News & Analysis as of

Long Term Care Facilities Provider Payments

Baker Donelson

New CMS Guidance for Long Term Care Facilities with COVID-19 Residents

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As long term care (LTC) facility cases of COVID-19 continue to rise, the Centers for Medicare and Medicaid Services (CMS) remains vigilant in its efforts to regulate the delivery of adequate care to those residents with...more

Baker Donelson

If You're Reading This, You're Too Late: Key Drivers in Rising Health Care Defaults

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Health care bankruptcy filings more than tripled in 2017 as compared to 2016 with no end in sight to the financial struggles facing owners and operators in the sector. According to Bloomberg, health care bankruptcies have...more

Baker Donelson

CMS Releases FY 2019 Proposed Payment Rules

Baker Donelson 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

Bass, Berry & Sims PLC

CMS Proposes New Payment Model and Other Changes for Home Health Agencies

Bass, Berry & Sims PLC on

Among the various payment updates proposed by the Centers for Medicare and Medicaid Services (CMS) this summer, the proposed payment update for the home health agency prospective payment system (HHA-PPS), published in the...more

Seyfarth Shaw LLP

New “Site Neutrality” Proposed Rule Would Slash Hospital Outpatient Payments for Off-Campus Services by 50%

Seyfarth Shaw LLP on

In a proposed rule published in the Federal Register on July 21, 2017, the Centers for Medicare & Medicaid Services (“CMS”) moved to cut payments for most services provided by off-campus locations of hospitals by 50 percent. ...more

Foley & Lardner LLP

21st Century Cures Act Provides Some Welcome Relief

Foley & Lardner LLP on

The 21st Century Cures Act (the “Cures Act”) (Pub. L. No. 114-255), which was signed into law by President Obama on December 13, 2016, includes a number of important health care provisions, and several address the...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

Baker Donelson

CMS Releases the 2017 IPPS and LTCH PPS Final Rule, Including MOON Requirements

Baker Donelson on

On August 2, 2016, CMS issued its final rule addressing new payment rates and policies under both the Hospital Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System...more

King & Spalding

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

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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

Baker Donelson

CMS's Proposed IPPS and LTCH FY 2017 Rule: Key Takeaways

Baker Donelson on

On April 18, 2016, CMS released its proposed rule addressing new payment rates and policies under both the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS),...more

King & Spalding

MedPAC Publishes Report to Congress on 2017 Policies, Recommends Payment Reforms and Cuts to Part B Payments to Hospitals for 340B...

King & Spalding on

On March 15, 2016, MedPAC submitted its 2016 annual report to Congress on Medicare payment policies for 2017. In the Report, MedPAC makes a number of recommendations to Congress pertaining to payment under Medicare...more

King & Spalding

CMS Issues FY 2016 IPPS and LTCH Proposed Rule

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On April 17, 2015, CMS released a proposed rule (Proposed Rule) to update the fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital...more

King & Spalding

D.C. Circuit Overturns PRRB’s Decision that Only Newly Built Hospitals Can Qualify for Favorable Capital Reimbursement Rates

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In Select Specialty Hospital – Bloomington, Inc. v. Burwell, No. 15-5355 (D.C. Cir., Jul. 8, 2014), a group of long-term care hospitals (LTCHs) successfully challenged the Secretary’s determination that they were not “new...more

Baker Donelson

CMS Publishes Inpatient Prospective Payment System (IPPS) FY 2015 Proposed Rule

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On April 30, 2014, CMS posted its proposed changes and updates to the Medicare IPPS [PDF] that would apply beginning in fiscal year (FY) 2015. Comments are due by June 30, 2014. Below is a summary of the major changes to the...more

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