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Payment Systems Healthcare

King & Spalding

Supreme Court Holds that Those “Entitled to Supplemental Security Income Benefits” Means Receiving Cash Payment for Hospital DSH...

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Last week, the Supreme Court issued its opinion in Advocate Christ Medical Center v. Kennedy, siding with the government and holding that, for purposes of the Medicare disproportionate share hospital (DSH) calculation,...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes Medicare Payment Policies for Hospital Inpatient Services for Federal Fiscal Year 2026

The Centers for Medicare & Medicaid Services (CMS) recently published the fiscal year (“FY”) 2026 proposed rule for Hospital Inpatient Prospective Payment Systems (IPPS) (the “Proposed Rule”). Comments to the Proposed Rule...more

Ropes & Gray LLP

CMS Publishes Federal Fiscal Year 2026 Hospital Payment Proposed Rule

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On April 11, 2025, the Centers for Medicare & Medicaid Services (“CMS”) published its annual proposed rule for the federal fiscal year (“FFY”) 2026 inpatient prospective payment system (“IPPS”) and long-term care hospital...more

King & Spalding

CMS Issues Proposed FY 2026 PPS Rule for Inpatient Psychiatric Facilities

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On April 11, 2025, CMS issued its fiscal year (FY) 2026 prospective payment system (PPS) proposed payment rule for inpatient psychiatric hospitals (IPFs). In addition to updating Medicare payment rates, adjustment factors,...more

King & Spalding

CMS Issues IPPS and LTCH Proposed Rule for FY 2026

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On Friday, April 11, 2025, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Proposed Rule for Fiscal Year (FY) 2026 (the Proposed...more

McDermott+

CMS Releases FY 2026 Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule

McDermott+ on

On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2026 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment...more

McDermott+

CMS Releases CY 2025 Hospital Outpatient Prospective Payment and ASC Payment Systems Final Rule

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On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Final Rule [CMS-1809-F],...more

Baker Donelson

Significant Changes Affecting Hospitals in CMS's FY 2025 IPPS Final Rule

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CMS published its FY 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) final rule on August 1, 2024. Under this final rule, CMS is implementing several changes to its Hospital Inpatient Quality Reporting...more

McDermott+

CMS Releases FY 2025 Hospital Inpatient Prospective Payment System (IPPS) Final Update

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On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the Hospital Inpatient Prospective Payment System (IPPS) final update for fiscal year (FY) 2025, along with proposed policy and regulation changes....more

ArentFox Schiff

Post-Chevron Health Care Regulations: Using Loper Bright as a Shield in Stark Law Litigation

ArentFox Schiff on

Previously, we discussed how the US Supreme Court’s opinion in Loper Bright Enterprises v. Raimondo and Relentless, Inc. v. Department of Commerce could create opportunities for private litigants to challenge health...more

Akin Gump Strauss Hauer & Feld LLP

The Regulatory Race Is On: The Biden Administration Sprints to Issue Key Health Policies

The upcoming election, and the approaching end of the President’s four-year term, introduce additional dynamics into the agencies’ rulemaking process and even the guidance process. From now through the November election, the...more

McDermott+

McDermottPlus Check-Up: April 17, 2024

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House Energy & Commerce Health Subcommittee Holds Hearing on Cybersecurity. During the hearing, there was bipartisan concern about UnitedHealth Group’s response to the Change Healthcare cyberattack and consensus around the...more

McDermott+

McDermottPlus Check-Up: April 5, 2024

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Senate HELP Committee Holds Field Hearing on Private Equity. In the hearing, held at the Massachusetts State House, members discussed the impact of private equity ownership on patients, providers, quality of care and...more

McDermott+

COVID-Era Flexibilities Granted in Wake of Change Healthcare Cybersecurity Attack

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Today marks one month since United Health Group’s (UHG) Change Healthcare reported that it had been hit by a cybersecurity attack. The attack has caused a major disruption to the US healthcare system, significantly impacting...more

ArentFox Schiff

Health Care Providers Navigate Fallout of Major Cyberattack on Change Healthcare

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Change Healthcare, an affiliate of Optum and UnitedHealth Group, processes more than 15 billion health care transactions annually and touches one of every three patient records. On February 21, Change disconnected its...more

McDermott+

The Doctor (Fix) Is In: Regulatory Implications of the Minibus Healthcare Package

McDermott+ on

Last Sunday, Congress released the text of a minibus package, which will likely be signed into law by tomorrow. While the bill’s primary purpose is to keep the government open, it also includes healthcare extenders through...more

McDermott+

McDermottPlus Check-Up: March 1, 2024

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Appropriations Update. As appropriators continue to finalize the 12 funding bills for fiscal year (FY) 2024 – which began on October 1, 2023 – a series of stopgap CRs have been needed to avoid a government shutdown. This...more

McDermott Will & Emery

New PCI DSS 4.0 Will Impact the Digital Health and Healthcare Industries

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The healthcare industry – particularly the digital health industry – is increasingly becoming monetized and using an e-commerce model through direct interactions with the customer to accept credit card payments. This...more

McDermott+

Healthcare Preview for the Week of: November 27, 2023

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Limited Time Before the End of the Year and January 19 First, welcome back from what was hopefully a wonderful and restful Thanksgiving break. Although this year will not entail a year-end government funding package, we are...more

Gardner Law

Compliance Considerations in High-Tech Healthcare

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Cutting-edge technology is desirable to consumers for its ability to deliver innovative solutions, improved efficiency, enhanced user experiences, and the promise of staying ahead in an ever-evolving digital landscape. The...more

McDermott Will & Emery

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

McDermott Will & Emery on

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

Robinson+Cole Health Law Diagnosis

CMS Announces 0.8 Percent Aggregate Home Health Payment Increase in 2024

On Wednesday, November 1, the Center for Medicare & Medicaid Services (CMS) released its Home Health Prospective Payment System Rate Update final rule for CY 2024 (the Final Rule). The Rule estimates that the aggregate...more

McDermott+

End-Stage Renal Disease Prospective Payment System CY 2024 Final Rule

McDermott+ on

On October 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Calendar Year (CY) 2024 final rule (CMS-1782-F). The rule finalizes minimal...more

McDermott+

McDermottPlus Check-Up: October 13, 2023

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CONGRESS - House Republicans Working to Elect New Speaker. On October 11, House Majority Leader Scalise won the Republican Conference’s nomination to become Speaker of the House after last week’s motion to vacate Speaker...more

McDermott+

New No Surprises Act Announcements Indicate Bumpy Road Ahead

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The bumpy road toward implementing the No Surprises Act took another turn last Friday, October 6, 2023. The US Departments of Health and Human Services (HHS), Labor and the Treasury (collectively, the Departments) provided...more

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