News & Analysis as of

Alternative Payment Models (APM) Proposed Rules

Bass, Berry & Sims PLC

CMS Proposes Mandatory Two-Sided Risk Model for Specialists Treating Heart Failure and Low Back Pain

Bass, Berry & Sims PLC on

On July 16, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule for the Ambulatory Specialty Model (ASM), a mandatory, five-year alternative payment model for select specialists who regularly treat...more

Benesch

CMS’s CY 2026 Fee Schedule Proposal: MSSP Reforms Take Center Stage in Push Toward Value

Benesch on

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

Holland & Knight LLP

CMS Releases CY 2026 Medicare Physician Fee Schedule Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) on July 14, 2025, issued the calendar year (CY) 2026 Proposed Rule, which proposes payment policies and other outpatient services covered under Medicare Part B. Comments are...more

McDermott Will & Emery

CY 2023 Physician Fee Schedule Proposed Rule

McDermott Will & Emery on

On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B Proposed Rule, which was published...more

Holland & Knight LLP

CMS Issues 2023 Medicare Physician Fee Schedule Proposed Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Proposed Rule on July 7, 2022, which impacts Medicare Part B payments starting Jan. 1,...more

Holland & Knight LLP

CMS Releases CY 2022 OPPS and ASC Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) on July 19, 2021, released its calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed...more

K&L Gates LLP

K&L Gates Triage: Quality Payment Program Updates in the CY2020 Physician Fee Schedule Proposed Rule - Part 3

K&L Gates LLP on

In this week’s episode, Steve Pine presents the last installment of our three part series addressing the CMS Quality Payment Program (QPP) updates in the CY2020 Physician Fee Schedule (PFS) Proposed Rule. In this episode, Mr....more

Holland & Knight LLP

CMS Releases 2020 MPFS and QPP Proposed Rule

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• The Centers for Medicare & Medicaid Services (CMS) published the Calendar Year (CY) 2020 Proposed Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B, while the...more

Foley & Lardner LLP

Proposed Overhaul to the Medicare Shared Savings Program Would Mean More Risk for ACOs

Foley & Lardner LLP on

On August 9, 2018, CMS introduced a proposed rule that would substantially overhaul the Medicare Shared Savings Program (MSSP), requiring Accountable Care Organizations (ACOs) that participate in the MSSP to accept some...more

Holland & Knight LLP

CMS Issues Proposed Rule on Medicare Physician Payment in 2019

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on July 12, 2018, published the CY 2019 Proposed Rule for the Medicare Physician Fee Schedule (PFS). While in previous years regulations for the Quality Payment Program (QPP)...more

Baker Donelson

CMS Cancels EPM and Cardiac Rehabilitation Incentive Program While Revising CJR in New Proposed Rule

Baker Donelson on

After initially delaying the implementation of Episode Payment Models (EPMs) earlier this year, CMS issued a Proposed Rule on August 17 that proposes to cancel all EPMs and the Cardiac Rehabilitation Incentive Program (CR)...more

Mintz - Health Care Viewpoints

CMS Proposes to Cancel Bundled Payment and Incentive Models

The U.S. Centers for Medicare & Medicaid Services (CMS) published a proposed rule last week regarding the cancellation of three bundled payment models and an incentive payment model while also reducing the scope of a third...more

Baker Donelson

CMS Releases MACRA Proposed Rule for 2018

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On June 20, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled, "Medicare Program; CY 2018 Updates to the Quality Payment Program." CMS proposes changes for the second year (2018) of the...more

Dorsey & Whitney LLP

CMS continues to tinker with new physician Quality Payment Program created by MACRA

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The Centers for Medicare & Medicaid Services (CMS) released an advanced copy of its latest proposed rule revising the Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The...more

King & Spalding

CMS Says MACRA Implementation Will Begin on January 1, 2017 but Physicians Can “Pick Their Pace of Participation”

King & Spalding on

On September 8, 2016, CMS announced in a blogpost that new physician payment model reforms, established in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), will begin implementation on January 1, 2017, as...more

Baker Donelson

Proposed Cardiac, Hip, and Femur Episode Payment Models Are Next Generation from BPCI and CJR

Baker Donelson on

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on July 25, 2016, entitled, Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and...more

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