News & Analysis as of

Medicare Access and CHIP Reauthorization (MACRA)

Key Health Care Provisions of Bipartisan Budget Act of 2018

by Baker Donelson on

The wide-reaching Bipartisan Budget Act of 2018 (BBA), passed by Congress and signed by the President on February 9, 2018, extends and modifies dozens of health care programs, including extending funding for two years for...more

Update On New Medicare Cards And The Transition To The Medicare Beneficiary Identifier

by Pierce Atwood LLP on

In an effort to combat identity theft and prevent fraud as well as to comply with the provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, the Centers for Medicare and Medicaid Services (CMS) will...more

Congress Makes Key Changes to Medicare Physician Payment Programs as Part of Short-Term Government Funding Bill

• Congress amended current law to prevent CMS from applying the “MIPS” payment adjustment to separately billed items like drugs and biologics, which will drastically reduce the total amount of payment adjustments to clinical...more

Bipartisan Budget Act of 2018: Major Impacts on Health Care

by Baker Donelson on

After a brief federal government shutdown overnight, Congress passed and the President signed into law the Bipartisan Budget Act of 2018 on February 9, 2018. The Senate voted 71-28 and the House voted 240-186 to approve the...more

House, Senate Proposals to Extend Funding for the Federal Government

by Holland & Knight LLP on

Congress moved one step closer to avoiding a government shutdown on Feb. 6, voting overwhelmingly (245-182) to pass a short-term, GOP-backed government funding bill (text; section-by-section) that would keep the federal...more

CMS Releases Advance Notice and Call Letter for Medicare Advantage and Part D

Late last week, CMS released the Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2019 draft Call Letter (Advance Notice...more

Medicare Extenders Included in House-Passed Continuing Resolution

by Baker Donelson on

On February 6, 2018, the House voted 242-182 to pass a Continuing Resolution (CR) to extend government funding until March 23, 2018 (H.R. Res 128). The CR includes provisions to extend funding for a number of Medicare...more

OIG Offers Additional Guidance on Gainsharing Arrangement in Advisory Opinion 17-09

by Baker Ober Health Law on

A non-profit acute care hospital may share cost savings for certain spinal surgeries with neurosurgeons in a multi-specialty physician group following approval by the U.S. Department of Health & Human Services, Office of...more

BPCI Advanced – CMS Offers a Familiar Program with a New Twist

by Baker Ober Health Law on

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

MACRA: Rolled Out and Still Rolling

by Burr & Forman on

Most physicians have, by this point, gained some familiarity with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The name of this law has appeared frequently in commentary over the past several years, and...more

Future of Medicare: Funding for Extenders and Payment Policy Priorities

by Baker Donelson on

Health care stakeholders are increasing pressure on Congress to continue funding for a series of Medicare "extenders" – Medicare program and payment policies that expired at the end of 2017. Some examples of the extenders...more

Gainsharing Guidance: Clarification on Cost-Savings Arrangements Between Hospitals and Physicians

by Polsinelli on

The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) recently posted its first advisory opinion interpreting a gainsharing arrangement – that is, a financial relationship under which...more

OIG Issues Favorable Advisory Opinion Addressing Gainsharing CMP Arrangement

by Dorsey & Whitney LLP on

On January 5, 2018, the Office of the Inspector General of the United States Department of Health and Human Services (“OIG”) released a favorable Advisory Opinion 17-09 that addresses Section 1128A(b)(1) of the Social...more

CMS Announces an Advanced Alternative Payment Model - BPCI Advanced

by Foley & Lardner LLP on

On January 9, 2018, The Centers for Medicare & Medicaid Services (CMS) announced a new voluntary bundled payment model program – Bundled Payment for Care Improvement Advanced (BPCI Advanced). The episode payment model, which...more

Alston & Bird Healthcare Week in Review

by Alston & Bird on

On January 8, 2018, the Department of Veterans Affairs (VA) issued a rule entitled, Reimbursement for Emergency Treatment. The VA revised its regulations concerning payment or reimbursement for emergency treatment for...more

CMS Proposes New Voluntary Bundled Payment Model

by Holland & Knight LLP on

On January 9, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary bundled-payment demonstration program, also known as Bundled Payments for Care Improvement (BPCI) Advanced. The new model will test...more

CMS Announces First Advanced Alternative Payment Model Under MACRA: Bundled Payments for Care Improvement Advanced

On January 9, 2018, the Centers for Medicare & Medicaid (CMS) Center for Medicare and Medicaid Innovation announced a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced). ...more

CMS Quality Payment Program: Are you ready for round two?

by Bricker & Eckler LLP on

2018 marks the commencement of the second performance year for the Medicare Quality Payment Program (QPP), implemented under the Medicare Access and CHIP Reauthorization Act of 2015 (otherwise known as MACRA). ...more

OIG Issues Favorable Gainsharing Advisory Opinion

by King & Spalding on

On December 29, 2017, OIG issued a favorable advisory opinion interpreting the application of the gainsharing civil monetary penalty provision (Gainsharing CMP) and the Anti-Kickback Statute in connection with a proposed...more

ML Strategies – 2018 Health Care Preview

Happy New Year!?! 2017 was an eventful year for health care, and now we can all sit back and relax with very little concern that major health policy will be on the table in 2018. Right? Why must Speaker Ryan ruin our...more

Health Care Industry Must be Mindful of ‘Information Blocking’

by Polsinelli on

Under the 21st Century Cures Act (Cures Act), the Health and Human Services (HHS) Secretary is mandated to have promulgated regulations by Dec. 13, 2017 that, among other requirements, prohibit “information blocking” as a...more

Telemedicine on the Rise: Five Factors Driving Telehealth Growth in 2017 – and Beyond

by Faegre Baker Daniels on

Telehealth has been a growing point of emphasis in U.S. health care discourse, as health care providers look to leverage interconnectivity to treat patients from a distance and legislators seek new ways to improve care. In...more

2017 Healthcare Year in Review

by Burr & Forman on

If the 2017 healthcare environment could be summed up in one word, it would be “uncertainty.” With the largely unexpected election of Donald Trump as President, the multiple, unsuccessful attempts by the Republican controlled...more

MACRA Quality Payment Program Final Rule: Implications for 2018 and Beyond

On November 2, 2017, CMS published its final rule (the “Final Rule”) on the 2018 Quality Payment Program (“QPP”), authorized by the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). This final rule adopted many...more

Congressional Hearings Focus on Health Policy Issues

by Reed Smith on

A number of Congressional panels have scheduled or held recent hearings on health policy issues, including the following: On November 30, 2017, the House Energy & Commerce Committee is holding a hearing on implementation...more

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