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Payment Systems Fee-for-Service

King & Spalding

OIG Audit Finds That Medicare Could Achieve Significant Savings if Critical Access Hospital Payments for Swing-Bed Services Were...

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On January 3, 2025, OIG posted the results of an audit that found that Medicare could have saved $7.7 billion if critical access hospitals’ (CAH) payments for swing-bed services were similar to those of the fee-for-service...more

King & Spalding

CMS Proposes Rule to Require Certain Health Plans to Electronically Share Data with Providers Regarding Prior Authorization...

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On December 13, 2022, CMS is set to publish in the Federal Register a proposed rule (Proposed Rule) requiring certain Medicare, Medicaid, Children’s Health Insurance Program, and Qualified Health Plan fee-for-service and...more

King & Spalding

MedPAC Issues Medicare Payment Policy Report to Congress

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On March 15, 2021, the Medicare Payment Advisory Commission (MedPAC) released its Medicare Payment Policy report to Congress updating payment recommendations for providers paid under Medicare’s traditional fee-for-service...more

McDermott Will & Emery

Managing the Transition to Transformation: Implementing a CJR Collaborator Agreement

Summary - McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and...more

McDermott Will & Emery

Managing the Transition to Transformation: Changing the Dynamic: How Alternative Payment Systems Are Changing the Strategic Goals...

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Introduction - The transition of the US health care payment system from fee-for-service (FFS) to alternative value-based, budget-based, episode or procedure-based (e.g., bundled) and/or population-based payment models...more

King & Spalding

MedPAC Discusses Changes to Medicare Advantage Payment System

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On October 8 and 9, 2015, the Medicare Payment Advisory Commission (MedPAC) held its second meeting of the 2015-2016 session. Commissioners met to examine ways to improve the Medicare Advantage (MA) payment system, including...more

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