The fiscal year 2025 Inpatient Prospective Payment System (IPPS) final regulation has been released! Embedded in this massive, 2,987-page final reg is a new episode-based payment model, called the Transforming Episode...more
Summary On June 17, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) released a notice of funding opportunity (NOFO) for Innovation in Behavioral Health...more
Summary- On January 18, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) announced Innovations in Behavioral Health (IBH), a new eight-year model focused...more
The goal of value-based care (VBC) is to promote better care for individual patients and improved health outcomes for communities at reduced costs. This is an important and admirable purpose as many VBC stakeholders attempt...more
The Miles & Stockbridge Health Care Practice Group hosted its inaugural Hot Topics in Health Care Law seminar last month for clients from Maryland and beyond. Miles & Stockbridge health care lawyers kicked off the seminar...more
Palliative Care Defined The term “palliative care” is often used by doctors and other health care professionals during a serious illness or toward the end of life. Federal regulations define palliative care as...more
On January 9, 2024, the Centers for Medicare and Medicaid Services (CMS) approved the New York State (NY) 1115 Medicaid waiver “Medicaid Redesign Team” (MRT). The MRT is a long-standing waiver in NY that has continuously...more
On January 18th, the Centers for Medicare & Medicaid Services (CMS) announced a new demonstration model called the Innovation in Behavioral Health (IBH) Model, which is designed to improve outcomes for adults with mental...more
The Center for Medicare and Medicaid Innovation (CMMI) has provided new updates on CMS’ planned initiatives to address prescription drug costs in a blog post from Director Liz Fowler. One test, the Accelerating Clinical...more
The CMS Center for Medicare and Medicaid Innovation (CMMI) is launching a new Alternative Payment Model (APM) focused on Dementia Care: The GUIDE model. It will launch in July 2024 and run for eight years. More details will...more
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
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
On August 14, 2023, the Centers for Medicare & Medicaid Services (CMS) released guidance on changes to the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model starting in performance...more
The new MCP Model is a 10.5-year multi-payer model with three participation tracks that build upon previous primary care models. Colorado, Massachusetts, Minnesota, New Mexico, New Jersey, North Carolina, Washington and...more
CMMI was established to test innovative payment and service delivery models expected to reduce expenditures and preserve or enhance care quality under Medicare, Medicaid, and the Children’s Health Insurance Program. Over the...more
In this session, McDermott Will & Emery partner Matthew Perreault moderated a panel that discussed the current state of value-based care in original Medicare and lessons learned from the panelists’ experiences with various...more
In October of 2021, the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) unveiled its 2030 vision to achieve “equitable outcomes through high quality, affordable, and...more
Since 2010, a reported 140 rural hospitals have closed their doors, including a record 19 hospitals in 2020 alone as a result of the financial pressures of COVID-19 compounded by many other long-standing challenges facing...more
As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more
Are Accelerated Approval Drugs a New Target for Cost Reductions? As outlined in our prior analysis, the Inflation Reduction Act (IRA) included sweeping drug pricing reforms for the Medicare program and the Biden-Harris...more
On February 14, 2023, and in response to Executive Order 14087 (“Lowering Prescription Drug Costs for Americans”), the Secretary of Health and Human Services (HHS) issued a report announcing the selection of three models that...more
Many health system leaders are developing health equity plans to participate in new value-based care payment models. The new ACO REACH payment model from the Center for Medicare and Medicaid Innovation (CMMI) has increased...more
The Center for Medicare and Medicaid Innovation (CMMI) is launching a long awaited new oncology model, the Enhancing Oncology Model (EOM). EOM is a successor to the Oncology Care Model (OCM), which ended June 30, 2020 after a...more
As Congress reconvenes, it faces a packed agenda in a legislative year that will be shortened by the upcoming midterm elections and remains buffeted by the persistent coronavirus pandemic. The list of healthcare priorities is...more
Last month, the Center for Medicare and Medicaid Innovation (the Innovation Center, or CMMI) released its long-anticipated white paper, “Innovation Strategy Center Refresh,” outlining the Innovation Center’s strategic outlook...more