News & Analysis as of

Hospitals Medicare Access and CHIP Reauthorization (MACRA)

King & Spalding

CMS Announces CMMI Milestones and Updates

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CMS recently announced updates and milestones for several programs run by the Center for Medicare and Medicaid Innovation (CMMI). CMMI is the internal CMS agency responsible for developing and testing new health care payment...more

Sheppard Mullin Richter & Hampton LLP

Overview of Proposed Rule from the Centers for Medicare & Medicaid Services Regarding Interoperability and Patient Access to Data

On March 4, 2019, the Centers for Medicare & Medicaid Services (“CMS”) published a wide-ranging proposed rule (“Proposed Rule”) with the intent to “move the health care ecosystem in the direction of interoperability” in...more

Baker Donelson

OIG July 2018 Work Plan Update

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The OIG added six new items to its Work Plan in the July 2018 update. Areas addressed include HHS cybersecurity vulnerabilities, increased payments for transfer claims with outliers, oversight of funds for Access Increases in...more

Arnall Golden Gregory LLP

Top 10 Lessons Learned from First-to-Second Generation Transactions

Michael Barry and Max Reiboldt joined Mark Coker to discuss the Top 10 Lessons Learned from First-to-Second Generation Transactions. Mr. Barry is a partner in the Corporate Practice and the Healthcare Practice and focuses his...more

Bass, Berry & Sims PLC

Stark Under the Microscope: Congress and HHS Examine Reform of the Stark Law for a Value-Based System

Bass, Berry & Sims PLC on

On July 17, 2018, the U.S. House of Representatives' Ways and Means Committee Subcommittee on Health ("Subcommittee") expressed its commitment to modernizing the Stark Law during a hearing in which industry and government...more

Holland & Knight LLP

House, Senate Proposals to Extend Funding for the Federal Government

Holland & Knight LLP on

Congress moved one step closer to avoiding a government shutdown on Feb. 6, voting overwhelmingly (245-182) to pass a short-term, GOP-backed government funding bill (text; section-by-section) that would keep the federal...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

Polsinelli

Gainsharing Guidance: Clarification on Cost-Savings Arrangements Between Hospitals and Physicians

Polsinelli on

The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) recently posted its first advisory opinion interpreting a gainsharing arrangement – that is, a financial relationship under which...more

Dorsey & Whitney LLP

OIG Issues Favorable Advisory Opinion Addressing Gainsharing CMP Arrangement

Dorsey & Whitney LLP on

On January 5, 2018, the Office of the Inspector General of the United States Department of Health and Human Services (“OIG”) released a favorable Advisory Opinion 17-09 that addresses Section 1128A(b)(1) of the Social...more

King & Spalding

OIG Issues Favorable Gainsharing Advisory Opinion

King & Spalding on

On December 29, 2017, OIG issued a favorable advisory opinion interpreting the application of the gainsharing civil monetary penalty provision (Gainsharing CMP) and the Anti-Kickback Statute in connection with a proposed...more

Benesch

Hospitals & Physician Organizations Summary Report - November 2017

Benesch on

Uncertainty and pressures continue to mount for healthcare providers, creating a new operating environment – Uncertainty around Medicaid and other programs, the shift to value-based care, margin pressures, the need to search...more

Holland & Knight LLP

Top Takeaways for Medicare Physician and Hospital Payments in 2018

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2017, released the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System Final Rule for...more

Mintz - Health Care Viewpoints

Hospitals and Others Respond to “Red Tape Relief Project” Requests

Last week, a number of health care industry associations sent letters to Congress detailing ways in which the government could relieve them of the burdens associated with “red tape.” The letters are in response to the first...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

Mintz - Health Care Viewpoints

CMS Proposes to Cancel Bundled Payment and Incentive Models

The U.S. Centers for Medicare & Medicaid Services (CMS) published a proposed rule last week regarding the cancellation of three bundled payment models and an incentive payment model while also reducing the scope of a third...more

Baker Donelson

CMS Releases MACRA Proposed Rule for 2018

Baker Donelson on

On June 20, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled, "Medicare Program; CY 2018 Updates to the Quality Payment Program." CMS proposes changes for the second year (2018) of the...more

Mintz - Health Care Viewpoints

Insiders Say New MACRA Rule Likely as Providers Look to Sec. Price to Ease Burden

The Trump administration is considering releasing a rule to ease the burden that small practices are facing in trying to comply with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), according to a recent...more

Bass, Berry & Sims PLC

Healthcare Transactions: Year in Review - January 2017

Healthcare transactional activity continued unabated throughout 2016, continuing a years long trend of sustained growth. This activity is due to a number of factors: innovative technology, pharmaceuticals, and services that...more

Baker Donelson

Final Rule Implements Quality Payment Program under MACRA

Baker Donelson on

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

Arnall Golden Gregory LLP

2016 Health IT Leadership Summit Insights

On December 7, 2016, lawyers from Arnall Golden Gregory LLP’s Healthcare Technology team attended the annual Health IT Leadership Summit. While there, we noted several overarching themes. At the forefront were the topics of...more

Burr & Forman

2016 Health Care Year in Review

Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Sheppard Mullin Richter & Hampton LLP

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

McDermott Will & Emery

Managing the Transition to Transformation: Quality and Payment Reform: Who Is Asking for What and Why?

McDermott Will & Emery on

McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and care delivery...more

Baker Donelson

Proposed Cardiac, Hip, and Femur Episode Payment Models Are Next Generation from BPCI and CJR

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The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on July 25, 2016, entitled, Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and...more

King & Spalding

CMS Proposes New Bundled Payment Models for Cardiac and Orthopedic Care

King & Spalding on

On July 25, 2016, CMS posted a proposed rule that would create three new Medicare Parts A and B episode payment models for patients admitted for care for a heart attack, bypass surgery or surgical hip/femur fracture treatment...more

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