On December 12, 2019, CMS approved South Carolina’s proposal for a demonstration project that would add work, or community engagement, requirements as part of the eligibility determinations for the state’s Medicaid plan. ...more
On July 29, 2019, CMS published a proposed rule revising the factors for determining Medicare payment rates under the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more
8/7/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Hospitals ,
Innovative Technology ,
Inpatient Quality Reporting ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Price Transparency ,
Proposed Rules ,
Rural Health Care Program ,
Section 340B ,
Surgical Center Requirements
In a long-awaited ruling, on May 6, 2019, Judge Rudolph Contreras of the U.S. District Court for the District of Columbia declined to vacate the Secretary’s CYs 2018 and 2019 Outpatient Prospective Payment System (OPPS)...more
5/15/2019
/ American Hospital Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Injunctive Relief ,
Medicare ,
Motion to Vacate ,
Outpatient Prospective Payment System (OPPS) ,
Prescription Drugs ,
Remand ,
Secretary of HHS ,
Section 340B ,
Ultra Vires ,
Vacatur
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
CMS intends to release its second enrollment period for the Bundled Payment for Care Improvement (BPCI) Advanced payment model sometime in April 2019, allowing for eligible providers to participate beginning January 1, 2020...more
January 18, 2019, CMS’s Center for Medicare and Medicaid Innovation (CMMI) announced a new payment model aimed at lowering drug prices in Medicare Part D, named the Part D Payment Modernization model (the Part D Model). In...more
In OIG Report No. A-01-17-00500 (the OIG Report), OIG allegedly identifies “significant vulnerabilities” in the wage index system that result in inappropriately-adjusted Medicare payments. The OIG Report recommends several...more
On November 13, 2018, CMS issued a letter to State Medicaid Directors, SMD #18--011 (Letter), announcing strategies to support innovative service delivery systems for adults with serious mental illness (SMI) and children with...more
CMS made available the First Annual Report (the Report) evaluating performance year one of the Comprehensive Care for Joint Replacement (CJR) model. Although performance year one was abbreviated (only April 1, 2016, to...more