News & Analysis as of

Office of Management and Budget Medicare

Final Medicare Provider Payment Rules in the Pipeline

by Reed Smith on

The White House Office of Management and Budget (OMB) is reviewing several CMS rules that would finalize CY 2018 Medicare payment policies for various types of providers and suppliers. Specifically, OMB is reviewing final...more

Washington, D.C. Update – June 2017

by Baker Donelson on

Having returned from its Memorial Day recess, Congress now enters one of the longest continuous work periods of the year and – with the exception of the week of the Fourth of July – will likely be in session until the end of...more

Regulatory “Freeze” Thaws for HHS: Medicare FY 2018 IPPS/LTCH Rulemaking Process Gets Underway

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) is moving ahead on its annual Medicare hospital payment update rule – and it actually is ahead of last year’s pace. Specifically, on March 8, 2017 CMS sent to Office of...more

The MOON Notification is Coming: CMS Publishes Final Changes

by Baker Ober Health Law on

CMS is moving forward with implementing the Medicare Outpatient Observation Notice (MOON) as announced in its FY 2017 IPPS Final Rule [PDF] on August 2, 2016, and published in the Federal Register on August 22, 2016 (Final...more

Also In The News - Health Headlines - September 2016

by King & Spalding on

Interim Final Rule Increases Civil Monetary Penalty Amounts – On September 2, 2016, the Department of Health and Human Services (HHS) released an interim final rule that “adjust[s] for inflation the maximum civil monetary...more

Also In The News - Health Headlines - August 2016 #3

by King & Spalding on

CMS Releases Medicare Outpatient Observation Notice For Public Comment – CMS announced that the public has the opportunity to comment on the Medicare Outpatient Observation Notice (MOON). The MOON is a standardized form...more

CMS Issues Pay Increase for Inpatient Psychiatric Facilities

by King & Spalding on

On July 28, 2016, CMS issued a notice updating the prospective rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities. Beginning in fiscal year 2017, inpatient psychiatric facilities will...more

Also In The News - Health Headlines - June 2016 #3

by King & Spalding on

OMB Reviewing Proposal on Handling of 340B Disputes -- On June 15, 2016, the Office of Management and Budget (OMB) started its review of a proposed rule under the 340B discount program, according to the OMB’s website. Under...more

A&B Healthcare Week in Review

by Alston & Bird on

I. REGULATIONS, NOTICES, & GUIDANCE - On April 4, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the Final Calendar Year (CY) 2017 Medicare Advantage Capitation Rates and Medicare Advantage (MA) and...more

Also In The News - Health Headlines - March 2016 #2

by King & Spalding on

OMB to Review Proposed Rule on Merit-Based Medicare Payment for Physicians – The White House Office of Management and Budget (OMB) is reviewing a proposed rule that would implement the Merit-Based Incentive Payment System...more

A&B Healthcare Week in Review

by Alston & Bird on

I. REGULATIONS, NOTICES, & GUIDANCE - On March 29, 2016, Centers for Medicare & Medicaid Services (CMS) issued a final rule entitled, “Medicaid and Children’s Health Insurance Programs: Mental Health Parity and...more

CMS Moving Ahead on Medicare Physician Payment Reform; Proposed MACRA Rule at OMB

by Reed Smith on

The White House Office of Management and Budget (OMB) is now reviewing a highly-anticipated Centers for Medicare & Medicaid Services’ (CMS) proposed rule to implement major Medicare physician payment reform provisions...more

Also In The News - Health Headlines - March 2016

by King & Spalding on

OMB to Review Medicare Appeals Procedures – The Office of Information and Regulatory Affairs (“OIRA”) within the Office of Management and Budget (“OMB”) is set to review new Medicare appeals process proposed rulemaking. ...more

Washington Healthcare Update

by McGuireWoods LLP on

This Week: The President took a victory lap in Wisconsin, announcing that 20 million people have gained health insurance through the Affordable Care Act... That figure includes people newly covered through insurance...more

A&B Healthcare Week in Review

by Alston & Bird on

I. REGULATIONS, NOTICES, & GUIDANCE - On February 24, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a guidance entitled, “Special Enrollment Confirmation Process” that will enhance program integrity...more

Also In The News - Health Headlines - January 2016 #2

by King & Spalding on

OMB to Review Proposed Rule on Conditions of Participation for Hospitals – The White House Office of Management and Budget (OMB) received for review on January 4, 2016, a proposed rule (RIN 0938-AS21) that would revise...more

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

by King & Spalding on

OMB Reviewing Final Rule Regarding New Payment Model for Hip and Knee Replacements – The White House Office of Management and Budget (OMB) received for review on October 28, 2015, a final rule establishing a new Medicare...more

Blog: OIG Releases FY2016 Work Plan: Areas to be Reviewed Include SNFs, Drug Pricing, HIPAA

by Cooley LLP on

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) released this week its FY2016 Work Plan (Work Plan). The OIG Work Plan summarizes new and ongoing OIG reviews of various HHS programs and...more

CMS Sends Long-Awaited Medicare 60-Day Overpayment Rule to OMB for Final Clearance

by Reed Smith on

CMS is moving ahead on its much-anticipated final rule implementing Affordable Care Act (ACA) requirements on reporting and returning of Medicare overpayments. Under the ACA, enrolled providers and suppliers (and certain...more

CMS Sends Final 2016 Medicare Payment Rules to OMB for Review

by Reed Smith on

This week CMS referred major final calendar year 2016 Medicare payment rules to the White House Office of Management and Budget (OMB) for regulatory clearance. Specifically, OMB is reviewing the final CMS rules to update the...more

OMB Reviewing New Final Rule on ACO Waivers

by Locke Lord LLP on

Joint waivers issued by the Centers for Medicare and Medicaid Services (CMS) and HHS Office of Inspector General (OIG) relating the application of the physician self-referral law, the Federal anti-kickback statute, and...more

A&B Healthcare Week In Review, September 2015

by Alston & Bird on

On September 25, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled “Medicare Program: Medicare Clinical Diagnostic Laboratory Tests Payment System”. This proposed rule would...more

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

by King & Spalding on

Final ACO Fraud Waiver Under OMB Review – The White House Office of Management and Budget (OMB) reported on September 9, 2015, that it began its review of the final rule (CMS-1439-F; RIN 0938-AR30), titled “Medicare Shared...more

Also In The News - Health Headlines - September 2015

by King & Spalding on

CMS Announces New SNF Payment – On August 27, 2015, CMS announced “a new funding opportunity” for SNFs that is intended “to reduce avoidable hospitalizations by funding higher-intensity interventions in nursing...more

OMB Reviewing CMS Proposed Rule on PAMA Clinical Lab Test Payment Policy

by Reed Smith on

CMS is finally taking steps to implement the Medicare clinical laboratory payment reforms mandated by the Protecting Access to Medicare Act of 2014 (PAMA). Under PAMA, CMS must base Medicare payment rates for clinical...more

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