News & Analysis as of

Hospitals Value-Based Purchasing

K&L Gates LLP

Proposal to Change the Scoring Methodology for the Hospital Medicare Value-Based Purchasing Program to Address Health Equity

K&L Gates LLP on

The 1 May 2023 Federal Register contains a proposal from the Centers for Medicare & Medicaid Services (CMS) to revise the scoring methodology under the Hospital Value-Based Purchasing Program (Hospital VBP Program) as part of...more

McDermott Will & Emery

Biden Administration Takes Action to Improve Competition, Transparency and Quality for Hospitals and Nursing Homes

McDermott Will & Emery on

The Centers for Medicare & Medicaid Services (CMS) recently published detailed databases summarizing changes of ownership of Medicare-enrolled hospitals and skilled nursing facilities (SNFs). The databases currently include...more

Holland & Knight LLP

CMS Releases FY 2023 IPPS and LTCH Proposed Rule

Holland & Knight LLP on

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

McGuireWoods LLP

Value-Based Purchasing and the False Claims Act: Tenth Circuit Finds Falsified Quality Data Immaterial Under Escobar

McGuireWoods LLP on

Last month, the Tenth Circuit upheld a grant of summary judgment in U.S. ex rel. Janssen v. Lawrence Memorial Hospital, 2020 WL 594508 (10th Cir. Feb. 7, 2020), applying the “rigorous” and “demanding” standard of materiality...more

Baker Donelson

CMS Revises Discharge Planning Rules, Emphasizing Access to Quality Data, Patient Engagement

Baker Donelson on

In a long anticipated regulation, the Centers for Medicare & Medicaid Services (CMS) recently updated the hospital, critical access hospital (CAH) and home health agency (HHA) conditions of participation related to the...more

Holland & Knight LLP

CMS Releases Fiscal Year (FY) 2020 Inpatient Prospective Payment System (IPPS) Final Rule

Holland & Knight LLP on

On August 2, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital Prospective Payment System...more

Holland & Knight LLP

CMS Releases FY 2020 Inpatient Prospective Payment System Proposed Rule

Holland & Knight LLP on

• The Centers for Medicare & Medicaid Services (CMS) on April 23, 2019, released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule. • The proposed payment rate increase...more

Mintz - Health Care Viewpoints

OIG Opinion Illustrates the Need for New AKS Safe Harbors

The Department of Health and Human Services Office of the Inspector General (OIG) has issued Advisory Opinion No. 18-10 (Opinion) in response to a proposal by a surgical device and wound care product manufacturer...more

Manatt, Phelps & Phillips, LLP

CMS Shifts Quality Measures From Process to Outcomes

CMS Hospital Value-Based Purchasing Program - Relative weighting of quality measurement domains, FY 2013 – FY 2020 - The Medicare Hospital Value-Based Purchasing (VBP) Program marked one of the first major steps made by...more

King & Spalding

CMS Issues IPPS and LTCH PPS Final Rule for FY 2018

King & Spalding on

On August 2, 2017, CMS issued the Fiscal Year (FY) 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule (Final Rule) that updates...more

King & Spalding

GAO Releases Report on Evaluation Methodology in Hospital Value-Based Purchasing Program

King & Spalding on

On June 30, 2017, the Government Accountability Office (GAO) released a report on the Hospital Value-Based Purchasing (HVBP) program, which evaluates hospital performance on quality and efficiency measures, and provides...more

King & Spalding

CMS Releases FY 2018 Hospital Inpatient Prospective Payment System Proposed Rule and Request for Information

King & Spalding on

On April 14, 2017, CMS issued the annual Hospital Inpatient Prospective Payment System (IPPS) Rule for FY 2018 (the “Proposed Rule”) which will affect discharges on or after October 1, 2017. CMS estimates that IPPS operating...more

Holland & Knight LLP

Healthcare Law Update: March 2017

Holland & Knight LLP on

Enforcement - OIG Issues Advisory Opinion Allowing Free or Reduced-Cost Lodging and Meals - On March 3, 2017, the U.S. Department of Health and Human Services' (HHS) Office of Inspector General (OIG) issued...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

King & Spalding

CMS Releases FY 2017 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Final...

King & Spalding on

On August 2, 2016, CMS released a final rule (Final Rule) with updates to the Hospital Inpatient Prospective Payment System (Hospital IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) affecting...more

King & Spalding

CMS Releases Calendar Year 2017 OPPS Proposed Rule

King & Spalding on

On July 6, 2016, CMS released the Calendar Year (CY) 2017 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule. In addition to significant proposals...more

Foley & Lardner LLP

Additional Opioid Policy Changes Announced: What You Need to Know

Foley & Lardner LLP on

Despite the July 4 holiday, the past week featured significant regulatory and legislative action addressing the use of opioids and pain management. The changes are in keeping with the Government-wide push to better understand...more

BakerHostetler

FY 2017 IPPS Proposed Rule Results in Modest Increase for Hospitals

BakerHostetler on

CMS recently issued a proposed rule updating fiscal year (FY) 2017 Medicare payment policies and rates under the Medicare inpatient prospective payment system (IPPS) and the long-term care hospital (LTCH) prospective payment...more

Parker Poe Adams & Bernstein LLP

New Part B Drug Payment Model Proposed

On March 11, 2016, CMS proposed implementation of a new two-phase model for drugs reimbursed under Part B of the Medicare Program (“the Proposed Model”). Drugs reimbursed under Part B include drugs administered in hospital...more

Manatt, Phelps & Phillips, LLP

Manatt on Medicaid: CMS Approves California's Delivery System Reform Incentive Payment (DSRIP) Waiver Renewal

On December 30, 2015, the Centers for Medicare and Medicaid Services (CMS) approved California's request to renew its waiver under Section 1115 of the Social Security Act. A significant component of the waiver is the Delivery...more

King & Spalding

Also In The News - Health Headlines - November 2015

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CMS Publishes Medicaid Access Final Rule – CMS published a Final Rule in the Federal Register today, November 2, 2015, that implements a process for states to determine whether Medicaid payments satisfy what is known as the...more

Foley & Lardner LLP

Top Three Reasons ACOs Should Use Telehealth and Telemedicine

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Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more

King & Spalding

GAO Releases Report on Initial Results of CMS’s Hospital Value-Based Purchasing Program

King & Spalding on

The U.S. Government and Accountability Office (GAO) issued an October 2015 report to congressional committees concluding that the initial results of the Hospital Value-Based Purchasing (HVBP) program show “no apparent shift”...more

Manatt, Phelps & Phillips, LLP

Health Update - September 2015

Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure - As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more

Baker Donelson

CMS Issues FY 2016 Final Inpatient and Long-Term Care Hospital Rule

Baker Donelson on

On July 21, 2015, CMS issued a final rule updating the fiscal year (FY) 2016 Medicare payment polices and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment...more

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