Tag Archives: CMS

Public Policy August Recess Health Care Newsletter  

Public Affairs
Foley’s  Bipartisan Public Policy Team is pleased to share our Public Policy August Recess Health Care Newsletter  in which we compiled the top health care policy news and legislation from this month. The House was not in session and the Senate came back mid-month to focus on passing appropriation bills and presidential nominations. This Week in … Continue reading this entry

Proposed Overhaul to the Medicare Shared Savings Program Would Mean More Risk for ACOs

hospital staff
On August 9, 2018, CMS introduced a proposed rule that would substantially overhaul the Medicare Shared Savings Program (MSSP), requiring Accountable Care Organizations (ACOs) that participate in the MSSP to accept some downside risk and tightening other requirements to increase program integrity. At the same time, the proposed rule would allow ACOs increased flexibility in … Continue reading this entry

CMS Continues to Tighten the Belt on Hospital Off-Campus Provider-Based Departments

hospital
Hospitals with off-campus provider-based departments (PBDs) may want to rethink their end of summer vacation plans in order to focus on a recent slate of proposed regulations from the Center for Medicare and Medicaid Services (CMS) that seek to rein in Medicare reimbursement for outpatient hospital services – including at excepted/grandfathered off-campus locations.… Continue reading this entry

Health Care Information Exchanges and Price Transparency Initiatives: CMS Requests Input from Providers

data mining
On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule introducing changes to the Medicare physician fee schedule, and soliciting comments from providers on CMS data sharing initiatives.  In the proposed rule, CMS requests comments on methods to promote the exchange of health care information between health care providers, … Continue reading this entry

Medicare Proposes (and Rejects) New Telehealth Services for 2019

The telemedicine industry was pleased to learn CMS recently proposed adding new services to its list of Medicare-covered telehealth services.  But what may be more interesting are the services CMS declined to add, and why.  This article summarizes the newly-proposed additions as well as the services CMS rejected, explores some reasons for CMS’ decisions, and … Continue reading this entry

340B: DC Circuit Affirms Dismissal of Challenge to 2018 Reimbursement Cuts for 340B Hospitals; New Cuts Already Being Proposed by CMS for 2019

On Tuesday, July 17, 2018, the United States Court of Appeals for the District of Columbia ended a challenge brought by hospitals and hospital associations to the nearly 28 percent reimbursement cuts for 340B hospitals under the Medicare program. The payment cuts were finalized in the calendar year (CY) 2018 Medicare Outpatient Prospective Payment System … Continue reading this entry

CMS Proposes to Ever-So-Slightly Expand Stark Law Exceptions for Compensation Arrangements

The Centers for Medicaid & Medicare Services (CMS) proposes to revise regulations issued pursuant to the Federal physician self-referrals Statute (Stark Law) to harmonize the regulations with the newly enacted Bipartisan Budget Act of 2018 (Pub. L. 115-123, enacted on February 9, 2018).… Continue reading this entry

Medicare’s New Chronic Care Remote Physiologic Monitoring Codes: Everything You Need to Know

remote monitoring
Earlier this year, in a first-of-its-kind move, CMS made remote patient monitoring (RPM) a separately-reimbursable service under Medicare.  Now, CMS has proposed three new codes for RPM services, retitled “Chronic Care Remote Physiologic Monitoring,” which do a far better job reflecting how providers can more effectively and efficiently use RPM technology to monitor and manage … Continue reading this entry

Health Care Policy Newsletter

Foley & Lardner LLP’s Bipartisan Public Policy Team is pleased to share this week’s “Public Policy Health Care Newsletter” in which we compile the latest health care policy news and legislation. Please note that the next newsletter will be published on August 27th.… Continue reading this entry

Health Care Policy Newsletter

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health Care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

CMS Recoupment Efforts Stopped by Court While Overpayment Appeals Are Pending

Overpayment
Providers and suppliers who have been assessed overpayments for Medicare services are entitled, by statute, to a stay of recoupment while the provider or supplier’s appeal is pending – but only at the first two levels of administrative appeal. If both appeals are unfavorable to the provider or supplier, the next step is an appeal … Continue reading this entry

Medicare’s New Virtual Care Codes: A Monumental Change and Validation of Asynchronous Telemedicine

The Centers for Medicare and Medicaid Services just issued a proposed rule introducing monumental changes to the physician fee schedule, paving the way for asynchronous telemedicine and new technologies through a new set of virtual care codes.  CMS explained the impetus for the bold changes, declaring: “We now recognize that advances in communication technology have … Continue reading this entry

Health Care Policy Newsletter

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health Care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

New Demonstration Program Would Reward Clinicians for Accepting Risk in Medicare Advantage

government building
CMS recently announced that it wants to launch a new demonstration program, the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration. If approved and adopted as a demonstration project, the MAQI Demonstration would waive Merit-Based Incentive Payment System (MIPS) requirements for clinicians who participate sufficiently in qualifying risk programs of Medicare Advantage plans by making … Continue reading this entry

Health Care Policy Newsletter

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session. This Week in Health Care Policy (June 25-29, 2018)… Continue reading this entry

Health Care Policy Newsletter

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

Health Care Policy Newsletter

Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our “Public Policy Weekly* Health Care Newsletter” in which we compile the latest Health care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

Health Care Policy Newsletter

Policy
Foley’s Bipartisan Public Policy Team  is pleased to share our “Public Policy Health Care Newsletter” in which we compile the latest health care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

Health Care Policy Newsletter

Public Affairs
Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team  is pleased to share our “Public Policy Weekly  Health Care Newsletter” in which we compile the latest health care policy news and legislation. *Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

Health Care Policy Newsletter

Introduction Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to share our second “Public Policy Weekly* Health Care Newsletter” in which we compile the latest health care policy news and legislation. Please note that we publish this newsletter only when Congress is in session.… Continue reading this entry

This Week in Health Care Policy

Public Affairs
Foley & Lardner LLP’s (“Foley”) Bipartisan Public Policy Team is pleased to introduce “This Week in Health Care Policy,” a new weekly publication providing a compilation of  the latest health care policy news and legislation. This newsletter will be provided on weeks that Congress is in session. The first edition appears below.… Continue reading this entry

Medicare Enrollment for Providers No Longer Required Under Medicare Parts C and D

controlled substances
On April 2, 2018, CMS released the Contract Year 2019 Final Rules for Medicare Advantage (MA) and Part D (the MA Final Rule), incorporating changes that support CMS’ stated commitment to supporting flexibility and efficiency throughout the MA and Part D Programs.… Continue reading this entry

Medicaid Drug Rebate Agreements: Changes Require Immediate Action By Pharmaceutical Manufacturers

pharmaceutical
For the first time since the enactment of the Medicaid Drug Rebate Program (MDRP), the Centers for Medicare and Medicaid Services (CMS) revised the National Medicaid Drug Rebate Agreement (NDRA) entered into between drug manufacturers and the U.S. Department of Health and Human Services (HHS).… Continue reading this entry

California Medicaid Agency Proposes Significant Restrictions on FQHC and RHC Reimbursement

california
California’s Medicaid agency has posted draft language of a new state plan amendment (SPA) that would make major changes to federally qualified health center (FQHC) and Rural Health Clinic (RHC) reimbursement.  Public comments may be made on the proposal until 5 PM on March 23, 2018.  Following review of public comments, the California Department of … Continue reading this entry