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Health Care Reimbursement and Payor Dispute Update Special Edition – Year End Regulatory Review

The Centers For Medicare & Medicaid Services Issues New Inpatient Prospective Payment System Final Rule - On September 3, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2021 Medicare...more

CMS Launches New Primary Care Payment Models

On April 22, 2019, the Centers for Medicare and Medicaid Services (“CMS”) announced four new voluntary payment models that could allow primary care practitioners like physicians or advanced practice nurses, hospitals or other...more

Continuing Resolution Creates Significant Changes to Medicare and Medicaid Policies

The Bipartisan Budget Act of 2018, commonly referred to as the “Continuing Resolution,” was recently signed into law, creating a short-term fix to funding the federal government for six weeks while also raising the debt...more

CMMI Requests Ideas to Spur Innovation and Reduce Burden

The Center for Medicare & Medicaid Innovation (CMMI) is seeking ideas on how to better drive change and reduce regulatory burden. CMMI solicited ideas to shape the agency’s future activities through a September 2017 “request...more

MACRA: Proposed Changes to the Merit-Based Incentive Payment System Track

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule on the Medicare Quality Payment Program (QPP) in the Federal Register1 on June 30, 2017. This rule proposes the QPP program requirements for...more

340B Covered Entities Beware: CMS Proposes Drastic Drug Reimbursement Rate Cuts

In its Outpatient Prospective Payment System proposed rule ("Proposed Rule"), CMS outlined a significant Medicare Part B payment reduction for separately payable, nonpassthrough drugs provided in the hospital outpatient...more

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