News & Analysis as of

Inpatient Prospective Payment System (IPPS)

Texas Health System Pays Nearly $2 Million To Settle Allegations of Improper Billing for Inpatient Services

by King & Spalding on

On May 14, 2018, the U.S. Attorney’s Office for the Southern District of Texas announced that Memorial Hermann Health System (MHHS) will pay $1,929,071.38 to resolve allegations that it improperly billed government healthcare...more

Proposed IPPS Rule Changes

by BakerHostetler on

The Centers for Medicare & Medicaid Services (CMS) recently released its proposed rules for the Hospital Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2019. As discussed below, the proposed rule focuses on...more

CMS Publishes Six Proposed Medicare Payment Rules: What It All Means

by Morgan Lewis on

Key themes emerging from the hundreds of pages of proposed Medicare payment and policy rules impacting hospitals and post-acute providers include encouraging price transparency, promoting exchange of healthcare data, and...more

CMS Releases FY 2019 Proposed Payment Rules

by Baker Ober Health Law on

On April 24 and 27, 2018, CMS launched its annual gaggle of proposed regulations – each with the theme of "Patients over Paperwork" – with the stated goal of "advanc[ing] the agency's priority of creating a patient-driven...more

Medicare cost reporting changes on the horizon

by Dentons on

On April 24, 2018, CMS released its fiscal year 2019 hospital inpatient prospective payment system (IPPS) proposed rule (the Proposed Rule), in which the agency has proposed a number of changes to supporting documentation...more

CMS proposes to eliminate requirement for written inpatient admission orders

by Bricker & Eckler LLP on

On April 24, 2018, the Centers for Medicare and Medicaid Services (CMS) published the 2019 Medicare Inpatient Prospective Payment System proposed rule (2019 Proposed IPPS Rule), which contains a number of proposals designed...more

CMS Releases FY 2019 Medicare IPPS and LTCH PPS Proposed Rule, Proposes Significant Changes to Several Regulatory Requirements

by King & Spalding on

On April 24, 2018, CMS issued the annual Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System (PPS) Proposed Rule for FY 2019 (the Proposed Rule) which will...more

CMS Proposes Changes to Inpatient Admission Orders in 2019 IPPS Proposed Rule

by King & Spalding on

On April 24, 2018, the Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) Proposed Rule (CMS-1694-P). Among other changes, CMS proposes eliminating...more

Seeking Interoperability: Centers for Medicare & Medicaid Services

by Farrell Fritz, P.C. on

As we have discussed in an earlier blog post, the federal administrative agencies have been placing greater emphasis on being more transparent and promoting “interoperability”....more

Alston & Bird Healthcare Week in Review

by Alston & Bird on

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

FY 2019 IPPS proposed rule contains GME-related provisions

by Dentons on

On April 24, 2018, the Centers for Medicare & Medicaid Services (CMS) released the agency's fiscal year 2019 inpatient prospective payment system (IPPS) proposed rule. Although the rule contains many proposals relating to...more

CMS Extends Hospital and CAH Attestation Deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the eligible hospital and critical access hospital (CAH) attestation deadline from February 28, 2018 to March 16, 2018....more

Alston & Bird Healthcare Week In Review

by Alston & Bird on

I. Regulations, Notices, & Guidance - On February 12, 2018, the Food and Drug Administration (FDA) issued a guidance entitled, Bacillus Calmette-Guérin-Unresponsive Nonmuscle Invasive Bladder Cancer: Developing Drugs and...more

Alston & Bird Healthcare Week In Review

by Alston & Bird on

I. Regulations, Notices, & Guidance - On February 5, 2018, the Drug Enforcement Agency (DEA) issued a temporary scheduling order entitled, Schedules of Controlled Substances: Temporary Placement of Fentanyl-Related...more

Alston & Bird Healthcare Week In Review

by Alston & Bird on

On January 29, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a notice entitled, Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Extension of Temporary Moratoria on...more

Alston & Bird Healthcare Week In Review

by Alston & Bird on

On January 22, 2018, the Drug Enforcement Administration (DEA) issued a final rule entitled, Implementation of the Provision of the Comprehensive Addiction and Recovery Act of 2016 Relating to the Dispensing of Narcotic Drugs...more

Alston & Bird Healthcare Week In Review

by Alston & Bird on

On January 16, 2018, the Food and Drug Administration (FDA) issued a proposed rule entitled, Internal Agency Review of Decisions; Requests for Supervisory Review of Certain Decisions Made by the Center for Devices and...more

Alston & Bird Healthcare Week in Review

by Alston & Bird on

On January 2, 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a final rule entitled, Confidentiality of Substance Use Disorder Patient Records. The final rule makes changes to the SAMHSA...more

Alston & Bird Healthcare Week in Review

by Alston & Bird on

On December 11, 2017, the Food and Drug Administration (FDA) issued a guidance entitled, Product Name Placement, Size, and Prominence in Promotional Labeling and Advertisements. The guidance clarifies the requirements for...more

CMS Schedules Feb. 13 Town Hall Meeting on IPPS New Tech Applications

by Reed Smith on

On February 13, 2019, CMS is holding a public Town Hall meeting to discuss requests for add-on payments for new medical technologies under the Medicare hospital inpatient prospective payment system (IPPS). ...more

Alston & Bird Healthcare Week in Review

by Alston & Bird on

On November 27, 2017, the Food and Drug Administration (FDA) issued a guidance entitled, Pediatric Information for X-ray imaging Device Premarket Notifications. The guidance outlines FDA’s rationale regarding information that...more

CMS Extends Deadline for Providers to Submit an Initial or Revised Worksheet S-10 for FYs 2014 and 2015 until January 2, 2018

by King & Spalding on

Following a second update in less than a year to the instructions for completing Worksheet S-10, CMS has now also provided a further extension for providers to file an initial or revised Worksheet S-10, which is used by...more

The More Things Change, the More They Stay the Same – CMS’ Guidance on Co-Located Hospitals and the Removal of Certain Hospital...

by Polsinelli on

With recent changes to the Hospital within Hospital (“HwH”) rules, is it easier to meet the HwH standards? Likely, not. HwHs are hospitals excluded from the inpatient prospective payment system (“IPPS”), such as psychiatric,...more

CMS Corrects Final FY 2018 IPPS, LTCH, and SNF Payment Rules

by Reed Smith on

CMS has released corrections to two major fiscal year (FY) 2018 Medicare payment rules. First, CMS has made numerous technical corrections to the FY 2018 inpatient prospective payment systems (IPPS) and long term care...more

CMS Finalizes IPPS/LTCH Payment and Policy Changes for FY 2018

by Reed Smith on

CMS has published its final rule to update the Medicare acute hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) for fiscal year (FY) 2018. CMS projects...more

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