News & Analysis as of

Hospitals Bipartisan Budget Act

Bricker Graydon LLP

CMS issues mid-build audit determinations for provider-based locations

Bricker Graydon LLP on

At long last, the Centers for Medicare and Medicaid Services (CMS) has issued decisions on provider applications for the mid-build exception. Nearly four years after the deadline for hospitals to apply for the mid-build...more

Baker Donelson

D.C. Court Rejects CMS's 2018 "Budget Neutrality" Policy

Baker Donelson on

In a September 17, 2019 decision, the United States District Court for the District of Columbia invalidated a CMS rule expanding site-neutral payment reductions to evaluation and management (E&M) services furnished in...more

Foley & Lardner LLP

Site-Neutral Hospitals Find Reprieve for their Outpatient Departments Through the Courts

Foley & Lardner LLP on

On September 17, 2019, the D.C. District Court held that the Centers for Medicare & Medicaid Services (CMS) exceeded its statutory authority when it cut the payment rate for clinic services at off-campus provider-based...more

Bass, Berry & Sims PLC

Modernizing Medicare: CMS Expands Reimbursement for Virtual Care and Telehealth

Bass, Berry & Sims PLC on

As part of the 2019 Medicare Physician Fee Schedule Final Rule (Final Rule) published on November 23, 2018, the Centers for Medicare & Medicaid Services (CMS) took significant steps toward modernizing Medicare to expand...more

Foley & Lardner LLP

Medicare Proposes (and Rejects) New Telehealth Services for 2019

Foley & Lardner LLP on

The telemedicine industry was pleased to learn CMS recently proposed adding new services to its list of Medicare-covered telehealth services. But what may be more interesting are the services CMS declined to add, and why....more

Baker Donelson

QPP Year 3 – CMS Continues Implementation with Proposed Changes

Baker Donelson on

On July 12, 2018, CMS issued proposed revisions to Year 3 of the Quality Payment Program (QPP) in the rule entitled Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019;...more

Baker Donelson

CMS Proposes Major "Site-Neutral" Changes to Payments for Off-Campus Locations

Baker Donelson on

CMS recently published its proposed Medicare outpatient prospective payment system (OPPS) rule for calendar year (CY) 2019. The rule contains a number of "site-neutral" proposals that, if adopted, will result in lower...more

Baker Donelson

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

Baker Donelson on

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

McDermott Will & Emery

Mid-Year Digital Health Report: Focus on Medicare - July 2018

McDermott Will & Emery on

Where Things Stood - Understanding the impact of what we have seen so far this year first requires an understanding of where we were at the end of 2017, with respect to both Medicare reimbursement and provider adoption of...more

Holland & Knight LLP

Trump Administration Fiscal Year (FY) 2019 Budget and Healthcare Programs

Holland & Knight LLP on

The Trump Administration on Feb. 12 released its Fiscal Year (FY) 2019 budget request, titled "An American Budget." Unlike last year's budget, which was released in late May, the release of this budget conforms to the typical...more

McGuireWoods LLP

2018 Reimbursement Cuts for Some Off-Campus Hospital Provider-Based Departments

McGuireWoods LLP on

On Nov. 2, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized a rule changing reimbursement rates under the Medicare Physician Fee Schedule (MPFS) for certain non-excepted hospital off-campus provider-based...more

BakerHostetler

Back to School Rules Recap: Hospital and Physician Cheat Sheet on What CMS Did This Summer

BakerHostetler on

Summer was no vacation for the Centers for Medicare & Medicaid Services (CMS). The agency released a series of significant rules that signal the nature and pace of CMS Medicare payment and policy changes for hospitals and...more

McGuireWoods LLP

Reimbursement Changes for Hospital Off-Campus Provider-Based Departments

McGuireWoods LLP on

Off-campus provider-based departments (PBDs) of hospitals face changes in reimbursement beginning Jan. 1, 2017, the effective date of the Centers for Medicare & Medicaid Services (CMS) outpatient prospective payment system...more

King & Spalding

CMS Clarifies the Application Processes for the Mid-Build Exception under the 21st Century Cures Act and for Relocation Exception...

King & Spalding on

CMS has issued guidance documents addressing how hospitals can (1) qualify an off-campus provider-based department (PBD) for the “mid-build” exception set forth in the 21st Century Cures Act and (2) request from their CMS...more

Morgan Lewis

CMS Issues Time-Sensitive Instructions for Provider-Based Clinics That Have Relocated

Morgan Lewis on

Hospitals that have relocated a provider-based clinic after the enactment of the Bipartisan Budget Act must take action now. Centers for Medicare & Medicaid Services (CMS) recently released guidance on extraordinary...more

Morgan Lewis

21st Century Cures Act: Who Does the “Mid-Build” Exception Help?

Morgan Lewis on

The exception helps a number of hospitals with their provider-based sites that had been under construction in November 2015, but not as many as may initially appear. Read on if you are interested in understanding the...more

King & Spalding

CMS Reminds Providers to Identify Off-Campus Provider-Based Departments on Enrollment Forms

King & Spalding on

In connection with CMS’s implementation of Section 603 of the Bipartisan Budget Act of 2015 (BBA15), which directs CMS to no longer pay hospitals the full OPPS rate for services furnished in non-excepted off-campus...more

BakerHostetler

The Wait is Over: CMS Delivers Post-BBA Provider-Based Policies in Final 2017 OPPS

BakerHostetler on

Now that the rule is out, work to implement the BBA changes begins in earnest. CMS commemorated the one-year anniversary of the Bipartisan Budget Act of 2015 (BBA) with the traditional gift of paper, offering...more

Baker Donelson

CMS Releases the 2016 OPPS Final Rule

Baker Donelson on

On November 1, 2016, CMS published its final policy changes, quality provisions, and payment rates for 2017, as they relate to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center...more

K&L Gates LLP

CMS Announces Final Rule Implementing Site-Neutral Payment Rule for Certain Off-Campus Hospital Outpatient Provider-Based...

K&L Gates LLP on

On November 1, 2016, the Centers for Medicare & Medicaid Service (“CMS”) released the pre-publication form of its much-anticipated Hospital Outpatient Prospective Payment System (“OPPS”) CY 2017 final rule with comment period...more

Foley & Lardner LLP

OPPS Final Rule Finalizes Limits for Off Campus Departments

Foley & Lardner LLP on

Center for Medicare and Medicaid Services (CMS) issued the long-awaited implementation of the “site-neutrality” provisions of the H.R. 1314 Bipartisan Budget Act of 2015 (BiBA Section 603) on November 1, 2016. The Final Rule...more

McDermott Will & Emery

CMS Releases CY 2017 Final Rule Implementing Changes to Outpatient Prospective Payment System

McDermott Will & Emery on

The Centers for Medicare & Medicaid Services released the calendar year 2017 final rule implementing changes to the Medicare hospital Outpatient Prospective Payment System, or OPPS, including provisions implementing Section...more

King & Spalding

CMS Finalizes Policies on Off-Campus Provider-Based Status CMS Will Pay Non-Excepted PBDs in 2017, But Adopts Nearly All Other...

King & Spalding on

On November 1, 2016, the Centers for Medicare & Medicaid Services (CMS) issued its CY 2017 Outpatient Prospective Payment System (OPPS) Final Rule, which includes the agency’s final policies implementing legislative changes...more

Poyner Spruill LLP

Proposed 2017 Hospital OPPS Rule Would End Medicare Payments to Many Off Campus Facilities at the Same Levels as Hospital-Based...

Poyner Spruill LLP on

Published on July 14, 2016, CMS’s proposed 2017 Hospital Outpatient Prospective Payment System (OPPS) rule calls for site-neutral payments that would stop Medicare payments to many off-campus facilities at the same level as...more

Morgan Lewis

Provider-Based Rule and Stark—Is Joint Compliance Impossible in 2017?

Morgan Lewis on

The Centers for Medicare & Medicaid Services (CMS) will be putting hospitals in an untenable position if recent proposed rulemaking is implemented as is. In its proposal for acting on legislation reducing payments to new,...more

33 Results
 / 
View per page
Page: of 2

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide