News & Analysis as of

Hospitals Quality Payment Program (QPP)

Baker Donelson

CMS Interim Final Rule Expands Telemedicine Services and Bends Coverage and Payment Rules for Range of Patient Care Services...

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In a rapid and remarkable response to COVID-19, The Centers for Medicare & Medicaid Services (CMS) has altered a wide range of coverage and payment rules applicable to hospitals, practitioners and suppliers. In an interim...more

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

King & Spalding

CMS Releases FY 2020 Medicare IPPS and LTCH PPS Proposed Rule and Proposes Key Changes to Several Regulatory Requirements

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On April 23, 2019, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for FY 2020 (the Proposed Rule), which will affect...more

Holland & Knight LLP

CMS Releases the 2019 MPFS and QPP Final Rules

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• The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2019 Final Rule for the Medicare Physician Fee Schedule (PFS), which includes provisions related to Medicare physician payments as well...more

Holland & Knight LLP

Healthcare Law Update: September 2018

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Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

Baker Donelson

QPP Year 3 – CMS Continues Implementation with Proposed Changes

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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

Holland & Knight LLP

CMS Quality Payment Program Changes for 2019

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The Centers for Medicare & Medicaid Services (CMS) is proposing a redesign of incentives under the Merit-Based Incentive Payment System (MIPS) as part of the 2019 Updates to the Quality Payment Program (QPP). This affects...more

Baker Donelson

Maryland All-Payer Model's Progression to Total Cost of Care: Alignment Strategies for Stakeholders in New Cost Paradigm

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The State of Maryland is unique in its historical experimentation with rate setting and global budgets for hospitals, and that experimentation continues with the Maryland Total Cost of Care Model (TCOC). Beginning January...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

Bass, Berry & Sims PLC

New CMS Guidance on Information Blocking

Bass, Berry & Sims PLC on

Centers for Medicare & Medicaid Services (CMS) recently published two important guidance statements on so-called "information blocking," i.e., knowingly and willfully limiting or restricting the compatibility or...more

Holland & Knight LLP

Top Takeaways for Medicare Physician and Hospital Payments in 2018

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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

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

Baker Donelson

Final Rule Implements Quality Payment Program under MACRA

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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

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

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