On June 3, 2019, the Supreme Court issued an eagerly anticipated opinion in Azar v. Allina Health Services, a decision with far-reaching implications both for the calculation of disproportionate share payments and provider...more
7/10/2019
/ Administrative Procedure Act ,
Azar v Allina Health Services ,
Department of Health and Human Services (HHS) ,
Hospitals ,
Low-Income Issues ,
Medicare ,
Medicare Advantage ,
Medicare Part A ,
Medicare Part C ,
Notice and Comment ,
Pay Reductions ,
Provider Payments ,
Reaffirmation ,
Retroactive Application ,
SCOTUS ,
Substantive Rule ,
Vacated
On May 3, 2019, CMS published draft guidance regarding space sharing between co-located hospitals and hospitals co-located with other health care entities. ...more
On Wednesday July 25, 2018, the Centers for Medicare and Medicaid Services (CMS) released an advance copy of the CY 2019 Medicare Hospital Outpatient Prospective Payment System (OPPS) proposed rule. ...more
Hospitals with off-campus provider-based departments (“PBDs”) under construction (or “mid-build”) at the time of the Bipartisan Budget Act of 2015 – which limited Medicare payment to off-campus provider-based departments that...more
A new section of the 21st Century Cures Act provides much-needed relief for hospitals with an off-campus provider-based department (off-campus PBD) that was mid-build or under development as of November 2, 2015 (the Mid-Build...more
2/8/2017
/ 21st Century Cures Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Certification Requirements ,
Compliance Dates ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Medicare ,
Medicare Administrative Contractors (MAC) ,
Off-Campus Departments ,
Outpatient Prospective Payment System (OPPS) ,
Professional Development
CMS recently finalized sweeping changes to the way Medicare pays hospitals for services furnished in “new” off-campus provider-based departments (referred to as “off-campus PBDs”).
CMS revealed the changes on November 1...more
On Wednesday, members of the House Ways and Means Health Subcommittee introduced bipartisan legislation that would provide some welcome relief to hospitals who had already invested resources to develop new provider-based...more
In This Issue:
- Top News
..Congress Passes Omnibus Spending Package
..HRSA Cancels Plan for 340B ‘Mega Reg’; Congress Weighs Options
..Supreme Court to Hear Challenge to ACA...more
12/22/2014
/ Affordable Care Act ,
Appropriations Bill ,
Centers for Medicare & Medicaid Services (CMS) ,
Halbig v Burwell ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
HRSA ,
King v Burwell ,
Legislative Agendas ,
Medicare ,
Medicare Shared Savings Program ,
Physicians ,
SCOTUS ,
Section 340B ,
Subsidies
Polsinelli presents Crisis Management: a multi-part series (culminating in a webinar on 11.20.2014) on what companies must know to stay ahead of external interruption that risks serious impact to their business concerns....more
In This Issue:
- Top News
..The Congressional Agenda is Light as the Focus Shifts to the Midyear Elections
..Physician Supervision Requirement for Small and Rural Hospitals
..CMS Offers Hospitals...more
9/29/2014
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
HRSA ,
Medicaid ,
Medicare ,
Medicare Part B ,
MedPAC
In This Issue:
- Top News
..Congress Approves Budget Deal with Short-Term ‘Doc Fix'
..CMS “Two-Midnight” Rule delayed until March 31, 2014
..Individuals with Canceled Insurance Policies May Apply for...more
1/24/2014
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
EHR ,
Exempt Organizations ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Fraud ,
Healthcare Reform ,
Hospitals ,
Medicare ,
Misbranding ,
OCR ,
OIG ,
Prescription Drugs ,
Tax Exemptions
In This Issue:
- What Providers Should Know
- Requirements for Inpatient Admissions and Payment Under Medicare Part A
- New Rules Permitting Re-billing Under Medicare Part B for Denied Admissions
- New HAC...more
In This Issue:
- Top News
..HHS Releases Hospital Pricing Data in Transparency Effort; Results Show Significant Variation
..States Divided on Medicaid Expansion
..CMS Issues FY 2014 Proposed Rules for...more
5/13/2013
/ Centers for Medicare & Medicaid Services (CMS) ,
Contraceptives ,
Department of Health and Human Services (HHS) ,
Health Insurance Exchanges ,
Hospice ,
Hospitals ,
Long-Term Care ,
Medicaid ,
Medicaid Expansion ,
Nurses ,
Proposed Regulation
In this Issue:
- Top News
..Large Hospital Systems Settles for $25.5 Million for False Claims Act Allegations
..Catholics’ Challenge to Contraceptive Coverage Mandate Dismissed As Not Ripe
- States...more
4/17/2013
/ Centers for Medicare & Medicaid Services (CMS) ,
Contraceptive Coverage Mandate ,
False Claims Act (FCA) ,
Healthcare ,
Hospitals ,
IRS ,
Medicaid Expansion ,
Medicare Advantage ,
Physician Payments ,
Physicians ,
Subcontractors ,
Sunshine Act ,
Supervision ,
Sustainability
In This Issue:
- OMB Directs Department Heads to Prepare for Sequestration
- HHS Finalizes Omnibus HIPAA Rule, Enhances Privacy Requirements
- SCOTUS Says Equitable Tolling Not a Factor in DSH Case
- Report...more
1/25/2013
/ Data Protection ,
DSH ,
Equitable Tolling ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Omnibus Rule ,
HITECH Act ,
Hospitals ,
Medicaid ,
Medicare ,
OMB ,
Pay-For-Delay ,
Pharmaceutical Industry ,
SCOTUS ,
Sequestration
In response to the government’s continued focus on improving quality of care through payment policy, several changes to new and existing regulatory requirements recently came about through the 2013 Inpatient Prospective...more