News & Analysis as of

Medicare Bundled Payments

Foley Hoag LLP

BPCI Advanced Model Extended with Pricing Changes

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On October 13, 2022, CMS announced it will extend the Bundled Payments for Care Improvement Advanced Model (BPCI Advanced) for two years, with the opportunity for new entities to join the model beginning in 2024. CMS also...more

Foley & Lardner LLP

Transformative Health Care System Affiliations: A Growing Trend

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We continue to see activity in the hospital and health care system affiliation space. While few actually believe that the “Medicare for All” proposals will garner the support of a majority of the American people and are...more

Holland & Knight LLP

CMS Issues 2020 MPFS and QPP Final Rule

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The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B,...more

Foley & Lardner LLP

Radiation Oncology: What You Need to Know About the Long Awaited Bundled Payment Proposal

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On July 10, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Center for Medicare & Medicaid Innovation (Innovation Center) released a much awaited proposal for a new bundled payment model for radiation...more

Hogan Lovells

CMS Radiation Oncology Model proposed rule – summary and early insights

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Last week, the Centers for Medicare & Medicaid Services (CMS) announced new details of a proposed bundled payment model for radiation oncology services (RO Model), which would make fundamental (but temporary) changes to the...more

Holland & Knight LLP

Over 1,500 Medicare Providers Sign Up for BPCI Advanced

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Centers for Medicare & Medicaid Services (CMS) has published the list of 832 Acute Care Hospitals and 715 Physician Group Practices which will be participating in the Bundled Payments for Care Improvement – Advanced (BPCI...more

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

With a knee you can see: Yes, Obamacare helps to cut costs and improve care

Federal regulators may be forced to reconsider their plans to curtail a cost-containing experiment that affects some of the most commonly performed surgeries — knee and hip replacement procedures that hundreds of thousands of...more

Baker Donelson

Maryland All-Payer Model's Progression to Total Cost of Care: Alignment Strategies for Stakeholders in New Cost Paradigm

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The State of Maryland is unique in its historical experimentation with rate setting and global budgets for hospitals, and that experimentation continues with the Maryland Total Cost of Care Model (TCOC). Beginning January...more

K&L Gates LLP

K&L Gates Triage: Triage in 2018: Health Care Topics to Watch in the New Year

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We expect 2018 to be another year of rapid change within the health care industry. In this episode, Mary Beth Johnston highlights some of the key topics that the health care practice group will monitor in the coming year,...more

Baker Donelson

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

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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

Tucker Arensberg, P.C.

CMS Announces Bundled Payments Care Improvement Model

Tucker Arensberg, P.C. on

On January 11, 2018, CMS announced a new voluntary episode payment model (bundled payments for care improvement advanced–BPCI Advanced) that will test a new iteration of bundled payment for the following thirty-two (32)...more

Burr & Forman

2017 Healthcare Year in Review

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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

Baker Donelson

What's Next Now that Mandatory EPM and Cardiac Rehabilitation Payment Models Have Been Terminated?

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CMS released its Final Rule canceling the Episode Payment Model (EPM) and Cardiac Rehabilitation Incentive Payment Model (CR Incentive Payment Model). This was an expected result following August's proposed rule to cancel...more

Parker Poe Adams & Bernstein LLP

CMS Rolls Back Mandatory Bundled Payment Programs

The Trump administration is putting the brakes on a payment model that gained steam across the health care industry under the Obama administration. The Centers for Medicare & Medicaid Services announced yesterday it is...more

Mintz - Health Care Viewpoints

Hospitals and Others Respond to “Red Tape Relief Project” Requests

Last week, a number of health care industry associations sent letters to Congress detailing ways in which the government could relieve them of the burdens associated with “red tape.” The letters are in response to the first...more

Sheppard Mullin Richter & Hampton LLP

CMS Aims to Nix Obama-Era Payment Models

In a proposed rule published Tuesday, August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its intention to roll back a handful of payment models introduced under the Obama Administration. If...more

Mintz - Health Care Viewpoints

CMS Proposes to Cancel Bundled Payment and Incentive Models

The U.S. Centers for Medicare & Medicaid Services (CMS) published a proposed rule last week regarding the cancellation of three bundled payment models and an incentive payment model while also reducing the scope of a third...more

Sheppard Mullin Richter & Hampton LLP

CMS Delays Implementation of New Payment Models (Again)

On March 21, 2017, the Centers for Medicare and Medicaid Services (“CMS”) published an interim final rule (“Interim Final Rule”) delaying (i) the effective date of several new Medicare payment models developed by the CMS...more

Polsinelli

Medicare Mandatory Bundled Payments Rule: Minor Aspects Delayed, Others On-Schedule for July Implementation

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In a move the Centers for Medicare & Medicaid Services cites as a reaction to President Donald Trump's regulatory freeze, CMS announced that implementation of certain minor aspects of the final rule expanding Medicare...more

Foley & Lardner LLP

CMS Finalizes Mandatory Cardiac Care Bundled Payment Model and More

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On December 20, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (the Final Rule) which includes three new mandatory episode-based payment programs for cardiac care, as well as the expansion of the...more

Sheppard Mullin Richter & Hampton LLP

House Republicans Push Back on Medicare’s New Mandatory Bundled Payment Models

On July 25, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that promises to deliver coordinated, high-quality care for Medicare beneficiaries. The proposed rule (effective July 1, 2017)...more

McCarter & English, LLP

Health Law Insights - Issue 12

CMS Proposes Bundled Payments for Cardiac Care - In its most recent effort to hasten Medicare’s transformation from a fee-for-service payment model to a value-based payment model, the Centers for Medicare & Medicaid...more

King & Spalding

CMS Proposes New Bundled Payment Models for Cardiac and Orthopedic Care

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On July 25, 2016, CMS posted a proposed rule that would create three new Medicare Parts A and B episode payment models for patients admitted for care for a heart attack, bypass surgery or surgical hip/femur fracture treatment...more

Foley & Lardner LLP

CMS Expands Mandatory Bundled Payments to Cardiac Care

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On Monday July 25, 2016, CMS proposed new models that expand mandatory participation in bundled payments and continue CMS’s initiative to shift Medicare payments from fee for service to alternative payment models. Coming just...more

King & Spalding

Also In The News - Health Headlines - April 2016

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CMS Extends Participation in Bundled Payments for Care Improvement by Two Years – CMS has offered awardees the opportunity to extend participation in Models 2, 3, and 4 of the Bundled Payments for Care Improvement program...more

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