CMS recently published the First Annual Evaluation Report (the “Report”) highlighting its most significant observations in the first year following implementation of the Kidney Care Choices Model (the “KCC Model”). By way of...more
On Thursday, April 8, 2021, the Center for Medicare and Medicaid Innovation (the “Innovation Center”) announced its final list of 53 organizations set to participate in the Global and Professional Direct Contracting (“GPDC”)...more
On March 17, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum to provide information to organizations that participate in the Programs of All-Inclusive Care for the Elderly (“PACE”) program in...more
On April 21, 2019, the Center for Medicare and Medicaid Innovation (“CMMI”) announced the CMS Primary Cares Initiative – a voluntary, risk-based initiative to transform the Medicare program’s reimbursement of primary care...more
12/2/2019
/ Alternative Payment Models (APM) ,
Applications ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
Fee-for-Service ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
Letters of Intent ,
Medicaid ,
Medicare ,
Physicians ,
Value-Based Care
On December 27, 2018, the U.S. District Court for the District of Columbia issued an opinion that ruled against the Trump Administration in its plan to cut funding from the 340B Drug Pricing Program (“340B...more
1/15/2019
/ American Hospital Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Medical Reimbursement ,
Medicare ,
Pharmaceutical Industry ,
Preliminary Injunctions ,
Prescription Drugs ,
Section 340B ,
Trump Administration
Tuesday’s midterm elections showed that healthcare is now a top issue among voters, according to exit polls. In an NBC News poll, healthcare was the top issue for a plurality of voters, ahead of the economy, immigration, and...more
11/13/2018
/ Affordable Care Act ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Opioid ,
Preexisting Conditions ,
Prescription Drug Coverage ,
Prescription Drugs ,
Repeal ,
Trump Administration
On April 24, 2018, the Centers for Medicare & Medicaid Services (“CMS”) announced a new proposed rule (CMS-1694-P) (“Proposed Rule”). In an attempt to “empower patients through better access to hospital price information,”...more
5/14/2018
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Patients ,
Price Transparency ,
Proposed Rules ,
Public Comment
On Friday, February 9, 2018, President Trump signed the Bipartisan Budget Act of 2018 (the “Budget”), a two-year budget which, in significant part, made substantial revisions to Medicare, including the Medicare Advantage (MA)...more
2/16/2018
/ Bipartisan Budget Act ,
Budget Control Act of 2011 ,
Federal Funding ,
FQHC ,
Health Care Providers ,
IPAB ,
Low-Income Issues ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
Pharmaceutical Industry ,
Supplemental Benefits ,
Telehealth ,
Trump Administration
In November of last year, we wrote about a preliminary injunction being sought by hospital advocacy groups attempting to stop implementation of the Trump administration’s cuts to the 340B Drug Pricing Program (“340B...more
1/5/2018
/ Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Final Rules ,
Hospitals ,
Medical Reimbursement ,
Medicare ,
Medicare Payment Reform ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Preliminary Injunctions ,
Prescription Drugs ,
Section 340B
On November 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the final rule, “Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting...more
11/20/2017
/ Ambulatory Surgery Centers ,
American Hospital Association ,
Budget Cuts ,
Centers for Medicare & Medicaid Services (CMS) ,
Covered Entities ,
Drug Pricing ,
Final Rules ,
Health Clinics ,
Healthcare Facilities ,
Hospitals ,
HRSA ,
Medical Reimbursement ,
Medicare ,
Medicare Payment Reform ,
New Rules ,
Outpatient Prospective Payment System (OPPS) ,
Outpatient Quality Reporting ,
Pharmaceutical Industry ,
Preliminary Injunctions ,
Prescription Drugs ,
Presidential Memorandum ,
Public Health Service Act ,
Section 340B ,
Trump Administration
In a proposed rule published Tuesday, August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its intention to roll back a handful of payment models introduced under the Obama Administration. If...more
On June 20, 2017, CMS released its proposed rule updating MACRA’s Quality Payment Program (“QPP”) for CY 2018. At over 1,000 pages, the rule might not do much to simplify the already complex requirements of the QPP; however,...more
As reported by the New York Times in an article dated July 13, 2017, in an effort to crack down on fraud and abuse, and with a particular focus on opioids, the Department of Justice (“DOJ”) is charging 412 individuals for...more
In Part II of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we considered potential healthcare market consequences of a partial repeal of the Affordable Care Act (ACA). In...more
12/21/2016
/ Affordable Care Act ,
Health Insurance ,
Health Insurance Exchanges ,
Health Savings Accounts ,
Healthcare Reform ,
Malpractice Insurance ,
Medicaid ,
Medicare ,
Preexisting Conditions ,
Repeal ,
Tax Credits ,
Trump Administration
In Part I of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we discussed what the healthcare landscape looked like before the Affordable Care Act (ACA), how the law emerged...more