CMS finalized a rule last month that will significantly expand access to telehealth services for patients in Medicare Advantage plans. Implementing provisions of the Bipartisan Budget Act of 2018 (BiBA), the new rule will...more
Mixing innovative change with standing policy, the proposed physician fee schedule rule for CY 2019 highlights a Medicare payment system in transition. Clinicians and groups focused solely on driving volume without devoting...more
A new report suggests that the Stark law is obsolete in new payment models.
On June 30, the US Senate Committee on Finance (the Committee) released the report Why Stark, Why Now? Suggestions to Improve the Stark Law to...more
7/7/2016
/ Affordable Care Act ,
AHLA ,
Alternative Payment Models (APM) ,
Anti-Kickback Statute ,
Civil Monetary Penalty ,
False Claims Act (FCA) ,
Fraud Abuse and Waste ,
Health Care Providers ,
Legislative Agendas ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Physicians ,
Repeal ,
Stark Law
The report shows significant lapses in 2012 GIP service claims and recommends that CMS implement additional oversight and enforcement options....more
Tips on preserving the provider-based status for existing clinics.
The Bipartisan Budget Act of 2015 (H.R. 1314) was signed into law on Monday, November 2. Notwithstanding significant concerns raised by the hospital...more
11/4/2015
/ Centers for Medicare & Medicaid Services (CMS) ,
Critical Access Hospitals ,
Federal Budget ,
Health Care Providers ,
Healthcare ,
Hospitals ,
HRSA ,
Medicaid ,
Medicare ,
New Legislation ,
OPPS ,
Provider Payments ,
Section 340B ,
State Medicaid Programs
Major changes to Stark law are ahead, including new exceptions for timeshare arrangements and employment of NPPs.
The Centers for Medicare & Medicaid Services (CMS) released a proposed rule on July 8 for the 2016...more
7/10/2015
/ ACOs ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Client Referrals ,
Comment Period ,
Exceptions ,
FQHC ,
Healthcare ,
Hospitals ,
Medicaid ,
Medicare ,
Physician Fee Schedule ,
Physicians ,
Proposed Regulation ,
Rural Health Care Providers ,
Stark Law
The OIG’s recently released study examining Medicare hospice claims from 2007 to 2012 calls for targeted reviews of hospices that receive a high proportion of their payments for care in assisted living facilities....more
CMS reconsiders $10 million bounties for reporting of regulatory violations.
On December 5, the Centers for Medicare & Medicaid Services (CMS) finalized a rule (the Final Rule) that expands its program integrity and...more