News & Analysis as of

Health Care Providers Prospective Payment System (PPS)

Holland & Knight LLP

CMS Releases FY 2024 IPPS Final Rule

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The Centers for Medicare & Medicaid Services (CMS) on Aug. 1, 2023, published its final rule for the federal fiscal year (FY) 2024 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective...more

Robinson+Cole Health Law Diagnosis

CMS Issues Calendar Year 2023 Home Health Final Rule

On November 4, 2022, the Centers for Medicare & Medicaid Services (CMS) published the calendar year 2023 Home Health Prospective Payment System Rate final rule, which updates Medicare payment policies and rates for home...more

Holland & Knight LLP

CMS Releases FY 2023 IPPS and LTCH Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) on April 18, 2022, published its annual proposed rule for the federal fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH)...more

King & Spalding

CMS Issues Medicare IPPS and LTCH Final Rule for FY 2022

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On August 2, 2021, CMS published the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule for federal fiscal year (FY) 2022. The final...more

Baker Donelson

CMS SNF PPS Proposed FY 2022 Rule – An Overview

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On April 15, 2021, Centers for Medicare & Medicaid Services (CMS) published its Proposed Rule for the Medicare Program Prospective Payment System (PPS) and Consolidated Billing for Skilled Nursing Facilities (SNF) and Updates...more

Baker Donelson

CY 2021 Home Health PPS Final Rule Adds New Payment Rates, Wage Indices and the Home Infusion Services Benefit

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The Calendar Year (CY) 2021 final rule updating the Home Health Prospective Payment System (HH PPS) includes increases in the national, standardized 30-day period payment and per-visit payment for home health agencies (HHAs)...more

Health Care Compliance Association (HCCA)

CMS issues proposed rule updating end-stage renal disease payment policies

Compliance Today (October 2020) - On July 6, the Centers for Medicare & Medicaid Services (CMS) released details on a proposed rule that would make changes to the End-Stage Renal Disease (ESRD) Prospective Payment System...more

Baker Donelson

COVID-19 Pandemic Trickles Into Some Aspects of SNF PPS FY 2021 Final Rule

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On August 5, 2020, CMS issued its final rule updating FY2021 payment rates used under the prospective payment system (PPS) for Skilled Nursing Facilities (SNFs). The FY 2021 payment rates will be implemented to reflect the...more

Foley & Lardner LLP

FQHCs: Four Reimbursement Traps for the Unwary

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This is the third article in our series addressing important topics for federally qualified health centers (FQHCs) and the providers who work with them. The first post in the series offered five tips for contracting with...more

Foley & Lardner LLP

FQHCs: The Nuts and Bolts of Medicaid Reimbursement

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This is the second article in our series addressing important topics for federally qualified health centers (FQHC) and the providers who work with them. Our first post in the series offered five tips for contracting with...more

King & Spalding

CMS Issues Final Rule for CY 2020 Home Health Payments, CY 2021 Home Infusion Therapy Benefit

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On October 31, 2019, CMS issued a final rule with comment period (Final Rule), CMS-1711-FC, updating the payment rates for home health agencies (HHAs) for calendar year (CY) 2020...more

McDermott Will & Emery

2018 Digital Health Data Developments – Navigating Change in 2019

Data privacy and security legislation and enforcement saw significant activity in 2018 and early 2019. McDermott’s 2018 Digital Health Year in Review: Focus on Data report – the first in a four-part series – highlights...more

Alston & Bird

Alston & Bird Healthcare Week in Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Baker Donelson

Proposed 2019 Payment Rules Contain Notable Changes to Medicare's Telehealth Policy

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CMS has issued proposed payment rules for CY 2019 that hold significant implications for telehealth coverage and reimbursement. In the Proposed 2019 Home Health Prospective Payment System Rule (Proposed HH PPS Rule),...more

Baker Donelson

CMS Refines Proposed Changes to SNF Reimbursement with Patient-Driven Payment Model

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On May 8, 2018, in its Fiscal Year 2019 (FY 2019) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Proposed Rule, Centers for Medicare & Medicaid Services (CMS) proposed a new case-mix classification system...more

Holland & Knight LLP

CMS Proposes Changes to ESRD Prospective Payment System and DMEPOS Fee Schedule Amounts

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On July 19, 2018, The Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2019, and would update the...more

Bradley Arant Boult Cummings LLP

CMS Continues Shift toward Value-Based Payments with New Home Health Groupings Model in Proposal - Healthcare Alert

On July 2, 2018, the Centers for Medicare & Medicaid Services (CMS) published its annual proposed rule outlining both payment and policy changes for home health agencies. In a press release announcing the proposed rule, CMS...more

Arnall Golden Gregory LLP

CMS Proposes Overhaul of SNF Reimbursement System, Increases FY 2019 Payments

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on April 27, 2018 to overhaul the payment system for skilled nursing facilities (SNFs). Specifically, the rule would “update the payment rates used...more

Foley & Lardner LLP

California Medicaid Agency Proposes Significant Restrictions on FQHC and RHC Reimbursement

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California’s Medicaid agency has posted draft language of a new state plan amendment (SPA) that would make major changes to federally qualified health center (FQHC) and Rural Health Clinic (RHC) reimbursement. Public comments...more

Baker Donelson

BPCI Advanced – CMS Offers a Familiar Program with a New Twist

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The Centers for Medicare & Medicaid Services (CMS) is launching BPCI Advanced – the successor program to the Bundled Payments for Care Improvement Initiative. Providers that like the current BPCI program, or simply missed the...more

King & Spalding

CMS Releases MLN Matters Article on Care Coordination Services and Payment for Rural Health Clinics and Federally-Qualified Health...

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CMS recently issued a Medicare Learning Network (MLN) Matters article in connection with Change Request 10175 (issued August 11, 2017), which provides instructions for payment to Rural Health Clinics (RHCs) billing under the...more

Baker Donelson

Home Health Payment Rule Published

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On November 1, 2017, CMS released the Final Rule for the 2018 home health prospective payment system rate update, including the CY 2019 case mix adjustment methodology refinements. CMS also made changes to the Value Based...more

McGuireWoods LLP

CMS Updates End-Stage Renal Disease Prospective Payment System

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On Nov. 1, 2017, the Centers for Medicare & Medicaid Services (CMS) published a final rule that updates payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis...more

Bass, Berry & Sims PLC

Final Home Health Rule Drops Controversial Proposed Payment Model

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Last week, home health agencies welcomed the Centers for Medicare & Medicaid Services' (CMS) decision to drop a controversial proposed payment model and leave largely unchanged the current payment system. Responding to...more

Bass, Berry & Sims PLC

CMS Proposes New Payment Model and Other Changes for Home Health Agencies

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Among the various payment updates proposed by the Centers for Medicare and Medicaid Services (CMS) this summer, the proposed payment update for the home health agency prospective payment system (HHA-PPS), published in the...more

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