of CCJR

The Centers for Medicare & Medicaid Services (CMS) recently published a proposed rule that furthers the U.S. Department of Health and Human Services’ goal to promote cooperative, value-based care and tie at least 50 percent...more

Provider-Based Status Post-BBA: CMS Offers Limited Answers, Requests More Feedback

For those in the hospital industry hoping for additional clarity regarding the operation and billing of provider-based departments (PBDs), the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule provides some...more

The Future of Provider-Based Status Post-BBA 2015

This month, hospitals impacted by Section 603 of the Bipartisan Budget Act of 2015 (BBA) may finally get a glimpse of what the future holds for the off-campus departments they operated or were developing when the BBA was...more

CMS Finalizes Revisions to Stark to Ease Burden on Providers, Refines “Incident to” Requirements

In its calendar year 2016 Physician Fee Schedule Final Rule published in the Federal Register on November 16, 2015 (Final Rule), the Centers for Medicare and Medicaid Services (CMS) finalized amendments to the federal...more

Proposed Rule Aims to Refine Stark Regulations and Clarify “Incident To”

On July 15, 2015, the Centers for Medicare and Medicaid Services (CMS) published the calendar year (CY) 2016 Physician Fee Schedule Proposed Rule. In addition to updating several traditional Part B payment policies, the...more

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