On June 21, 2019, CMS finalized a decision memo updating the national coverage policy for Transcatheter Aortic Valve Replacement (TAVR), a procedure used to address aortic stenosis. The decision changes the volume...more
On April 26, 2019, CMS issued a letter to State Medicaid Directors (2019 Letter) inviting states to partner with CMS in one of three new opportunities to test state-driven approaches to integrating care for individuals who...more
On February 28, 2019, CMS issued a 48-page request for public comment (the Request) on several potential updates to and future considerations for the methodology used in the Overall Hospital Quality Star Rating. As explained...more
On November 30, 2018, CMS launched the Procedure Price Lookup tool that enables consumers to search the tool by type of procedure to compare the national average cost for procedures performed in both ambulatory surgery...more
On May 8, 2018, the Senate passed S. 1732, a bipartisan bill giving CMS the authority to offer incentive payments to “behavioral health providers” who implement certified electronic health records. The bill, titled,...more
The U.S. Department of Justice elected not to file a second amended complaint-in-intervention in U.S. ex rel. Poehling v. UnitedHealth Group Inc., 2:16-cv-08697, a Federal False Claims Act (FCA) case pending in the U.S....more
On October 13, 2017, HHS issued a transmittal change request to update Section 3.9 of the Medicare Program Integrity Manual (MPIM), stating that only one entity (CMS or a CMS contractor) may attend an ALJ hearing as a party,...more
CMS has issued guidance documents addressing how hospitals can (1) qualify an off-campus provider-based department (PBD) for the “mid-build” exception set forth in the 21st Century Cures Act and (2) request from their CMS...more
On November 30, 2016, the House of Representatives passed the 21st Century Cures Act, a bill intended to modernize health care delivery and speed up and improve medical research and innovations by removing bureaucratic...more
12/8/2016
/ 21st Century Cures Initiative ,
Centers for Medicare & Medicaid Services (CMS) ,
Food and Drug Administration (FDA) ,
Healthcare ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
MedPAC ,
National Institute of Health (NIH) ,
Pharmaceutical Industry ,
Sunshine Act ,
Telemedicine
On September 28, 2016, CMS issued a final rule to improve the care and safety of nursing home residents in long-term care facilities. The new rules are intended to reduce unnecessary hospital readmissions and infections,...more
On August 2, 2016, CMS released a final rule (Final Rule) with updates to the Hospital Inpatient Prospective Payment System (Hospital IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) affecting...more
8/10/2016
/ Administrative Procedure Act ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Hospitals ,
IMPACT Act ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Medicare ,
Provider Payments ,
Two-Midnight Rule ,
Value-Based Purchasing
On June 30, 2016, Senate Finance Committee Chairman Orrin Hatch released a white paper examining potential reforms to the Federal Stark law. The white paper, entitled “Why Stark, Why Now? Suggestions to Improve the Stark...more