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 Among other things, MACRA: 1) repealed the Sustainable Growth Rate that was applicable to...
View ArticleHouse 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...
View ArticleMIPS 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...
View ArticleCMS 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...
View ArticleTelemedicine 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...
View ArticleCMS 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...
View ArticleThe "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...
View ArticleSummary 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...
View ArticleNew 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...
View ArticleCMS 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...
View ArticleBlog: 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...
View ArticleCMS Proposes Expansion of Telehealth Services Eligible for Medicare...
Summary - The Centers for Medicare and Medicaid Services (CMS) released its CY2017 Physician Fee Schedule Proposed Rule on July 17 - after receiving requests from various stakeholders to add telehealth...
View ArticleCMS Call on MPFS Global Services Data Collection (Aug. 11)
On August 11, 2016, CMS is hosting a call to discuss its plans, set forth in the proposed 2017 Medicare physician fee schedule rule......By: Reed Smith
View ArticleProvider-Based Rule and Stark—Is Joint Compliance Impossible in 2017?
The Centers for Medicare & Medicaid Services (CMS) will be putting hospitals in an untenable position if recent proposed rulemaking is implemented as is. In its proposal for acting on legislation...
View ArticleAlso In The News - Health Headlines - August 2016
CMS Provides Update Regarding Patient Status Review Delay – On July 27, 2016 CMS posted an update regarding Quality Improvement Organization (QIO) reviews of patient status claims, which are currently...
View ArticleProposed 2017 Hospital OPPS Rule Would End Medicare Payments to Many Off...
Published on July 14, 2016, CMS’s proposed 2017 Hospital Outpatient Prospective Payment System (OPPS) rule calls for site-neutral payments that would stop Medicare payments to many off-campus...
View ArticleCMS ICD-10 Coding Flexibility Policy to End October 1, 2016. Period.
On October 1, 2016, CMS is definitively ending an ICD-10 coding “flexibility” policy announced last year that prevents practitioner Medicare Part B physician fee schedule claims from being denied based...
View ArticleCompliance Concerns Raised Over Proposed Hospital Outpatient Department Rule
In an August 26, 2016, letter to the Centers for Medicare & Medicaid Services (CMS), the American Hospital Association (AHA) expressed serious concern over the portion of the calendar year 2017...
View ArticleMedicare Proposes Tiered Outpatient Therapy Evaluation Codes for 2017
In July, the Centers for Medicare & Medicaid Services (CMS) announced its intent to add several new codes for physical therapy and occupational therapy evaluation under the Medicare Physician Fee...
View ArticleLawmakers Join MedPAC in Speaking Out Against CMS Surgeon Data Collection...
On September 16, 2016, approximately 112 congressional representatives submitted a letter to HHS Secretary Sylvia Matthews Burwell and CMS acting Administrator Andy Slavitt requesting that CMS not...
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