News & Analysis as of

Healthcare Medicare Shared Savings Program

DLA Piper

Proposed CY 2026 Medicare Physician Fee Schedule: Key Changes Impacting the Medicare Shared Savings Program

DLA Piper on

On July 14, 2025, the Centers for Medicare and Medicaid Services (CMS) released the 2026 calendar year (CY 2026) Medicare Physician Fee Schedule (Proposed Rule). Among the many changes proposed, the Proposed Rule includes...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

McDermott+

CMS releases CY 2026 Physician Fee Schedule Proposed Rule

McDermott+ on

On July 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B [CMS-13271]...more

McCarter & English, LLP

Guideless: Collaborations Among Competitors

McCarter & English, LLP on

Companies depend on regulatory guidance to establish robust compliance programs but recent withdrawals of key antitrust guidelines are leaving businesses in a guideless void. What Happened - The US antitrust agencies...more

McDermott+

ACO REACH: What Recent Performance Results Could Mean for the Model’s Future

McDermott+ on

Decisions, decisions, decisions. The Centers for Medicare & Medicaid Services (CMS) under the Trump Administration will have its hands full making decisions about Center for Medicare and Medicaid Innovation (CMMI) models...more

McDermott+

Digesting the Huge Buffet of CMS Regs: Highlights from the CY 2025 PFS Final Reg

McDermott+ on

While we all are focused on the election results, let’s take a quick break to digest some regs and eggs. The Centers for Medicare & Medicaid Services (CMS) “spoiled” all of us in the health policy world with a huge buffet of...more

King & Spalding

DOJ Alters Standards for Information Sharing in Healthcare

King & Spalding on

On Friday, February 3, DOJ announced that it is withdrawing three policy statements of antitrust guidance it has provided and that have been adopted by the healthcare industry for close to 30 years. The statements include...more

Robinson+Cole Health Law Diagnosis

Key Changes to the Medicare Shared Savings Program

On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued changes to the Medicare Shared Savings Program to advance CMS’ broader strategy of growth, alignment, and equity. To improve the overall...more

Robinson+Cole Health Law Diagnosis

CMS Issues Final Rules Concerning the 2023 Outpatient Prospective Payment System Rates and Physician Fee Schedule

On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued final rules concerning the 2023 Hospital Outpatient Prospective Payment System (OPPS) payment rates and 2023 Medicare Physician Fee Schedule...more

Smith Anderson

The ACO Specialist Manual

Smith Anderson on

The ACO Specialist Manual is a strategic guide to getting the optimum value-add contributions from each medical specialty in integrated health care. For purposes of this Manual, the teams are generally termed accountable care...more

Smith Anderson

ACOs Have New Options for Beneficiary Incentive Programs

Smith Anderson on

With CMS’s continued “regulatory sprint to coordinated care,” the new Medicare Shared Savings Program regulations expand the playing field for ACOs to offer beneficiary incentive programs to encourage healthy outcomes. Termed...more

Dorsey & Whitney LLP

“Pathways to Success” – CMS Finalizes Overhaul of National ACO Program

Dorsey & Whitney LLP on

On December 21, 2018, CMS announced a final rule, subsequently published in the December 31 issue of the federal register, significantly overhauling the Medicare Shared Savings Program (“MSSP”). Among the important changes in...more

Smith Anderson

[Webinar] Strategies for an ACO's "Pathway to Success": The New MSSP Rule - January 22nd, 12:30pm ET

Smith Anderson on

A live webinar presented by Smith Anderson health care lawyers Julian "Bo" Bobbitt, Robert Shaw and Shawn Parker. On December 21, 2018, CMS published “Pathways to Success,” the final rules overhauling Medicare’s ACO...more

Foley & Lardner LLP

“Pathways to Success:” CMS Publishes Final Rule Modifying the Medicare Shared Savings Program

Foley & Lardner LLP on

The Centers for Medicare and Medicaid Services (CMS) issued a final rule (the Rule) on December 21, 2018, which reshapes the Medicare Shared Savings Program (MSSP). Termed “Pathways to Success,” the Rule, among other things, ...more

Holland & Knight LLP

CMS Proposes Major ACO Overhaul

Holland & Knight LLP on

On Aug. 9, 2018, Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would update the Medicare Shared Savings Program (MSSP). Called "Pathways to Success," the proposal significantly alters the...more

Pierce Atwood LLP

CMS Continues Efforts to Improve Patient Care, Spending, and Population Health

Pierce Atwood LLP on

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

McDermott Will & Emery

Managing the Transition to Transformation: Digital Health Solutions: Essential Ingredients in Alternative Health Care Delivery and...

McDermott Will & Emery on

INTRODUCTION - Digital health—the intersection of health care related software applications, analytical tools, medical device technology and electronic data assets that are enabled and achieved through the use of the...more

Pierce Atwood LLP

CMS Releases List of Additional Advanced APM’s and Announces Vermont’s All-Payer ACO

Pierce Atwood LLP on

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

Polsinelli

Making Sense of the MACRA Final Rule, Part 1 of 3: Essential Concepts

Polsinelli on

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

Polsinelli

DOJ-AmEx Case Could Have Ramifications for Health Care Providers

Polsinelli on

The U.S. Department of Justice's loss to American Express sends a message to health care providers: Steering, tiering, exclusive dealing and other contractual arrangements that appear to suppress competition in one part of...more

Sheppard Mullin Richter & Hampton LLP

Vermont to Launch a First-in-the-Nation All-Payer System for All Healthcare Providers

As recently reported by Modern Healthcare and other major healthcare news outlets, the Obama administration has granted tentative approval for Vermont to establish an all-payer reimbursement system. If granted final approval,...more

Saul Ewing Arnstein & Lehr LLP

CMS and OIG Issue Final ACO Waivers

On Thursday, October 29, 2015, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of Inspector General (“OIG”) jointly issued a rule (the “Final Rule”) to finalize five (5) waivers of certain fraud and abuse...more

Foley & Lardner LLP

Top Three Reasons ACOs Should Use Telehealth and Telemedicine

Foley & Lardner LLP on

Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more

Foley & Lardner LLP

OIG and CMS Issue Rule: Finalizing Fraud and Abuse Waivers for MSSP ACOs

Foley & Lardner LLP on

The Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General (OIG) of the Department of Health and Human Services just issued a final rule setting forth waivers of specified fraud and abuse laws...more

Mintz - Health Care Viewpoints

Mintz Levin Health Care Qui Tam Update: Recent Developments & Unsealed Cases - September 2015

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

87 Results
 / 
View per page
Page: of 4

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide