CMS Outlines New Standard for Challenging Medicare Payment Denials, Echoing...
On October 31, 2019, the Office of General Counsel for the U.S. Department of Health and Human Services (HHS) issued an important memo from Kelly M. Cleary, CMS Chief Legal Officer, and Brenna E....
View ArticleCMS Issues Proposed Rule Aimed at Increasing Transparency and Reducing...
On November 18, 2019, CMS published the proposed Medicaid Fiscal Accountability Rule (the Proposed Rule) which, if finalized, would result in dramatic changes to the Medicaid program. Through the...
View ArticleHospitals Sue CMS Citing Price Transparency Final Rule as Anything but...
In what has become the new “normal” in Washington, DC, these days, hospitals and their associations filed a lawsuit against the US Secretary of Health and Human Services (Secretary) challenging the...
View ArticleGME @ Dentons: Hahnemann bankruptcy to leave residents without malpractice...
On June 30, 2019, Philadelphia-based Hahnemann University Hospital and St. Christopher’s Hospital for Children filed for bankruptcy protection in the US Bankruptcy Court for the District of Delaware....
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 ArticleMedicare Spreads Sunshine Act Coverage to New Categories of Payments, Recipients
On November 15, 2019, the Centers for Medicare and Medicaid Services ("CMS") finalized changes to the Open Payments Program as part of the CY 2020 Physician Fee Schedule Final Rule....By: Baker Ober...
View ArticleThe Nightmare Came True: Minor Licensing Actions Could Lead to Disastrous...
As forewarned, CMS's finalization of the Calendar Year (CY) 2020 Physician Fee Schedule, effective January 1, 2020, brings significant changes to its authority to deny or revoke a Medicare enrollment...
View ArticleCMS Issues Final Rule to Implement SUPPORT Act Coverage and Reimbursement of...
On November 15, 2019, the Centers for Medicare & Medicaid Services (“CMS”) published its final rule outlining changes to the Medicare Physician Fee Schedule (“PFS”) for the Calendar Year (“CY”)...
View Article2021 Changes for Evaluation and Management Services
E/M office visit historical background - For years, providers have voiced their concerns about the amount of data entry required for Evaluation and Management (E/M) visits. Many state they spend twice...
View ArticleCMS Proposes Rules to Implement SUPPORT Act Coverage and Reimbursement of...
Recently, the Centers for Medicare & Medicaid Services (“CMS”) published its annual proposed rule outlining potential changes to the Medicare Physician Fee Schedule (“PFS”) for upcoming Calendar...
View ArticleCMS Proposes Revising Physician Payments Sunshine Act Reporting Requirements
On July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Medicare CY 2020 Physician Fee Schedule proposed rule (the Proposed Rule), including proposed changes to regulations...
View ArticleProposed Physician Fee Schedule Rule Tweaks, Expands Open Payments Program
The Open Payments program established by the Physician Payments Sunshine Act (Sunshine Act) requires manufacturers of covered drugs, medical devices, biologicals, and medical supplies (applicable...
View ArticleD.C. District Court Vacates CMS Final Rule, Finds that CMS’ Lesser...
On September 17, 2019, the U.S. District Court for the District of Columbia ruled against the Centers for Medicare and Medicaid Services (“CMS”), vacating CMS’ 2018 Final OPPS Rule, which cut Medicare...
View ArticleReimbursement for Remote Patient Monitoring Services in 2019
Medicare reimbursement for remote patient monitoring has taken a number of steps forward throughout this year. New and proposed rules from the Centers for Medicare and Medicaid Services both expand the...
View ArticleHealth Care E-Note - September 2019
On July 29, 2019, the Centers for Medicare & Medicaid Services ("CMS") issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services...
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