News & Analysis as of

Value-Based Payments Medicaid

Hogan Lovells

Center for Medicare and Medicaid innovation (CMMI) to end four payment models in cost-cutting effort

Hogan Lovells on

On March 12, 2025, the Centers for Medicare & Medicaid Services’ (CMS’s) Center for Medicare and Medicaid Innovation (CMMI) announced that it intends to end early four payment models to achieve $750 million in savings: the...more

McDermott+

Value-Based Care at a Crossroads: What’s Next and How To Prepare

McDermott+ on

The Trump administration will have its own vision on value-based care, creating specific priorities for the Center for Medicare & Medicaid Innovation (CMMI), the federal government’s primary testing ground for payment and...more

Whiteford

Navigating Value-Based Care in Anesthesia: Enhancing Patient Outcomes Amid Legal Complexities

Whiteford on

Value-based care (VBC) is a healthcare delivery model that prioritizes patient outcomes over the volume of services provided. This approach aims to enhance the quality of care while controlling costs by incentivizing...more

Proskauer - Health Care Law Brief

Long Awaited Approval of the 1115 Waiver Amendment for NYS Medicaid – Just in Time for the New York State Executive Budget State...

On Tuesday, January 16, 2024, Governor Kathy Hochul released the SFY 2025 New York State Executive Budget (“Executive Budget”). While still subject to legislative approval, the Executive Budget incorporates the recently...more

King & Spalding

CMS Solicits Comments on Improving Medicare Advantage Data Transparency

King & Spalding on

On January 25, 2024, CMS released a Request for Information (RFI) seeking public input on how it can enhance and increase transparency of Medicare Advantage (MA) data. CMS says that the RFI “builds on our existing MA data...more

Harris Beach Murtha PLLC

New York Issues Technical Specifications Manual that Addresses Medicaid Payment Reporting

The New York Department of Health (DOH) announced March 8 that the 2022-2023 Value Based Payment (VBP) Reporting Requirements Technical Specifications Manual is available....more

Cozen O'Connor

CMS Releases Final Stark Rules To Promote Value-Based Care

Cozen O'Connor on

On Friday, November 20, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released final regulations to remove certain barriers to the implementation of physician compensation arrangements under value-based payment...more

Akerman LLP - Health Law Rx

Possible Changes to Stark Law in 2019

Last summer The Centers for Medicare and Medicaid Services (CMS) solicited input on potential amendments to the federal Physician Self-Referral Law (the Stark Law)....more

Bradley Arant Boult Cummings LLP

CMS Continues Shift toward Value-Based Payments with New Home Health Groupings Model in Proposal - Healthcare Alert

On July 2, 2018, the Centers for Medicare & Medicaid Services (CMS) published its annual proposed rule outlining both payment and policy changes for home health agencies. In a press release announcing the proposed rule, CMS...more

Epstein Becker & Green

New Audits and Penalties on Medicaid Plans and Providers Related to Encounter Data in Value-Based Payment Models

Epstein Becker & Green on

For value-based payments, encounter data[1] provides valuable information in much the same way that claims data does for fee-for-service arrangements. With the growing prevalence of value-based payments, especially in the...more

Troutman Pepper Locke

Value-Based Contracting for Prescription Drugs and Medical Devices: An Innovative Solution Impaired by Outdated Regulations

Troutman Pepper Locke on

Often lost in the cacophony of headlines surrounding rising health care costs is the promise that value-based contracting offers as a possible solution. In contrast to the traditional fee-for-service model, value-based...more

Burr & Forman

2016 Health Care Year in Review

Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Holland & Knight LLP

CMS Finalizes Sweeping Changes to Medicare Physician Payments

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Oct. 14, 2016, released the highly anticipated Final Rule implementing the Medicare physician payment reforms enacted as part of the Medicare Access and CHIP...more

Carlton Fields

MACRA: Top 10 FAQs

Carlton Fields on

Significant changes to the Medicare payment system are underway. The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) is set to take effect January 1, 2017. MACRA represents a deliberate departure by the...more

McDermott Will & Emery

Digital Health: An Improving Environment for Investors

McDermott Will & Emery on

The integration of technology into health care delivery is exploding throughout the health industry landscape. Commentators speculating on the implications of the information revolution’s penetration of the health care...more

Polsinelli

Understanding the Implications of MACRA, MIPS and APMs

Polsinelli on

On May 9, 2016, the Centers for Medicare & Medicaid Services (CMS) published a notice of proposed rulemaking to implement the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Although the...more

Mintz - Health Care Viewpoints

MA Health Policy Updates – Moves to Strengthen HPC and Expand Telemedicine

In a recent Alert, the Mintz Levin Health Law Practice and ML Strategies provided a comprehensive look at recent developments in Massachusetts health policy. In addition to a detailed report on recent Health Policy Commission...more

Mintz - ML Strategies

Recent Developments in Massachusetts Health Policy

Mintz - ML Strategies on

Building on the momentum of early October hearings on the state’s growing health care expenditures, the Health Policy Commission (HPC), the Joint Committee on Health Care Financing, Governor Charlie Baker, and others spent...more

Polsinelli

Payment Innovation: 30 Day Window to Provide CMS Comments on Physician Payment Changes Under MACRA Begins

Polsinelli on

On September 28, 2015, the Centers for Medicare & Medicaid Services (CMS) published a Request for Information (RFI) seeking stakeholder comments related to innovative physician payment models required by the Medicare Access...more

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