The Centers for Medicare & Medicaid Services (CMS) issued the final rule for fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) on Aug. 1, 2024....more
The Centers for Medicare & Medicaid Services (CMS) issued the CMS Interoperability and Prior Authorization Final Rule (Final Rule) on Jan. 17, 2024. The agency proposed the rule in December 2022 (See Holland & Knight's...more
The Centers for Medicare & Medicaid Services (CMS) released the final calendar year (CY) 2024 Physician Fee Schedule (PFS) on Nov. 2, 2023. The rule, which finalizes policies for Medicare payments under the PFS and other...more
11/15/2023
/ Ambulance Providers ,
Centers for Medicare & Medicaid Services (CMS) ,
Community Health Systems ,
Data Collection ,
Effective Date ,
Electronic Monitoring ,
Final Rules ,
Health Care Providers ,
Medicare ,
Medicare Part B ,
Physician Fee Schedule ,
Physicians ,
Prescription Drugs ,
Rural Health Care Providers ,
Telehealth
Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more
11/13/2023
/ Artificial Intelligence ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Confirmation Proceedings ,
Congressional Committees ,
Continuing Resolution ,
Executive Orders ,
False Advertising ,
Federal Funding ,
Final Rules ,
Government Shutdown ,
Health Care Providers ,
Medicare Advantage ,
Medicare Part D ,
National Institute of Health (NIH) ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Prescription Drugs
The Centers for Medicare & Medicaid Services (CMS) released a final rule on Nov. 2, 2023, detailing how the agency will remedy underpayments from 2018 to 2022 for drugs acquired via the 340B Drug Pricing Program. The final...more
11/13/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Final Rules ,
Hospitals ,
Medicare ,
MedPAC ,
Outpatient Prospective Payment System (OPPS) ,
Prescription Drugs ,
Section 340B ,
Underpayment
Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector.
...more
10/18/2023
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Deductibles ,
Department of Health and Human Services (HHS) ,
Final Rules ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Hospitals ,
Information Reports ,
Medicare ,
Medicare Part A ,
Medicare Part B ,
National Institute of Health (NIH) ,
Nonprofits ,
Outpatient Prospective Payment System (OPPS) ,
Pfizer ,
Physician Fee Schedule ,
Premiums ,
Presidential Nominations ,
Public Policy ,
Section 340B ,
Speaker of the House
The Centers for Medicare & Medicaid Services (CMS) on Aug. 1, 2023, published its final rule for the federal fiscal year (FY) 2024 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective...more
8/8/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
EHR ,
Final Rules ,
Graduate Medical Education ,
Health Care Providers ,
Healthcare Facilities ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Medicare ,
Prospective Payment System (PPS) ,
Rural Health Care Providers ,
Value-Based Care
The Centers for Medicare & Medicaid Services (CMS or Agency) on April 10, 2023, published its annual proposed rule for the federal fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital...more
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2022, released the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule...more
11/15/2022
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medicare ,
Mental Health ,
Organ Transplant Centers ,
Outpatient Prospective Payment System (OPPS) ,
Pain Management ,
Prescription Drugs ,
Rural Health Care Providers ,
Section 340B ,
Telehealth
The Centers for Medicare & Medicaid Services (CMS) on Aug. 1, 2022, released the final rule for the federal fiscal year (FY) 2023 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) payment system....more
8/11/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Coronavirus/COVID-19 ,
Disproportionate Share Adjustments ,
Final Rules ,
Graduate Medical Education ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Long Term Care Facilities ,
Medicare ,
Reproductive Healthcare Issues ,
Rural Health Care Providers
Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics...more
8/3/2022
/ Appropriations Bill ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Final Rules ,
Health Care Providers ,
Medicaid ,
Medicare Part D ,
Nursing Homes ,
Proposed Legislation ,
Public Health Emergency ,
Telehealth
The Centers for Medicare & Medicaid Services (CMS) has released the Final Rule with a comment period for the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; Changes to Medicare Graduate Medical...more
12/21/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Consolidated Appropriations Act (CAA) ,
Final Rules ,
FTEs ,
Graduate Medical Education ,
Health Care Providers ,
Healthcare Facilities ,
Hospitals ,
HRSA ,
Inpatient Prospective Payment System (IPPS) ,
Medicaid ,
Medicare ,
Organ Donation ,
Rural Health Care Providers
The Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule on Nov. 2, 2021,...more
The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2021 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Note that the...more
12/9/2020
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Clinical Laboratories ,
Coronavirus/COVID-19 ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Physician-Owned Hospitals ,
Prescription Drugs
The Centers for Medicaid & Medicaid Services (CMS) has released the Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final...more
Under Section 1557 of the Affordable Care Act (Section 1557), "covered entities," which were defined as health programs or activities that receive "federal funding" from the U.S. Department of Health and Human Services (HHS)...more
On November 15, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule requiring pricing information to be made publicly available. The 2020 Outpatient Prospective Payment System (OPPS) & Ambulatory...more
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, released the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule....more
11/13/2019
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Community Health Systems ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Rural Health Care Providers ,
Section 340B ,
Transparency
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B,...more
11/11/2019
/ Alternative Payment Models (APM) ,
Ambulance Providers ,
Bundled Payments ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Treatment ,
Final Rules ,
Health Care Providers ,
Medical Records ,
Medicare ,
Medicare Part B ,
MIPS ,
Open Payments ,
Opioid ,
PHI ,
Physician Fee Schedule ,
Physicians ,
Public Comment ,
Quality Payment Program (QPP) ,
Substance Abuse ,
Telehealth
On August 2, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital Prospective Payment System...more
8/9/2019
/ Applications ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Payment Systems ,
Proposed Rules ,
Public Comment ,
Rulemaking Process ,
Value-Based Purchasing ,
Wage Index
• The Centers for Medicare & Medicaid Services (CMS) has issued the Calendar Year (CY) 2019 Final Rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory...more
11/13/2018
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Data Collection ,
Emergency Rooms ,
Final Rules ,
Health Care Providers ,
Health Clinics ,
Hospitals ,
Medicare ,
Off-Campus Departments ,
Outpatient Prospective Payment System (OPPS) ,
Payment Rates ,
Physician Fee Schedule ,
Physician Medicare Reimbursements ,
Physicians ,
Policies and Procedures ,
Prescription Drugs ,
Section 340B
• The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2019 Final Rule for the Medicare Physician Fee Schedule (PFS), which includes provisions related to Medicare physician payments as well...more
11/7/2018
/ Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medicare ,
Medicare Part B ,
MIPS ,
MPFS ,
Pharmaceutical Industry ,
Pharmacies ,
Physician Medicare Reimbursements ,
Physician Payments ,
Physicians ,
Policies and Procedures ,
Prescription Drugs ,
Quality Payment Program (QPP) ,
Telehealth
On Aug. 1, 2018, the Departments of Health and Human Services (HHS), Labor and Treasury jointly issued the Short-Term, Limited-Duration Insurance Final Rule. The rule is the second of three regulations resulting from...more
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2017, released the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System Final Rule for...more
11/13/2017
/ ADLT ,
Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Hospitals ,
Laboratories ,
Medicaid ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Medicare Part B ,
MPFS ,
Outpatient Prospective Payment System (OPPS) ,
Payment Rates ,
Physicians ,
Policies and Procedures ,
Prescription Drugs ,
Quality Payment Program (QPP)