Thomas Coons

Baker Donelson

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CMS Final Rule and 21st Century Cures Act Include Good and Bad News for Provider-Based Sites

CMS recently published its final outpatient prospective payment system (OPPS) rule, which includes its new policies governing payment related to services furnished at off-campus provider-based departments (OPBDs). 81 Fed....more

12/16/2016 / 21st Century Cures Initiative , Centers for Medicare & Medicaid Services (CMS) , Dedicated Emergency Departments , Final Rules , Hospitals , Medicare , Off-Campus Departments , Outpatient Prospective Payment System (OPPS) , Provider Payments , Relocation

Highlights of the 2015 OPPS and ASC Final Rule

On October 31, 2014, CMS published its 2015 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Policy Changes and Payment Rates final rule. This annual rule affects the 4,000...more

11/18/2014 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Hospitals , OPPS , Patient Prospective Payment System

CMS Waves Partial White Flag in Appeals of Payment Status Denials

For the last several years, hospitals, on the one hand, and the Centers for Medicare and Medicaid Services and its contractors (collectively, CMS), on the other, have been engaged in a spirited dispute over claims denials for...more

9/8/2014 / Administrative Appeals , Centers for Medicare & Medicaid Services (CMS) , Claim Procedures , Final Rules , Hospitals , Inpatient Prospective Payment System (IPPS) , Medicaid , Medicare , OMHA

CMS Publishes FY 2015 Final IPPS Rule

On August 4, 2014, CMS posted its final changes and updates to the Medicare Inpatient Prospective Payment System (IPPS) that apply for fiscal year (FY) 2015, effective October 1, 2014. Below are some of the highlights of the...more

8/12/2014 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Hospitals , Inpatient Prospective Payment System (IPPS) , Long Term Care Facilities , Medicaid , Medicare , Physician Medicare Reimbursements

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