CMS Proposes Lab Data Collection Requirements to Update Fee Schedule
On September 25, 2015, CMS released proposed rulemaking that would extensively revise payment and reporting requirements for clinical diagnostic laboratory tests (CDLTs), as paid on the Clinical...
View ArticleCMS Proposes Major Changes to Medicare Clinical Lab Test Payment Policy
On October 1, 2015, the Centers for Medicare & Medicaid Services (CMS) published its long-awaited proposed rule to base Medicare clinical laboratory fee schedule (CLFS) reimbursement on private...
View ArticleNew CMS Proposed Rule Provides Who/What/When for Clinical Laboratory...
Clinical laboratories will see significant changes to their Medicare payments for clinical diagnostic laboratory tests (CDLTs) starting January 1, 2017, but the basis for new payment rates will come...
View ArticleCMS Sends Final 2016 Medicare Payment Rules to OMB for Review
This week CMS referred major final calendar year 2016 Medicare payment rules to the White House Office of Management and Budget (OMB) for regulatory clearance. Specifically, OMB is reviewing the final...
View ArticleWashington Healthcare Update
Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA)...
View ArticleBudget Proposal Would Limit Provider-Based Status - New Off-Campus...
On October 26, 2015, Congressional and White House budget negotiators released the legislative text of the Bipartisan Budget Act of 2015. The Act is aimed primarily at lifting the Federal debt limit...
View ArticleCongress Take Step Toward Site-Neutral Medicare Payments in Bipartisan Budget...
On October 28, 2015, the U.S. House of Representatives approved legislation that, if enacted, would, among other things, substantially alter how and how much Medicare pays for outpatient services...
View ArticleProvider-Based Status: A Quiet Casualty of the Bipartisan Budget Act
Without fanfare or any significant discussion, the Bipartisan Budget Act (Act) contains the first legislative action related to provider-based status—and it is a sweeping action with negative financial...
View ArticleBudget Deal to Limit Provider-Based Status, Extend Sequestration
On October 28 and 30, 2015, the U.S. House of Representatives and U.S. Senate approved the Bipartisan Budget Act of 2015 (the Act)—a measure designed to raise the limit on Federal borrowing that would...
View ArticleBudget Deal Limits Payment to New Off-Campus Hospital Outpatient Departments
On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015 (the “Act”) into law. The Act, widely hailed as a rare act of bipartisan cooperation, raises the federal debt ceiling and...
View ArticleCMS Issues CY 2016 Medicare Physician Fee Schedule Final Rule
On October 30, 2015, CMS released the CY 2016 Medicare Physician Fee Schedule (PFS) Final Rule updating payment policies, payment rates, and quality provisions for services furnished under the PFS on...
View ArticleCMS Finalizes Stark Law Changes in CY 2016 Medicare Physician Fee Schedule...
This past July, on the heels of a decision in which a judge for the U.S. Court of Appeals for the Fourth Circuit characterized the federal physician self-referral prohibition commonly known as the...
View ArticleCMS Issues Final Payment Rules for Physicians and Hospitals
On October 30, 2015, the U.S. Department of Health and Human Services (HHS) released several final rules related to physician and hospital Medicare payments for 2016. Specifically, HHS’s Centers for...
View ArticleCMS Finalizes Major Changes and Clarification to the Stark Law Regulations
Introduction - Since the passage of the Physician Self-Referral Act, also known as the “Stark Law,” health care providers have had to learn to work within and adjust to certain statutory and regulatory...
View ArticleStark Updates Included in Final 2016 Physician Fee Schedule
With the final Medicare physician fee schedule (PFS) for 2016, the Centers for Medicare and Medicaid Services (CMS) has made a series of updates to the Stark physician self-referral regulations. The...
View ArticleDon’t Mail That Overpayment Disclosure Just Yet: Implications of CMS’ Final...
The Centers for Medicare and Medicaid Services (CMS) on Nov. 16, 20151 published the calendar year 2016 physician fee schedule final rule, fundamentally reducing the burden on entities seeking to...
View ArticleNew Year, New Flexibility: Top 10 Takeaways from CMS Stark Law Final Rule
On November 16, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published the Calendar Year 2016 Physician Fee Schedule final rule with comment period, which includes a final rule (the...
View ArticlePatient Access and Medicare Protection Act Signed Into Law; Includes...
On December 28, 2015, President Obama signed into law S. 2425, the Patient Access and Medicare Protection Act, which includes a number of Medicare provisions that were not included in the Consolidated...
View ArticleCMS Seeks Comments on Draft Physician Fee Schedule Quality Measure...
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to develop quality measures that will apply to Medicare payments to physicians when new Merit-based Incentive Payment...
View ArticleHealth Law Pulse - January 2016
CHANGES TO STARK LAW, NEW ADVANCE CARE PAYMENTS INCLUDED IN 2016 PHYSICIAN FEE SCHEDULE - The Centers for Medicare & Medicaid Services (CMS) recently published a final rule (Final Rule) regarding...
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