Hedy Silver Rubinger on Medicare

CMS Seeks Input on Direct Provider Contracting

The Centers for Medicare & Medicaid Services (CMS) announced that it is seeking input on direct provider contracting (DPC) between “payers and primary care or multi-specialty groups to inform potential testing of a DPC model”...more

5/9/2018 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Advantage , Medicare Part A , Medicare Part B , Physicians

CMS Proposes Overhaul of SNF Reimbursement System, Increases FY 2019 Payments

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on April 27, 2018 to overhaul the payment system for skilled nursing facilities (SNFs). Specifically, the rule would “update the payment rates used...more

5/3/2018 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Prospective Payment System (PPS) , Skilled Nursing Facility

CMS Files Objection in Skilled Nursing Bankruptcy Case

An increasing number of Medicare providers have found themselves in financial distress and are contemplating bankruptcy filings. While provider bankruptcies include a host of issues outside the government reimbursement...more

4/26/2018 / Bankruptcy Court , Centers for Medicare & Medicaid Services (CMS) , Commercial Bankruptcy , Health Care Providers , Medicare , Skilled Nursing Facility

New CMS Medicare Advantage Policy Could Have Significant Impact on Senior Living and In-Home Care Providers

A Centers for Medicare & Medicaid Services (CMS) call letter (the “Call Letter”) released on April 2, 2018, could mean a dramatic and positive shift in CMS policy related to Medicare Advantage (MA) plans and senior living and...more

4/12/2018 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Advantage

CMS Reminds Providers and Suppliers of Reporting Requirements

The Centers for Medicare & Medicaid Services (CMS) recently released a new Medicare Learning Network “MLN Matters” education document to remind applicable providers and suppliers about the need to timely report provider...more

2/7/2018 / Centers for Medicare & Medicaid Services (CMS) , Durable Medical Equipment , Health Care Providers , Medicare , Reporting Requirements

CMS Adds New Quality Measures to Nursing Home Ratings

On August 10, 2016, the Centers for Medicare & Medicaid Services (CMS) announced that it has incorporated five new quality measures to the calculations for its nursing home Five-Star Quality Ratings. The five measures are now...more

8/16/2016 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Nursing Homes

CMS Revises Enrollment-Related Provisions in the Medicare Program Integrity Manual

The Centers for Medicare & Medicaid Services (CMS) made changes to important written guidance to Medicare providers by issuing a Change Request on June 24, 2016, to Chapter 15 of its Program Integrity Manual (titled “Medicare...more

7/20/2016 / Centers for Medicare & Medicaid Services (CMS) , Home Health Agencies , MACs , Medicare

MedPAC Opposes Medicare FY2017 Payment Increases for SNFs and Pushes for Payment Reform

The Medicare Payment Advisory Commission (MedPAC) issued a letter on May 25, 2016, commenting on the Centers for Medicare & Medicaid Services’ (CMS) proposed rule relating to payment updates for skilled nursing facilities...more

6/7/2016 / Centers for Medicare & Medicaid Services (CMS) , Medicare , MedPAC , Skilled Nursing Facility

OIG Issues Report on Enhanced Medicare Screening

After reviewing Medicare and Medicaid enrollment and revalidation applications, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued a report titled Enhanced Enrollment Screening of...more

5/11/2016 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Enrollment , Health Care Providers , Medicare , OIG

CMS Begins Cycle 2 of Provider/Supplier Enrollment Revalidation

The Centers for Medicare & Medicaid Services (CMS) Division of Enrollment Operations is beginning Cycle 2 of the provider and supplier revalidation process, as required under Section 6401 (a) of the Affordable Care Act. CMS...more

3/15/2016 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Enrollment , Health Care Providers , Medicare

CMS Implements Changes to Prospective Payment System for Long-Term Care Hospitals

The Centers for Medicare & Medicaid Services (CMS) has implemented a revised payment system for Long-Term Care Hospitals (LTCHs). The changes, which became effective on October 1, define two separate payment categories for...more

10/6/2015 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Hospitals , Long Term Care Facilities , MACs , Medicaid , Medicare , Patient Prospective Payment System

Hedy Silver Rubinger

Arnall Golden Gregory LLP

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