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Arnall Golden Gregory LLP

Healthcare Authority Newsletter - August 2025 #3

News Briefs - Physician Productivity Rising, But Reimbursement Isn't -Physicians are working more than ever, but reimbursement isn't rising in tandem. It's a worrying mismatch that could translate into access problems for...more

King & Spalding

CMS Issues FY 2026 Inpatient Rehabilitation Facility Prospective Payment System and Quality Reporting Program Final Rule

King & Spalding on

On August 1, 2025, CMS issued a final rule updating the Medicare rates and policies applicable to inpatient rehabilitation facilities (IRFs) under the IRF Prospective Payment System (PPS) and the IRF Quality Reporting Program...more

Ropes & Gray LLP

Hospital and Health Systems Reimbursement Check July 2025

Ropes & Gray LLP on

In the early days of the second Trump Administration, several federal funding agencies announced caps to indirect cost (“IDC”) rates for federally funded research awards. In many cases, these caps would substantially reduce...more

Brownstein Hyatt Farber Schreck

Understanding the Rural Health Transformation Program

On July 4, President Donald Trump signed into law H.R. 1, commonly known as the “One Big Beautiful Bill,” or OBBB. The bill is a sweeping package that includes an estimated $1 trillion in cuts to Medicaid. These cuts include...more

Alston & Bird

Health Care Week in Review | Congress Passes Recissions Package, CMS Releases CY 2026 PFS and OPPS Proposed Rules

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Benesch

Dialysis & Nephrology Digest - July 2025

Benesch on

CMS Releases Proposed Rule for 2026 ESRD PPS - As the nephrology organization representing the specialty on socioeconomic and physician practice issues, the Renal Physicians Association analyzes and disseminates...more

Holland & Knight LLP

CMS Releases CY 2026 Medicare Physician Fee Schedule Proposed Rule

Holland & Knight LLP on

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

Fisher Phillips

Minimum Staffing Rules for Long-Term Care Facilities Tossed Out by Federal Courts and Budget Bill: Key Points for Medicare and...

Fisher Phillips on

A federal judge in Iowa recently struck down key parts of a Biden-era final rule that set new minimum staffing standards for long-term care facilities as a condition of participation in Medicare or Medicaid programs. The June...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - June 2025 #4

News Briefs - Federal Judge Rejects Nursing Home RN Staffing Mandate - A federal judge has struck down the federal nursing home staffing mandate's demands that a registered nurse be on duty 24/7 every day of the year, as well...more

Benesch

CMS Terminates KCF Model and Finalizes Significant Revisions to CKCC Participation and Payment Framework

Benesch on

On May 28, 2025, the Centers for Medicare & Medicaid Services (“CMS”) Innovation Center formally announced the early termination of the Kidney Care First (“KCF”) model effective December 31, 2025, and issued a suite of...more

McDermott+

Inpatient Prospective Payment System (IPPS) Data Dashboard (UPDATED)

McDermott+ on

What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient volumes changed over time for inpatient hip and femur...more

Maynard Nexsen

Nursing Home Operators Wary of Steep Medicaid Cuts as "One Big Beautiful Bill" Moves to Senate

Maynard Nexsen on

Even as long-term care providers celebrate a proposed 10-year moratorium on the nursing home staffing mandate[1], they are sounding the alarm over major Medicaid cuts included in the House-passed budget reconciliation bill...more

Stevens & Lee

CMS Issues Updated Hospital Price Transparency Guidance and Related RFI

Stevens & Lee on

The Centers for Medicare & Medicaid Services (CMS) released new Updated Hospital Price Transparency Guidance (Guidance) to “strengthen the Hospital Price Transparency requirements, requiring hospitals to post the actual...more

Robinson+Cole Health Law Diagnosis

CMS Issues Guidance and Requests Information to Promote Hospital Price Transparency Compliance and Enforcement Efforts

On May 22, 2025, the Centers for Medicare & Medicaid Services (CMS) took a series of actions to promote enhanced price transparency compliance by hospitals and identify challenges thereto, in order to inform future price...more

Proskauer - Health Care Law Brief

Disproportionate Impact: Supreme Court Narrows Disproportionate Share Hospital Reimbursement to Supplemental Security Income Cash...

The U.S. Supreme Court has issued a significant ruling affecting hospitals that serve low-income Medicare beneficiaries, narrowing the interpretation of the Disproportionate Share Hospital (“DSH”) payment formula. In...more

J.S. Held

All Is Not What It Seems, Or When Is A Dollar A Dime?

J.S. Held on

Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - May 2025 #1

News Briefs - Hospitals Lose Supreme Court HHS Payment Case - The U.S. Supreme Court sided with the U.S. Department of Health and Human Services in a lawsuit brought by more than 200 hospitals that serve low-income...more

Dentons

Ep. 60 – Assess EHR Safety Issues Using the 2025 SAFER Guides

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If your organization uses Electronic Health Records (EHRs), the recent updates to the SAFER Guidelines (Safety Assurance Factors for EHR Resilience) are essential for helping you assess the potential safety issues posed by...more

Baker Donelson

Noteworthy GME Payment Policies in CMS FY 2026 IPPS and IPF Proposed Rules

Baker Donelson on

This month, the Centers for Medicare & Medicaid Services (CMS) issued several noteworthy proposed Graduate Medical Education (GME) payment policies and opportunities in its fiscal year (FY) 2026 Medicare Inpatient Prospective...more

Polsinelli

CMS Extends Revalidation Deadline for Skilled Nursing Facilities to August 1, 2025

Polsinelli on

In its April 17 MLN Newsletter, the Centers for Medicare and Medicaid Services (CMS) once again extended the deadline for skilled nursing facilities (SNF) to submit their off-cycle revalidation from May 1 to August 1, 2025....more

Sheppard Mullin Richter & Hampton LLP

CMS to Withdraw Federal Medicaid Match for Workforce, Social Needs, and Infrastructure: What States, Health Care Providers and...

In a move signaling a major shift in federal priorities, the Centers for Medicare & Medicaid Services (“CMS”) recently announced it will limit federal funding for state Medicaid initiatives that support services beyond direct...more

McDermott Will & Schulte

CMS Updates SNF Attachment Guidance Ahead of May 1 Enrollment Deadline

Skilled nursing facilities (SNFs) historically have been required to disclose ownership and managerial control information as part of their Medicare enrollment. However, these requirements were significantly expanded to...more

Alston & Bird

Health Care Week in Review | House and Senate Agree to Budget Resolution; CMS Releases Inpatient and Post-Acute Payment Proposed...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Dentons

Ep. 56 – Avoid these compliance mistakes when implementing delegated credentialing for telehealth providers

Dentons on

Delegated credentialing for telehealth providers has become commonplace since the Centers for Medicare & Medicaid Services (CMS) relaxed the Medicare Conditions of Participation for hospitals more than 10 years ago. Delegated...more

Saul Ewing LLP

New Executive Order and the Risks of Non-Compliance with Healthcare Price Transparency Rules

Saul Ewing LLP on

On February 25, 2025, President Trump issued an Executive Order titled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information” (the 2025 Order). This directive...more

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