Edward White on Centers for Medicare & Medicaid Services (CMS)

HHS Final Rule Targets Suspicious Billing Practices for Medical Equipment (CMS-1799-F)

Summary: On September 24, 2024, the Biden administration issued a final rule designed to address suspicious billing for durable medical equipment that may have cost the Medicare program more than $2 billion....more

10/1/2024 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Investigations , Medical Equipment , Medical Expenses , Medical Supplies , Medicare , Medicare Shared Savings Program

FY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS)...

On August 1, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to increase Medicare inpatient prospective payment system rates for certain acute care hospitals by a net 2.9% in fiscal year 2025, compared...more

8/8/2024 / Acute Facilities , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Final Rules , Health Care Providers , Health Insurance , Healthcare , Healthcare Reform , Inpatient Prospective Payment System (IPPS) , Long Term Care Facilities , Long-Term Care , Medicare

Physicians Face Proposed Medicare Reimbursement Cuts for 2025 (RIN 0938-AV33)

Physician Fee Schedule Faces Cuts in CY25 - Overall Medicare payments to physicians and clinicians would be cut by a proposal to decrease average base payment rates by 2.93% from calendar year 2024 under a proposed rule...more

7/22/2024 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Medicare , Physician Fee Schedule , Physician Medicare Reimbursements , Physicians

Using A Value-Based Enterprise to Integrate Specialists and Primary Care: Taking Value-Based Care to the Next Level

Meaningful progress has been made in value-based care, but the documented advances in reducing costs and improving patient outcomes have taken place predominately in the primary care sector. Significantly less headway has...more

5/28/2024 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Health Care Providers , Health Insurance , Healthcare , Healthcare Reform , Stark Law , Value-Based Care

Using the New Value-Based Rules to Enhance Your ACO

In November 2020, the Centers for Medicare & Medicaid Services (CMS) finalized value-based exceptions under the Stark law, and the Office of Inspector General (OIG) finalized value-based safe harbors under the Anti-Kickback...more

4/26/2022 / ACOs , Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Healthcare Reform , OIG , Safe Harbors , Stark Law , Value-Based Care

New Opportunities in Value-Based Care Part 4: How to Create a Partial Risk Value-Based Enterprise

This is the fourth in a five-part series discussing the new Value-Based Regulations adopted last year by the Centers for Medicare & Medicaid Services and the Office of Inspector General. The Stark Meaningful Downside...more

5/17/2021 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Physicians , Risk Assessment , Safe Harbors , Stark Law , Value-Based Care

New Opportunities in Value-Based Care Part 2: Creating a Value-Based Enterprise

This is the second in a five-part series discussing the new Value-Based Regulations adopted last year by the Centers for Medicare & Medicaid Services and the Office of Inspector General. Creating a “value-based enterprise”...more

5/6/2021 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Stark Law , Value-Based Care , Value-Based Payments

New Opportunities in Value-Based Care Part 1: New Opportunities for Provider Collaboration

This is the first in a five- part series discussing the new Value-Based Regulations adopted last year by the Centers for Medicare & Medicaid Services and the Office of Inspector General. At the end of 2020 the Centers for...more

5/4/2021 / Affordable Care Act , Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , OIG , Stark Law , Value-Based Care

[Webinar] Stark and Anti-Kickback Proposed Rules: Where Are We Headed Now? - December 5th, 2:00 pm ET

Members of Nelson Mullins' healthcare team will host a 90-minute webinar to discuss the Department of Health and Human Services' and Centers for Medicare & Medicaid Services' new Stark and Anti-Kickback proposed rules, both...more

11/20/2019 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Physicians , Proposed Rules , Self-Referral , Stark Law , Webinars

Edward White

Nelson Mullins Riley & Scarborough LLP

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