News & Analysis as of

Patient Protection and Affordable Care Act (PPACA) Centers for Medicare & Medicaid Services (CMS) Payment Plans

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
Baker Donelson

CMS Proposes FQHC Prospective Payment System

Baker Donelson on

On September 23, 2013, CMS published a proposed rule to overhaul the payment methodology for federally qualified health centers (FQHCs). The proposed rule will change FQHC reimbursement from an all inclusive rate (AIR),...more

King & Spalding

CMS Releases FY 2014 Hospital IPPS Final Rule

King & Spalding on

On August 2, 2013, CMS released the annual Hospital Inpatient Prospective Payment System Final Rule for FY 2014 (the “Final Rule”), effective for discharges occurring on or after October 1, 2013....more

Baker Donelson

CMS Proposes FY 2014 Payment Rates and Policies for Medicare Inpatient Rehabilitation Facilities

Baker Donelson on

On May 2, 2013, CMS released a proposed rule [PDF] for the Inpatient Rehabilitation Facility Prospective Payment System for fiscal year (FY) 2014. The proposed rule sets forth Medicare payment policies and rates governing...more

BakerHostetler

Bringing Sunlight to Healthcare Pricing: The CMS Release of Hospital Charge Data

BakerHostetler on

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337 Medicare hospitals for 100 of the most common inpatient diagnosis related...more

Morgan Lewis

OIG Revises Special Advisory Bulletin on Exclusions

Morgan Lewis on

OIG continues its aggressive interpretation of scope and effect of exclusion from participation in Federal health care programs and clarifies several open questions....more

Baker Donelson

The New DSH - Are You Supplying The Correct Data That Will Drive Your Payments?

Baker Donelson on

Effective October 1, 2013, CMS will begin paying disproportionate share hospitals differently. Congress ordered the change to the disproportionate share hospital (DSH) adjustment payment methodology as part of the Patient...more

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