The Centers for Medicare & Medicaid Services (CMS) on July 31, 2025, issued the final rule to update Medicare payment policies and rates for fiscal year 2026 under the Inpatient Prospective Payment System (IPPS) and the...more
Ropes & Gray attorneys share their analysis of administrative and court litigation, regulatory developments, key developments affecting federal program payments to hospitals and health systems, and other reimbursement-related...more
Congress is officially in recess for the month of August and will return after Labor Day. On the regulatory front, the Centers for Medicare & Medicaid Services (CMS) released the final fiscal year (FY) 2024 Inpatient...more
The Centers for Medicare & Medicaid Services (CMS) on Aug. 1, 2022, released the final rule for the federal fiscal year (FY) 2023 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) payment system....more
On August 2, 2021, CMS published the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule for federal fiscal year (FY) 2022. The final...more
Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in healthcare regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies, and...more
As we reported in our Managed Care Newsletter in April 2020, the CARES Act passed by Congress last year provides for a 20% increase to the DRG weights in the Medicare Inpatient Prospective Payment system (“IPPS”) for patients...more
On April 27, 2021, CMS issued the fiscal year (FY) 2022 proposed rule for the hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (the Proposed Rule). Among...more
Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more
Report on Medicare Compliance 29, no. 39 (November 2, 2020) - CMS said Oct. 28 that Medicare will pay hospitals extra when they treat inpatients with drugs or biologicals approved by the Food and Drug Administration (FDA)...more
On August 26, 2020, the Centers for Medicare and Medicaid (CMS) released an updated Frequently Asked Questions (FAQ) guide for questions related to COVID-19 and the public health emergency (PHE). The guide supplements the...more
The Centers for Medicaid & Medicaid Services (CMS) has released the Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final...more
The Office of Inspector General (OIG) for the Department of Health and Human Services recently announced a new addition to its work plan: auditing whether payments made by Medicare for COVID-19 inpatient discharges billed by...more
With the COVID-19 pandemic response and civil discourse on race and health disparities raising new questions about the future of U.S. health care policy, the winners of the 2020 federal elections will face a multitude of...more
On March 27th, Congress passed and the President signed the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act). On both the federal and state levels we have seen efforts to support social distancing in the...more
The Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which was signed by the President on March 27, 2020, includes several provisions affecting group health plans, as discussed below. Health Plan Rules and...more
As the number of COVID-19 cases in the U.S. continues to grow, the CARES Act makes a number of changes to support the ability of the health care system to respond to the crisis over the coming months. In addition, the package...more