News & Analysis as of

Medicare American Medical Association

Health Care Compliance Association (HCCA)

Compliance with Medicare’s updated 2024 split (or shared) visit policy

Split (or shared) visits—the current term used by the Center for Medicare & Medicaid Services (CMS)—allow non-physician practitioners (NPPs) and physicians who work for the same employer/entity to share patient visits on the...more

Holland & Knight LLP

Holland & Knight Health Dose: February 6, 2024

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

McDermott Will & Emery

Remote Monitoring and Digital Therapies: CMS Updates Coverage and Payment Policies

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In recent years, the Centers for Medicare & Medicaid Services (CMS) has expanded payment for remote monitoring services in an effort to pay for non-face-to-face services that improve care coordination for Medicare...more

Foley & Lardner LLP

Medicare Remote Therapeutic Monitoring: Top FAQs for 2023

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On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) finalized new policies related to remote therapeutic monitoring (RTM) services reimbursed under the Medicare program. The changes, part of the...more

Foley & Lardner LLP

Remote Therapeutic Monitoring: What You Need to Know About CMS’ Proposed Changes

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On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed five new changes to Remote Therapeutic Monitoring (RTM) services under the Medicare program. The changes, part of the proposed 2023 Medicare...more

ArentFox Schiff

Providing Remuneration to Address Physician Burnout: Stark Law Considerations

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Hospitals and Other Providers Should Make Sure Any Items or Services of Value That They Provide to Their Referring Physicians To Alleviate Burnout Comply With the Stark Law - Amidst the ongoing labor market shortages and...more

Jackson Lewis P.C.

AMA and AHA Seek to Enjoin Certain Provisions of the No Surprises Act’s Implementing Rule

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In December 2020, Congress passed the “No Surprises Act” (NSA) as part of the Consolidated Appropriations Act of 2021. The NSA applies most commonly in situations where a patient receives out-of-network medical services from...more

Sheppard Mullin Richter & Hampton LLP

News Flash: Last Minute Congressional Action Saves Physicians from a Nearly 10% Cut to Medicare Payments

Physicians and other providers can take a deep breath as Congress has acted to prevent the trio of Medicare payment cuts that were set to take effect at the beginning of 2022—a 3.75% cut due to scheduled changes in the...more

Foley & Lardner LLP

2022 Medicare Remote Therapeutic Monitoring FAQs: CMS Final Rule

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Continuing the trend of expanded Medicare reimbursement for remote monitoring, the Centers for Medicare and Medicaid Services (CMS) released the 2022 Physician Fee Schedule final rule on its new Remote Therapeutic Monitoring...more

Benesch

Dialysis & Nephrology Digest - August 2021

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DaVita, former CEO indicted in federal market collusion case - DaVita and the company’s former CEO, Kent Thiry, were alleged to have conspired with Surgical Care Affiliates to suppress competition for senior-level...more

Benesch

Dialysis & Nephrology Digest - March 2021 #2

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AMA report suggests Medicare spending fell 19% YoY during first half of 2020; reduction in nephrology much smaller The report from the American Medical Association (AMA) found Medicare payments to physicians the first six...more

King & Spalding

CMS Finalizes the Physician Fee Schedule Rule for Calendar Year 2021

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On December 2, 2020, CMS issued a final rule updating the payment policies and rates for services to be furnished under the Medicare Physician Fee Schedule (PFS) in calendar year (CY) 2021. The final rule includes...more

Foley & Lardner LLP

Challenging Physician Judgment: Is Your Institution Exposed to False Claims Act Liability?

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Many health care providers treating senior patients rely on Medicare reimbursement and undertake significant measures to ensure proper billing and compliant practices. However, providers across the country may soon be subject...more

K&L Gates LLP

2021 Physician Fee Schedule Proposed Rule

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On 3 August 2020, the Centers for Medicare & Medicaid Services (CMS) released its Physician Fee Schedule (PFS) proposed rule (Proposed Rule) for Calendar Year (CY) 2021.1 The agency will accept comments on the Proposed Rule...more

Akin Gump Strauss Hauer & Feld LLP

New CMS National Coverage Determination and FDA Regulatory Approach: the Next Generation for NGS Testing Policy?

• The new national Medicare coverage determination covers only FDA-authorized NGS tests with companion diagnostic indications, leaving NGS cancer tests without that specific indication to seek coverage from local Medicare...more

Baker Donelson

Congress Takes Long Look at Proposed Health Insurance Mergers

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While the Department of Justice Antitrust Division is responsible for reviewing the proposed Anthem/Cigna and Aetna/Humana mergers for any potential competitive concerns, Congress jumped into the process with both feet in...more

Patrick Malone & Associates P.C. | DC Injury...

Yep, There’s a Billing Code for That

If you think you’re waiting even longer at your doctor’s office these days, you might be right. And it might be due to the overhaul of the medical billing code system that requires providers to enter an alphanumeric...more

King & Spalding

Also In The News - Health Headlines - September 2015 #3

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FDA and CDC Issue An Alert on Properly Cleaning Medical Devices – On September 11, 2015, the CDC and FDA issued a joint advisory alerting providers and facilities about properly cleaning medical devices, due to concern with...more

King & Spalding

Also In The News - Health Headlines - July 2015 #2

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CMS and AMA Announce Efforts to Help Providers Get Ready for ICD-10 – On July 6, 2015, CMS and AMA announced efforts to continue to assist providers to get ready for the upcoming October 1 switch from ICD-9 to ICD-10 coding...more

Arnall Golden Gregory LLP

CMS Proposes to Establish Separate Payment for End of Life Planning Services

On July 8, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that updates payment rates and related reimbursement and quality policies for physician services furnished under the Medicare...more

Faegre Drinker Biddle & Reath LLP

Brace Yourself for another Round of Death Panel Debate

Remember the notorious “death panel” debate of 2009? Congress was considering a proposal to pay doctors for end-of-life counseling. Former vice presidential candidate Sarah Palin led the attack on the proposal, claiming...more

McGuireWoods LLP

What You Need To Know About the AKS Proposed Local Transportation Safe Harbor

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On October 3, 2014, the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) published a proposed rule to expand the safe harbors and make other modifications applicable to the federal...more

Cozen O'Connor

Health Care Reform Implementation Update

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Congress begins its summer recess this week, but last week legislators were busy holding hearings on management issues regarding HealthCare.gov, introducing legislation to increase payments to primary care doctors under...more

Faegre Drinker Biddle & Reath LLP

AMA To Recommend Physicians Be Paid For End-Of-Life Planning

Brace yourself for a reprise of the death panel debate of 2009. The AMA will soon formally recommend to CMS that physicians be paid—or “reimbursed” in health care-speak—for talking with Medicare patients and their families...more

Akerman LLP - Health Law Rx

CMS Releases Unprecedented Amount Of Medicare Billing Information, Increasing Risk Related To Fraud Lawsuits

On April 9, 2014, the Center for Medicare and Medicaid Services ("CMS"), a branch of the Department of Health and Human Services ("HHS"), released data showing utilization, payments, and submitted charges for services and...more

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