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Interim Final Rules (IFR) Reimbursements

King & Spalding

Ninth Circuit Vacates Low-Wage-Index Policy

King & Spalding on

On December 11, 2024, the Ninth Circuit struck down an HHS policy that boosted the wage index, and therefore the Medicare reimbursement rate, for hospitals in low-income communities in Kaweah Delta Health Care District v....more

Sheppard Mullin Richter & Hampton LLP

Executive Order on Promoting Competition in the American Economy: The Biden Administration Considers Drug Pricing Strategies While...

On August 10, 2021, the Centers for Medicare and Medicaid (“CMS”) published a proposed rule (“Proposed Rule”) to rescind the Most Favored Nation Model (“MFN Model”) interim final rule that was published on November 26, 2020...more

Baker Donelson

CMS Delays Regulatory Definition of Reasonable and Necessary

Baker Donelson on

Although Centers for Medicare & Medicaid Services (CMS) finalized its regulatory definition of reasonable and necessary through its recently published Final Rule, the Final Rule has now become subject to review under the...more

Baker Donelson

Medicare Issues Interim Final Rule to Lower Payments to Hospitals and Physicians for Certain Drugs Starting January 1, 2021

Baker Donelson on

On November 20, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment period (IFC) to implement a payment model that will significantly reduce Medicare reimbursement rates for...more

Hogan Lovells

Medicare links Part B payment rates to international prices: Most Favored Nation Model

Hogan Lovells on

On November 20, 2020, the U.S. Centers for Medicare & Medicaid Services (CMS) issued an interim final rule (IFR) with comment period implementing a mandatory “Most Favored Nation” demonstration model (MFN Model) to test...more

Mitchell, Williams, Selig, Gates & Woodyard,...

Agent Fees and the Payment Protection Program

Last week, Arkansas saw its first class action where “agents” claimed entitlement to payment of fees under the Payment Protection Program (PPP). This class action illustrates another area of confusion surrounding the...more

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