HealthLaw HotSpot - A Look at Alternative Reimbursement Models in Value-Based Care
Jones Day Talks Health Care: The Eliminating Kickbacks in Recovery Act
Value-based health care: fraud & abuse laws
Tax Developments Affecting Health Care Organizations and Investor-Owned Hospital Companies
On July 14, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released the proposed rule for the Calendar Year (“CY”) 2026 Medicare Physician Fee Schedule (“PFS”), formally titled CMS-1832-P....more
On November 2, 2016, the Centers for Medicare and Medicaid Services (CMS), released the 2017 Medicare Physician Fee Schedule (MPFS) final rule, which finalized a number of new policies designed to improve Medicare payment for...more
Many observers view the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a game changer for the delivery and payment of health care services. On Oct. 14, 2016 the Centers for Medicare & Medicaid Services...more
On the heels of the release of its final rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA), the Centers for Medicare and Medicaid Services (CMS) released its 2017 list of Advanced Alternative Payment...more
On Oct. 14, the Centers for Medicare & Medicaid Services (CMS) published a final rule with comment period implementing the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The nearly 2,400 pages of...more
McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and care delivery...more
The Centers for Medicare & Medicaid Services (CMS) on Oct. 14, 2016, released the highly anticipated Final Rule implementing the Medicare physician payment reforms enacted as part of the Medicare Access and CHIP...more
After receiving roughly 4,000 comments to its proposed rule, the Centers for Medicare and Medicaid Services (CMS) on October 14, 2016 released its final rule for implementing the Medicare Access and CHIP Reauthorization Act...more
Trends & Analysis - Since our last Qui Tam Update, we have identified 39 health-related False Claims Act (“FCA”) qui tam cases that have been unsealed. Of those cases...more
The Centers for Medicare & Medicaid Services (CMS) is changing reimbursement methodologies for healthcare providers from a fee-for-service model to a value-based model. Healthcare providers are responding to the changing...more
This is the fourth post in Health Care Law Today’s series on the final rule. This post addresses how CMS assigns beneficiaries to an ACO participating in the MSSP. In the MSSP ACO Final Rule, CMS finalized new...more
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
This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more
On March 19th, Representative Michael C. Burgess, M.D. (R-TX) and Senate Finance Committee Chairman Orrin Hatch (R-UT) unveiled a bipartisan plan to repeal and replace the sustainable growth rate (SGR) physician payment...more
CMS ANNOUNCES NEW RULES THAT MAKE OWNER DOCTORS LIABLE FOR ALL PRACTICE MEDICARE DEBTS - Even after they leave the Practice. CMS announced its final rules on "Medicare Provider Oversight" on December 3, 2014. ...more
One week prior to the unveiling of the President’s first budget under a completely Republican-controlled Congress, the Department of Health and Human Services (HHS) made its most formal announcement yet on the Obama...more
In this presentation: - The Changing Healthcare Landscape - Key Features of an ACO/CIN - ACO Standards and Quality Metrics - Examples of Quality Standards - Impact on Board and Corporate...more
The consolidation of health care markets and the impact of this consolidation on prices, costs, and quality, has been a hotly debated topic in the health care industry. Hospitals across the country are merging and acquiring...more
Our Secret Weapon and Our Biggest Disappointment - In our last column, we highlighted the Rio Grande Valley Health Alliance, an accountable care organization in McAllen, Tex., composed of 14 independent primary care...more
While concepts and theories can go a long way, sometimes the best way to understand something is through a concrete example. So, from time to time, ACO Insider will check in on a new accountable care organization composed of...more
With ever more data demonstrating that patient-centered medical homes are the core of successful Accountable Care Organizations (ACO), it’s becoming clear that primary care physicians can have a meaningful role in the...more
The June 28th Supreme Court ruling to uphold the Patient Protection and Affordable Care Act ("ACA") removed some of the uncertainty surrounding the immediate short-term prospects for health care reform. Now that the debate...more