12 Business and Legal Considerations for Successfully Developing a “Hybrid”...
In recent years, changes to Centers for Medicare and Medicaid Services’ (CMS) reimbursement policies for outpatient interventional procedures has both expanded the scope of surgical services that may...
View ArticleK&L Gates Triage: Quality Payment Program Updates in the CY2020 Physician Fee...
In this week’s episode, Limo Cherian presents the first segment of a three part series addressing the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP) updates in the...
View ArticleCourt Invalidates Latest CMS Effort to Reduce Reimbursement at Off-Campus...
The Medicare program, in recent years, has been moving toward "site neutrality" — paying comparable reimbursement for comparable services without regard to service site. In particular, "site...
View ArticleA Massive Number of New Health Law Regulatory Proposals as Part of the...
Today, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) each released their long-anticipated proposed rules...
View ArticleK&L Gates Triage: Quality Payment Program Updates in the CY2020 Physician Fee...
In this week’s episode, Steve Pine presents the last installment of our three part series addressing the CMS Quality Payment Program (QPP) updates in the CY2020 Physician Fee Schedule (PFS) Proposed...
View ArticleCMS and OIG Release Long-Awaited Stark Law and Anti-Kickback Statute Proposed...
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) recently released two proposed rules restructuring...
View ArticleD.C. Court Rejects CMS's 2018 "Budget Neutrality" Policy
In a September 17, 2019 decision, the United States District Court for the District of Columbia invalidated a CMS rule expanding site-neutral payment reductions to evaluation and management (E&M)...
View ArticleMedicare Remote Patient Monitoring: CMS Finalizes New Code and General...
CMS just released the 2020 final rule with changes to remote patient monitoring (RPM), officially titled “Chronic Care Remote Physiologic Monitoring,” reimbursed under the Medicare program, as part of...
View ArticleCMS Issues 2020 MPFS and QPP Final Rule
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates...
View ArticleTelehealth: Medicare Finalizes New Services for 2020 in Physician Fee Schedule
CMS just released the 2020 final rule with changes to its virtual care codes. The new provision, officially titled “Communication Technology-Based Services,” introduces three new covered Telehealth...
View ArticleBlog: CMS Updates to Open Payments Program Finalized in CY 2020 Physician Fee...
The Centers for Medicare & Medicaid Services (CMS) recently released the CY 2020 Physician Fee Schedule Final Rule (PFS Final Rule) which is expected to be published this week in the Federal...
View ArticleCMS Rules: Direct Supervision Is Gone, Prior Auth Is Here; Documentation Fix...
Report on Medicare Compliance 28, no. 40 (November 11, 2019) - CMS has given the green light to prior authorization for five types of procedures in an attempt to control “unnecessary increases” in...
View ArticleCMS Finalizes Changes Expanding the Scope of the Open Payments Program
On November 15, 2019, the Centers for Medicare & Medicaid Services ("CMS") finalized changes to the Open Payments Program as part of the CY 2020 Physician Fee Schedule Final Rule. The Open Payments...
View ArticleCMS Finalizes CY 2020 Physician Fee Schedule
On November 1, 2019, CMS released the Calendar Year (CY) 2020 Physician Fee Schedule (PFS) final rule (the Final Rule). The Final Rule updated payment policies, payment rates, and quality provisions...
View ArticleCMS Finalizes Changes to the Stark Advisory Opinion Regulations; 2020 DHS...
In the calendar year 2020 Medicare physician fee schedule final rule (“PFS”), which was published in the Federal Register on November 15, 2019 (available here), CMS finalized changes to the advisory...
View ArticleCMS Expands Open Payments Reporting
The “National Physician Payment Transparency Program: Open Payments” requires certain manufacturers of drugs, devices and certain other products to disclose annually to the Centers for Medicare and...
View ArticleHospital Price Transparency Requirements
CMS finalized the Outpatient Prospective Payment System hospital price transparency rules on November 15, 2019. As of January 1, 2021, hospitals will have to publicly post (and update annually) two...
View ArticleOncology Care First: What You Need to Know About the Proposed Oncology Care...
On November 1, 2019, the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) released a Request for Information (RFI) on the Oncology Care...
View ArticleCMS Withdraws Block Grant Guidance – What’s Next?
We’ve posted previously the long-standing rumor (substantiated by several folks within the Administration) that CMS is working on a guidance document to states to receive their Medicaid funding through...
View ArticleTrump Administration Announces Historic Price Transparency Requirements
Attached are links to the CMS Press Release and the Trump Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First. The Trump Executive Order was first...
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