Ann Hollenbeck on Centers for Medicare & Medicaid Services (CMS)

CMS Updates Kidney Care Choices Model

The Center for Medicare and Medicaid Innovation ("CMMI") announced sweeping changes to the Kidney Care Choices Model ("KCC Model"), a key set of value-based programs....more

7/14/2025 / Centers for Medicare & Medicaid Services (CMS) , CMMI , Health Care Providers , Health Insurance , Healthcare , Healthcare Reform , Medicare , Patent Quality Metrics , Patient Access , Physicians , Regulatory Reform , Trump Administration , Value-Based Care

Medicare's Innovation Center Charts New Direction: Part 2 – Digital Health and AI

The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the second of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding digital...more

6/6/2025 / AI Act , Artificial Intelligence , Centers for Medicare & Medicaid Services (CMS) , CMMI , Comment Period , Digital Health , Healthcare , Healthcare Reform , Medicare , Mobile Apps , Patient Access , Regulatory Reform , Telehealth , Value-Based Care

Medicare's Innovation Center Charts New Direction: Part 1 - Providers

The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the first of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding health care...more

6/2/2025 / Centers for Medicare & Medicaid Services (CMS) , CMMI , Government Agencies , Health Care Providers , Health Insurance , Healthcare , Healthcare Reform , Medicaid , Medicare , Regulatory Reform , Value-Based Care

CMS Innovation Center Announces Cost-Saving Restructuring of Value-Based Payment Model Portfolio

The Center for Medicare and Medicaid Services ("CMS") has announced significant changes to its value-based payment model portfolio projected to save $750 million as part of a shift in the agency's refocused strategy toward...more

4/16/2025 / Centers for Medicare & Medicaid Services (CMS) , Government Agencies , Health Insurance , Healthcare , Healthcare Reform , Hospitals , Medicaid , Medicare , Physicians , Regulatory Reform , Value-Based Care

CMS's New TCET Pathway Expedites Medicare Coverage for FDA Breakthrough Devices

The Centers for Medicare and Medicaid Services ("CMS") published a final notice outlining the processes and procedures for the Transitional Coverage for Emerging Technologies ("TCET") pathway, a Medicare coverage pathway...more

1/30/2025 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Food and Drug Administration (FDA) , Healthcare , Life Sciences , Medical Devices , Medicare , Pharmaceutical Industry , Regulatory Agenda , Regulatory Reform

CMS Finalizes The Increasing Organ Transplant Access Model

The Increasing Organ Transplant Access Model ("IOTA Model") introduces mandatory financial incentives and penalties for selected kidney transplant hospitals....more

1/29/2025 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Final Rules , Healthcare , Hospitals , Incentives , Medicare , Organ Transplant Centers , Penalties , Regulatory Requirements , Value-Based Care

U.S. Federal Actions Support Continued Telehealth Services for Medicare Beneficiaries

On March 15, 2022, President Biden signed into law the Consolidated Appropriations Act, 2022 (the "Act"), extending certain Medicare telehealth reimbursement flexibilities for 151 days following the end of the declared...more

3/24/2022 / Biden Administration , Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Health Insurance , Medicare , Patient Access , Relief Measures , Telehealth , Telemedicine

Vital Signs: Digital Health Law Update Winter 2022

Note From the Editors With 2022 well underway, the rapid pace of statutory, regulatory, policy, and industry activities in digital health continues in force. We bring you Vital Signs, a curated, one-stop resource on the most...more

A Dramatic Shift in Health Care Pricing Transparency

The Issue: On June 24, 2019, President Trump signed an executive order, which instructed the Department of Health and Human Services to publish rules requiring hospitals to publicly disclose their negotiated rates for...more

8/25/2019 / American Hospital Association , Centers for Medicare & Medicaid Services (CMS) , Executive Orders , Health Care Providers , Hospitals , Insurance Industry , Price Transparency , Proposed Rules , Secretary of HHS , Trump Administration

D.C. District Court Vacates 60-Day Medicare Advantage Overpayment Rule

The Situation: In 2016, several Medicare Advantage ("MA") organizations challenged a 2014 final rule promulgated by the Center for Medicare Services ("CMS") that broadly subjected MA organizations to potential liability under...more

11/8/2018 / Administrative Procedure Act , Affordable Care Act , Appeals , Centers for Medicare & Medicaid Services (CMS) , False Claims Act (FCA) , Final Rules , Medicare Advantage , Overpayment , Overpayment Recovery Time Limits , Social Security Act , Vacated

Legislation, Lawsuit Cloud Future of 340B Program Payment Rate Reductions

The Situation: A Final Rule published by the Centers for Medicare & Medicaid Services carries a provision that reduces reimbursement for most 340B Program drugs dispensed by disproportionate share hospitals and rural referral...more

12/6/2017 / Administrative Procedure Act , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Drug Pricing , Final Rules , Hospitals , HRSA , Medicare , MedPAC , OIG , Outpatient Prospective Payment System (OPPS) , Pharmaceutical Industry , Physician Medicare Reimbursements , Prescription Drugs , Section 340B

Ann Hollenbeck

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