On April 5, the Medicare Payment Advisory Commission (MedPAC) issued a unanimous recommendation to decrease some urban outpatient hospitals’ Medicare payments, while increasing rural hospital payments to improve emergency...more
Last week, leaders of the U.S. House Committee on Energy and Commerce (the “Committee”) sent letters to CMS and four hospital accreditation organizations, expressing concerns regarding the rigor of the accreditation survey...more
On December 29, 2017, the United States District Court for the District of Columbia granted the government’s motion to dismiss a pre-implementation challenge to CMS’s policy to cut the Medicare reimbursement rate for...more
For the first time in history, OIG rescinded an advisory opinion that had previously protected a patient assistance charity from anti-kickback statute (AKS) liability. In its letter to the charity, OIG stated that it based...more
On October 30, 2017, Chemed and several of its subsidiaries, including Vitas Hospice Services LLC and Vitas Healthcare Corporation (Vitas), entered into a $75 million settlement to resolve allegations that Vitas submitted...more
On August 18, 2017, the United States Court of Appeals for the District of Columbia ruled that HHS had inadequately justified its inclusion of data from hospitals that allegedly “turbo-charged” their cost-to-charge ratio when...more
On June 23, 2017, a South Carolina-based hospital system, AnMed Health, agreed to pay $1,295,000 to settle allegations that it violated the Emergency Medical Treatment and Labor Act (EMTALA). The HHS OIG alleged AnMed held...more
On June 12, 2017, OIG released a report on Medicare and Medicaid electronic health record (EHR) incentive payments, claiming that between May 2011 and June 2014, CMS paid an estimated $729 million to eligible professionals...more
In a recently announced proposed rule (CMS-1679-P), CMS proposes to increase aggregate pay by $390 million in fiscal year (FY) 2018 for skilled nursing facilities (SNFs). In a separate notice (CMS-1686-ANPRM), CMS is...more
After narrowly passing the Budget Committee, the Republican-sponsored health reform repeal and replace bill, the American Health Care Act (AHCA), is scheduled for a floor vote for Thursday, March 23, 2017, seven years to the...more
OIG recently issued a report determining that South Carolina’s Medicaid Managed Care program would not have realized any savings if the state agency implemented a minimum Medical Loss Ratio (MLR) similar to the current...more
The Congressional Budget Office (CBO) released a report on October 4, 2016, estimating that a bill in the U.S. House of Representatives to block the implementation of CMS’s proposed payment model for Part B drugs would cost...more
On September 8, 2016, CMS announced in a blogpost that new physician payment model reforms, established in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), will begin implementation on January 1, 2017, as...more
9/13/2016
/ ACOs ,
Alternative Payment Models (APM) ,
American Medical Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Electronic Health Record Incentives ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Medicare Part B ,
MIPS ,
Patient Centered Medical Homes ,
Physician Payments ,
Physicians ,
Proposed Rules ,
Value-Based Payments