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Introducing Stark Phase V

On November 16, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published the most significant changes to the physician self-referral law (“Stark Law”) regulations since 2008. Currently...

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Recent Changes to the Stark Law Provide Added Flexibility

The 2016 Medicare Physician Fee Schedule Final Rule ("Final Rule") contains recent changes to the Federal Stark Law, the majority of which took effect on January 1, 2016. The issuance of the Final Rule...

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Stark Law Update

The Stark Law has been updated effective January 1, 2016 in ways that may affect your medical practice and hospital relationships. Among other things, these updates add two new exceptions to the...

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Important Changes for Physicians from the 2016 Medicare Physician Fee...

On November 16, 2015 the Centers for Medicare and Medicaid Services (CMS) published the final Medicare Physician Fee Schedule (Final MPFS). The Final MPFS addresses changes to the physician fee...

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Important Changes for Physicians from the 2016 Medicare Physician Fee...

On November 16, 2015 the Centers for Medicare and Medicaid Services (CMS) published the final Medicare Physician Fee Schedule (Final MPFS).1 The Final MPFS addresses changes to the physician fee...

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Portable X-Ray Suppliers Receive Clearer Transportation Billing Guidance

Included among the 2016 Medicare Physician Fee Schedule (MPFS) changes is clarification from CMS regarding how it expects transportation charges billed by portable x-ray suppliers to be prorated among...

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A&B Healthcare Week in Review

I. REGULATIONS, NOTICES, & GUIDANCE - On March 8, 2016, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule entitled, “Medicare Program; Part B Drug Payment Model.” The...

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CMS’ New Initiative Intended to Transform Primary Health Care

CMS’ efforts to improve the delivery of primary health care moved into new territory this week when the agency announced a new five-year delivery model, Comprehensive Primary Care Plus (CPC+), which...

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2016 Stark Law Updates

Centers for Medicare and Medicaid Services (CMS) issued the 2016 Medicare Fee Schedule (the "Schedule") in an effort to facilitate compliance with the Physician Self-Referral Law (the "Stark Law")....

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Client Alert: CMS Issues Rule Proposing New Approach to Paying Clinicians for...

On April 16, 2015, President Obama signed the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). Among other things, MACRA: 1) repealed the Sustainable Growth Rate that was applicable to...

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House Committee Proposes Relief for Some Off-Campus Provider-Based Departments

On Wednesday May 18, 2016, members of the U.S. House Ways and Means Committee introduced a proposal to continue OPPS payment for those off-campus provider-based departments that were “mid-build” as of...

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MIPS Performance Scoring: Understanding How CMS Proposes to Calculate...

On May 9, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule addressing the implementation of physician payment reforms included in the Medicare Access and CHIP...

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CMS Proposed Rule Implements Limitations on Medicare Payments for Off-Campus...

In Depth - Background - On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) released the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule, which includes proposed...

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Telemedicine Gains Further Acceptance

Last month the American Medical Association (AMA) adopted ethical guidance related to the practice of telemedicine and telehealth which further expands upon the policy report on Coverage and Payment...

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CMS Issues Medicare Physician Fee Schedule Proposed Rule

On July 7, 2016, CMS issued a proposed rule that updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after...

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The "Primary Care Exception"—a limited opportunity for billing without...

In most circumstances, the Centers for Medicare & Medicaid Services (CMS) will not allow billing or payment under the Medicare Physician Fee Schedule (PFS) for services furnished by interns and...

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Summary of Major Provisions in the Proposed 2017 Physician Fee Schedule

The proposed Physician Fee Schedule for 2017 (PFS) includes several changes covering a litany of topics spanning from telehealth services to expanding the Diabetes Prevention Program Model. The...

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New Medicare Enrollment Requirements for MA Providers

In Depth - The Medicare Physician Fee Schedule proposed rule released by the Centers for Medicare & Medicaid Services (CMS) on July 7, 2016, (the Proposed Rule) requires certain providers and...

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CMS Proposes New Medicare Telehealth Coding Rules

The Centers for Medicare and Medicaid Services (CMS) issued its proposed Medicare Physician Fee Schedule (PFS) for CY 2017 on July 7, 2016. In it, CMS would require practitioners to use a new place of...

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Blog: Open Payments Changes On the Horizon?

The Centers for Medicare & Medicaid Services (CMS) recently announced in the 2017 Physician Fee Schedule proposed rule that since publication and implementation of the Open Payments Final Rule and...

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