News & Analysis as of

Final Rules Medicare Shared Savings Program

Bass, Berry & Sims PLC

New CMS Policies Position the MSSP for Expansion and Increased Savings

Bass, Berry & Sims PLC on

New policies tucked into the Centers for Medicare and Medicaid Services’ (CMS) 2025 Medicare Physician Fee Schedule Rule (Final Rule) will likely spur increased Accountable Care Organization (ACO) participation in the...more

King & Spalding

CMS Makes Modifications to the Medicare Shared Savings Program

King & Spalding on

In its Final Rule for the 2025 Medicare Physician Fee Schedule, CMS announced changes to the Medicare Shared Savings Program (the Program) targeted at incentivizing providers to both enroll and stay in the Program. The Final...more

Holland & Knight LLP

CMS Releases CY 2025 Medicare Physician Fee Schedule Final Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2024, released the calendar year (CY) 2025 Revisions to Payment Policies under the Physician Fee Schedule (MPFS) and Other Revisions to Medicare Part B...more

McDermott+

Digesting the Huge Buffet of CMS Regs: Highlights from the CY 2025 PFS Final Reg

McDermott+ on

While we all are focused on the election results, let’s take a quick break to digest some regs and eggs. The Centers for Medicare & Medicaid Services (CMS) “spoiled” all of us in the health policy world with a huge buffet of...more

Bass, Berry & Sims PLC

New Rule Curbs Impact of Suspect DME Claims on 2023 MSSP Financial Calculations

Bass, Berry & Sims PLC on

Effective October 15, a new Final Rule issued by the Centers for Medicare & Medicaid Services (CMS) will allow the Medicare Shared Savings Program (MSSP) to adjust calendar year (CY) 2023 benchmark and expenditure...more

BakerHostetler

Healthcare Providers Beware: Finalized Disincentives Sharpen the Teeth of Information Blocking Rule

BakerHostetler on

On June 24, 2024, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) at the Department of Health and Human Services (HHS) issued the 21st...more

McDermott Will & Emery

HHS Issues Provider Information Blocking Disincentives Final Rule

On July 1, 2024, the US Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) published a final rule in...more

Foley & Lardner LLP

Top 5 Rules for Medicare 2024 Remote Patient Monitoring and Remote Therapeutic Monitoring: What Companies Need to Know

Foley & Lardner LLP on

On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) finalized new policies related to remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services reimbursed under the Medicare...more

Bass, Berry & Sims PLC

CY 2023 Medicare Physician Fee Schedule: Medicare Provider and Medicare Shared Savings Program

Bass, Berry & Sims PLC on

On November 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued CY 2023 Physician Fee Schedule Final Rule (Final Rule), implementing certain updates and policy changes for Medicare payments under the Physician...more

Holland & Knight LLP

CMS Issues 2023 Medicare Physician Fee Schedule Final Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Final Rule on Nov. 1, 2022, which impacts Medicare Part B payments starting on Jan. 1, 2023....more

Robinson+Cole Health Law Diagnosis

CMS Issues Final Rules Concerning the 2023 Outpatient Prospective Payment System Rates and Physician Fee Schedule

On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued final rules concerning the 2023 Hospital Outpatient Prospective Payment System (OPPS) payment rates and 2023 Medicare Physician Fee Schedule...more

King & Spalding

CMS Releases Final Rule Regarding Payment Policies under the Physician Fee Schedule and Several Other Changes to Medicare Part B...

King & Spalding on

Last week, CMS issued a final rule addressing several topics, including changes to the physician fee schedule (PFS) and changes to Medicare Part B payment policies. Key changes include a net reduction in the PFS conversion...more

Jones Day

HHS Finalizes New AKS Safe Harbors for Patient Engagement and CMS-Sponsored Arrangements

Jones Day on

The Situation: As health care providers transition to value-based care models, they have often been forced to rely on safe harbors under the Anti-Kickback Statute, or AKS, that were never designed with value-based payment...more

Holland & Hart - Health Law Blog

Final Rules for Stark and Anti-Kickback Reforms Issued by CMS and OIG

On November 20, 2020 the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of the Inspector General (OIG) issued two final rules to modernize and clarify the Physician...more

K&L Gates LLP

K&L Gates Triage: Triage in 2019: Health Care Topics to Watch in the New Year

K&L Gates LLP on

As K&L Gates begins its third season of Triage: Rapid Legal Lessons for Busy Health Care Professionals, Hilary Bowman previews several topics that the health care practice group anticipates will have a significant impact on...more

Robinson+Cole Health Law Diagnosis

CMS Finalizes Overhaul of the Medicare Shared Savings Program in “Pathways to Success” Final Rule

On December 31, 2018, the Centers for Medicare and Medicaid Services (CMS) published a final rule (Final Rule) establishing the “Pathways to Success” program that overhauls the Medicare Shared Savings Program (MSSP). ...more

Dorsey & Whitney LLP

“Pathways to Success” – CMS Finalizes Overhaul of National ACO Program

Dorsey & Whitney LLP on

On December 21, 2018, CMS announced a final rule, subsequently published in the December 31 issue of the federal register, significantly overhauling the Medicare Shared Savings Program (“MSSP”). Among the important changes in...more

Smith Anderson

[Webinar] Strategies for an ACO's "Pathway to Success": The New MSSP Rule - January 22nd, 12:30pm ET

Smith Anderson on

A live webinar presented by Smith Anderson health care lawyers Julian "Bo" Bobbitt, Robert Shaw and Shawn Parker. On December 21, 2018, CMS published “Pathways to Success,” the final rules overhauling Medicare’s ACO...more

Verrill

CMS Issues Final Rule to ACOs: It’s Time to Take a Risk

Verrill on

Just before the holidays, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) that will overhaul the Medicare Shared Savings Program (“MSSP”). As of January 2018, the MSSP included 561...more

Foley & Lardner LLP

“Pathways to Success:” CMS Publishes Final Rule Modifying the Medicare Shared Savings Program

Foley & Lardner LLP on

The Centers for Medicare and Medicaid Services (CMS) issued a final rule (the Rule) on December 21, 2018, which reshapes the Medicare Shared Savings Program (MSSP). Termed “Pathways to Success,” the Rule, among other things, ...more

Bradley Arant Boult Cummings LLP

CMS Finalizes Redesign of Medicare Shared Savings Program - Healthcare Alert

On December 31, 2018, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule that redesigns the Medicare Shared Savings Program (MSSP). The rule implementing this redesign, titled “Pathways to Success,”...more

Sheppard Mullin Richter & Hampton LLP

“Pathways to Success” Update: CMS Issues Final Rule on Changes to the ACO Program

As discussed in our August 16, 2018 blog post, CMS Proposes Massive Changes to ACO Program – Pushing Providers to Accept Downside Risk, on August 9, 2018, the Centers for Medicare & Medicaid Services (“CMS”) published a...more

Robinson+Cole Health Law Diagnosis

2019 Physician Fee Schedule Rule Review: Option to Extend MSSP Agreements for Currently-Expiring ACOs Finalized

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Physician Fee Schedule Final Rule (PFS Rule), which contains a number of significant substantive changes to Medicare payment practices...more

McDermott Will & Emery

Slow and Steady – CMS Expands Telehealth Reimbursement Opportunities in 2018

McDermott Will & Emery on

The Centers for Medicare & Medicaid Services (CMS) reiterated its commitments to expanding access to telehealth services and paying “appropriately” for services that maximize technology in the Medicare Program; Revisions to...more

Bradley Arant Boult Cummings LLP

2016 – Health Law Year in Review

We are pleased to present our annual review of developments in the field of health law. The year was marked by key changes in False Claims Act jurisprudence and Medicare payment policy. 2016 also brought with it focused...more

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