Value-Based Contracting: Is It Right For Your Practice?
Measures of success: How value-based pricing may change the pharmaceutical industry
On July 31, 2024, CMS issued a final rule (the Final Rule) for fiscal year (FY) 2025 updating Medicare payment policies and rates for skilled nursing facilities (SNFs) under the SNF Prospective Payment System (PPS). Under the...more
On July 31, 2023, CMS issued its final rule updating the rates and Medicare payment policies under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for FY 2024 (the Final Rule). The Final Rule also includes...more
On August 1, 2022, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Final Rule for FY 2023 (the Final Rule). In the Final Rule, CMS...more
At the end of March 2022, the Centers for Medicare & Medicaid Services (CMS) released guidance to drug manufacturers and states on reporting Medicaid Best Price under value based purchasing (VBP) arrangements (Medicaid Best...more
On November 2, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) that advances the shift from paying for Medicare home health services based on volume to a system that pays based on...more
On November 2, 2021, CMS put on display its final rule that, among other things, updates the home health and home infusion therapy services payment rates for calendar year (CY) 2022; makes significant changes to the provider...more
Trump Administration Finalizes Rulemaking on Value-Based Purchasing, Multiple Best Prices, Expanded Alternative URA, and other MDRP Drug Pricing Changes - On December 21, 2020, the Centers for Medicare & Medicaid Services...more
On July 31, 2020, CMS issued Final Rule CMS-1737-F for fiscal year 2021, in its yearly update to Medicare payment policies for SNFs (the Final Rule). In addition to updating Medicare payment rates under the SNF prospective...more
On October 31, 2019, CMS issued a final rule with comment period (Final Rule), CMS-1711-FC, updating the payment rates for home health agencies (HHAs) for calendar year (CY) 2020...more
On October 31, 2019, the Centers for Medicare and Medicaid Services (CMS) finalized its 2020 payment and policy changes rule for Home Health Agencies (HHA Rule). The final rule is scheduled to be posted in the Federal...more
On August 2, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital Prospective Payment System...more
On November 1, 2017, CMS released the Final Rule for the 2018 home health prospective payment system rate update, including the CY 2019 case mix adjustment methodology refinements. CMS also made changes to the Value Based...more
On November 1, 2016, CMS published its final policy changes, quality provisions, and payment rates for 2017, as they relate to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center...more
On November 3rd, CMS published the Final Prospective Payment System (PPS) Rule for Home Health Agencies (HHAs) for CY 2017 at 81 FR 76702 (Nov. 3, 2016). The rule implements annual changes to the PPS rate for HHAs and...more
On November 1, 2016, CMS released the final payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) final rule (OPPS Final Rule) and Ambulatory Surgical Center Payment System Final Rule...more
On August 2, 2016, CMS released a final rule (Final Rule) with updates to the Hospital Inpatient Prospective Payment System (Hospital IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) affecting...more
The Centers for Medicare & Medicaid Services (“CMS”) has released the final version of its much anticipated revisions to the regulations governing Medicaid managed care (the “Final Rule”). First proposed in May 2015, the...more
CMS Publishes Medicaid Access Final Rule – CMS published a Final Rule in the Federal Register today, November 2, 2015, that implements a process for states to determine whether Medicaid payments satisfy what is known as the...more
On July 31, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a final rule (Final Rule) updating fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS)...more
CMS Issues SNF Final Payment Rule for FY 2016 – On July 30, 2015, CMS released the final Medicare FY 2016 payment rule for skilled nursing facilities (SNFs). The final rule will result in an estimated increase of $430 million...more
CMS Releases Final Payment Rules (IPPS, IRF, LTCHs, Hospice, and Psych): At the end of last week, the Centers for Medicare and Medicaid Services (CMS) released a set of final 2016 payment rules affecting acute care hospitals...more
On July 31, 2015, CMS issued its final rule to update the fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective...more
This is the fifth post in Health Care Law Today’s series on the final rule. The final Medicare Shared Savings Program (“MSSP”) rule released on June 4, 2015, contains a number of modifications to the financial...more
On August 2, 2013, CMS released the annual Hospital Inpatient Prospective Payment System Final Rule for FY 2014 (the “Final Rule”), effective for discharges occurring on or after October 1, 2013....more