On Thursday, April 8, 2021, the Center for Medicare and Medicaid Innovation (the “Innovation Center”) announced its final list of 53 organizations set to participate in the Global and Professional Direct Contracting (“GPDC”)...more
On December 3, 2020, Centers for Medicare & Medicaid Services (“CMS”) announced key details concerning a new value-based reimbursement and patient care model – the Geographic Direct Contracting Model (the “Model” or “Geo”)....more
On March 17, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum to provide information to organizations that participate in the Programs of All-Inclusive Care for the Elderly (“PACE”) program in...more
January 30th, 2020 marked a dramatic change in Medicaid funding, as the Trump Administration and Centers for Medicare & Medicaid Services (“CMS”) showcased a plan, called the “Healthy Adult Opportunity,” that would permit...more
On April 21, 2019, the Center for Medicare and Medicaid Innovation (“CMMI”) announced the CMS Primary Cares Initiative – a voluntary, risk-based initiative to transform the Medicare program’s reimbursement of primary care...more
12/2/2019
/ Alternative Payment Models (APM) ,
Applications ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Fee-for-Service ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Letters of Intent ,
Medicaid ,
Medicare ,
Physicians ,
Value-Based Care
On April 22, 2019, the U.S. Department of Health and Human Services (“HHS”) and Centers for Medicare & Medicaid Services (“CMS”) announced the CMS Primary Cares Initiative (the “Initiative”), which consists of new payment...more
On December 27, 2018, the U.S. District Court for the District of Columbia issued an opinion that ruled against the Trump Administration in its plan to cut funding from the 340B Drug Pricing Program (“340B...more
1/15/2019
/ American Hospital Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medical Reimbursement ,
Medicare ,
Pharmaceutical Industry ,
Preliminary Injunctions ,
Prescription Drugs ,
Section 340B ,
Trump Administration
On October 2, 2018, the CEOs of more than 700 hospitals and health systems representing healthcare providers in all fifty states sent a letter to Congress (the “Letter”) in a collective effort to protect the 340B Drug Pricing...more
As discussed in our previous blog, “CMS Pushes for Hospital Price Transparency in Proposed Rule”, on April 24, 2018, the Centers for Medicare & Medicaid Services (“CMS”) announced a proposed rule (CMS-1694-P) aimed at...more
On April 24, 2018, the Centers for Medicare & Medicaid Services (“CMS”) announced a new proposed rule (CMS-1694-P) (“Proposed Rule”). In an attempt to “empower patients through better access to hospital price information,”...more
5/14/2018
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Patients ,
Price Transparency ,
Proposed Rules ,
Public Comment
Despite the Trump Administration’s unsuccessful attempts to fully repeal and replace the Affordable Care Act (the “ACA”), the Administration has continued to target the ACA. In the Administration’s latest salvo, the Centers...more
On January 25, 2018, Associate Attorney General Rachel Brand issued a memorandum on behalf of the U.S. Department of Justice (DOJ) (the “Brand Memo”) which effectively limits the use and enforcement power of guidance...more
In November of last year, we wrote about a preliminary injunction being sought by hospital advocacy groups attempting to stop implementation of the Trump administration’s cuts to the 340B Drug Pricing Program (“340B...more
1/5/2018
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Final Rules ,
Hospitals ,
Medical Reimbursement ,
Medicare ,
Medicare Payment Reform ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Preliminary Injunctions ,
Prescription Drugs ,
Section 340B
On November 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the final rule, “Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting...more
11/20/2017
/ Ambulatory Surgery Centers ,
American Hospital Association ,
Budget Cuts ,
Centers for Medicare & Medicaid Services (CMS) ,
Covered Entities ,
Drug Pricing ,
Final Rules ,
Health Clinics ,
Healthcare Facilities ,
Hospitals ,
HRSA ,
Medical Reimbursement ,
Medicare ,
Medicare Payment Reform ,
New Rules ,
Outpatient Prospective Payment System (OPPS) ,
Outpatient Quality Reporting ,
Pharmaceutical Industry ,
Preliminary Injunctions ,
Prescription Drugs ,
Presidential Memorandum ,
Public Health Service Act ,
Section 340B ,
Trump Administration
As we reported last month, CMS’ proposed rule updating MACRA’s Quality Payment Program (“QPP”) for CY 2018 would extend and expand exceptions that would allow many practitioners to avoid participating in its Merit-based...more
In a proposed rule published Tuesday, August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its intention to roll back a handful of payment models introduced under the Obama Administration. If...more
On June 20, 2017, CMS released its proposed rule updating MACRA’s Quality Payment Program (“QPP”) for CY 2018. At over 1,000 pages, the rule might not do much to simplify the already complex requirements of the QPP; however,...more