News & Analysis as of

CMMI

Reportedly Leaked White House Policy “Wish-List” Lists “Serious 340B Reform,” Demonstration of Value-Based Payments for Drugs and...

by King & Spalding on

A While House policy “wish-list,” reportedly leaked on October 19 (Policy Document), identifies what appear to be the Trump Administration’s policy goals for various government programs, including Medicaid, the 340B Drug...more

CMMI Requests Ideas to Spur Innovation and Reduce Burden

by Polsinelli on

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

Trump Administration Seeks Stakeholder Input on New Direction

by K&L Gates LLP on

On September 20, 2017, the Centers for Medicare and Medicaid Services (“CMS”) released an informal request for information (“RFI”) seeking stakeholder feedback on the future direction of the Center for Medicare and Medicaid...more

CMS Seeks New Direction for Center for Medicare and Medicaid Innovation

by King & Spalding on

On September 20, 2017, the Center for Medicare and Medicaid Innovation (“CMMI”) issued an informal Request for Information (“RFI”) seeking public feedback on “a new direction to promote patient-centered care and test...more

Manatt on Health: September 2017

1332 Waivers Under Review at CMS - The Trump administration has approved one 1332 waiver to date, but four more are pending, including a sweeping Iowa waiver. Here is where things stand today...more

Impact of Value-Based Health Care on the Medical Device Industry: Three Takeaways From the Case for Transformation

by Ropes & Gray LLP on

Introduction: The Case for Transformation - In the world of fee-for-service health care, most medical devices were sold to hospitals or other health care providers for use in the diagnosis or treatment of patients. Except...more

CMMI Focuses on Behavioral Health

by Pierce Atwood LLP on

CMS recently announced that the Center for Medicare and Medicaid Innovation (CMMI) is interested in lowering the cost of care for Medicare and Medicaid beneficiaries with behavioral health conditions while improving the...more

Brave New World: Compliance and the Transition to Value-Based Care

by Ropes & Gray LLP on

The U.S. health care system is in the midst of a fundamental shift, away from traditional “fee-for-service” models that reward providers for the quantity of services provided to patients, toward value-based models designed to...more

Ten Things Investors Need to Know About Value-Based Healthcare

by Ropes & Gray LLP on

This article highlights key business and legal issues related to value-based healthcare for investors considering opportunities in the healthcare industry. 1. Value-Based Arrangements Are Here to Stay Value-based...more

More Federal Legislation Aimed at Expanding Medicare Coverage of Telehealth Services

by McDermott Will & Emery on

Late last month, Senator Cory Gardner (R-CO) and Senator Gary Peters (D-MI) introduced Senate Bill 787, the Telehealth Innovation and Improvement Act (Telehealth Improvement Act), which is focused on expanding Medicare’s...more

What’s Ahead for Value-Based Health Care?

by Ropes & Gray LLP on

Prior to the presidential election in November, experts believed that the trend toward value-based payment – the concept of rewarding providers based on the quality of care delivered, rather than the number of procedures...more

New Bundled Payments Are a Go…For Now

by Baker Ober Health Law on

CMS issued a final rule on January 3, 2017, implementing three new episode payment models (EPMs) and a Cardiac Rehabilitation (CR) incentive payment model under the authority of the Center for Medicare & Medicaid Innovation...more

Want to run the government like a business? Bring back the ACA.

by Snell & Wilmer on

Just days after his inauguration, President Donald Trump signed an executive order to delay further implementation of the Patient Protection and Affordable Care Act (ACA). This is just one of many steps the President and...more

CMS Finalizes Mandatory Cardiac and Joint Bundles … But Their Future is Uncertain

by BakerHostetler on

When Tom Price assumes the top post at the U.S. Department of Health and Human Services (HHS) later this month (subject to Senate confirmation), the ink will barely be dry on a final rule issued by the Centers for Medicare &...more

The New “Price” of U.S. Health Care: The Future of Value-based Reimbursement Under President-elect Trump and Tom Price

by Carlton Fields on

The total U.S. health care expenditure was $3.2 trillion in 2015, and is projected to grow to nearly $5.6 trillion by 2025. As our nation’s cost of care rises, both Democrats and Republicans recognize the overwhelming need to...more

CMS Issues Final Mandatory Episode Payment Models for Cardiac and Orthopedic Cases, Plus New Cardiac Rehabilitation Incentive...

by Reed Smith on

In the waning days of the Obama Administration, the Centers for Medicare & Medicaid Services (CMS) has unveiled a lengthy and complex final rule to establish mandatory Medicare bundled payment programs for acute myocardial...more

The ERISA Litigation Newsletter - December 2016

by Proskauer Rose LLP on

This month Richard Zall, Chair of Proskauer's Health Care Department, explores developments likely to occur with respect to the Affordable Care Act as a result of the new administration. In our Rulings, Filings and...more

CMS Announces Three New Innovation Models, Focusing on Patient Engagement and Dual-Eligible Population

by Reed Smith on

The CMS Center for Medicare & Medicaid Innovation (CMMI) continues to launch initiatives to test ways to improve the quality of health care while controlling cost, despite an uncertain fate under the future Trump...more

Comparison of Key Repeal and Replace Proposals

As the incoming Congress and administration develop plans to “repeal and replace” the Affordable Care Act (ACA), analysis of five earlier repeal and replace proposals provides insights into the key features likely to appear...more

Repealing and Replacing the ACA: Five Developments Likely to Occur in the Years Ahead

by Proskauer Rose LLP on

On the back of the 2016 United States presidential election results, the health care industry ponders how a Republican president and Congress will transform the business environment. The health care industry has a number of...more

What Trump’s HHS Secretary Appointment Could Mean for Healthcare Providers

by Nilan Johnson Lewis PA on

President-elect Donald Trump announced on November 28, 2016, that current House Budget Chair Representative Tom Price is his choice for Health and Human Services (HHS) Secretary. Many providers are wondering what health care...more

The Future of the Medicare Part B Payment Demo under a Republican-held Congress

There has been much controversy over the Medicare Part B payment demonstration proposed by the Center for Medicare and Medicaid Innovation (CMMI) in March 2016. As we await the release of the final rule, the fate of this...more

Promise to Repeal the ACA Poses Threat to MACRA Implementation

Most of the post-election discussion of the ACA has focused on how promises to repeal the law could impact the newly insured. But one priority area of the ACA that has received very little discussion is the federal...more

Will Republicans Embrace CMMI’s Authority?

The Affordable Care Act (ACA) and the Medicare and CHIP Reauthorization Act (MACRA) provided the Centers for Medicare & Medicaid Services (CMS) and the newly created Center for Medicare and Medicaid Innovation (CMMI)...more

Looking Ahead to a Trump Administration: Health Care and Life Sciences Industry Perspectives

by Reed Smith on

Observers are digesting what the Trump Administration will mean for the health care and life sciences industry. Forecasting is more challenging for this incoming Administration than most given the relatively sparse policy...more

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