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Medicaid › Accountable Care Organizations › Health Care Providers

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Holland & Knight LLP

CMMI Signals New Strategy and Terminates 4 Value-Based Care Models

Holland & Knight LLP on

The Center for Medicare and Medicaid Innovation (CMMI) has released a statement on plans to unveil a new strategy focused on "improving the health of Americans through disease prevention via evidence-based practices,...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+

CMMI’s Accountable Care Strategy: A Perspective

McDermott+ on

McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to subscribe to future blog posts. October 10, 2024 – For several years, the Center for Medicare & Medicaid...more

King & Spalding

Physician Fee Schedule Proposed Rule Proposes New Quality-Driven Payment Policies

King & Spalding on

Within its proposed CY 2025 Physician Fee Schedule (PFS) rule (the Proposed Rule), CMS is proposing to implement new payment policies intended to advance health equity and support whole-person care. CMS expects these new...more

Mintz - Health Care Viewpoints

Transforming Primary Care: CMS Launches Making Care Primary (MCP) Model

Mintz - Health Care Viewpoints on

The Centers for Medicare & Medicaid Services (CMS) announced a new primary care model—the Making Care Primary (MCP) Model—geared towards smaller, independent primary care practices and organizations that want to participate...more

Sheppard Mullin Richter & Hampton LLP

Day 1 Notes from the 41st Annual J.P. Morgan Healthcare Conference

Sheppard Mullin Richter & Hampton LLP on

I was struck on the first day of the 41st Annual J.P. Morgan Healthcare Conference by Sanjay Doddamani (CEO of UpStream Healthcare) saying that “Health is a state of independence.” A simple statement, but a very profound and...more

Foley Hoag LLP - Medicaid and the Law

Medicaid and the LawFoley Hoag LLP CMS Approves Two New Medicaid Waivers to Expand Coverage, Provide Flexibilities

Foley Hoag LLP - Medicaid and the Law on

On September 28, 2022, the Centers for Medicare & Medicaid Services (CMS) issued approval letters for Section 1115 Medicaid demonstration applications previously submitted by Oregon and Massachusetts. Section 1115 waivers...more

King & Spalding

CMS Proposes Sweeping Changes to the Medicare Shared Savings Program

King & Spalding on

As part of the CY 2023 Physician Fee Schedule proposed rule (the Proposed Rule) released on July 7, 2022, CMS has proposed significant changes to the Medicare Shared Savings Program (MSSP). The agency’s press release...more

Greenbaum, Rowe, Smith & Davis LLP

COVID-19 And Medicare Alternate Payment Programs

Greenbaum, Rowe, Smith & Davis LLP on

Insurance payments for healthcare services and supplies are frequently based on projections of future costs, often measured against a baseline calculated on past costs. However, COVID-19 and its attendant changes to the...more

Ballard Spahr LLP

CMS and OIG Release Long-Awaited Stark Law and Anti-Kickback Statute Proposed Rules

Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) recently released two proposed rules restructuring the Physician Self-Referral...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

Dorsey & Whitney LLP

CMS’s New “Primary Cares Initiative” Places Primary Care at the Center of the Shift to Value-Based Care

Dorsey & Whitney LLP on

On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced two sweeping new payment innovation models under the Primary Cares Initiatives. The models will seek to incentivize primary care and other...more

Downs Rachlin Martin PLLC

Vermont Legislative Update 01/18/2019 - An analysis from DRM's Government & Public Affairs Team

Downs Rachlin Martin PLLC on

The Senate Health and Welfare Committee reviewed a report Thursday on the state’s progress with health care payment and delivery system reform efforts. Department of Vermont Health Access Deputy Commissioner Michael Costa...more

Robinson+Cole Health Law Diagnosis

2019 Physician Fee Schedule Rule Review: Option to Extend MSSP Agreements for Currently-Expiring ACOs Finalized

Robinson+Cole Health Law Diagnosis on

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Physician Fee Schedule Final Rule (PFS Rule), which contains a number of significant substantive changes to Medicare payment practices...more

Verrill

No Summer Slump for CMS: Major Changes Proposed for the Medicare Shared Savings Program

Verrill on

On August 17, 2018, the Centers for Medicare & Medicaid Services (“CMS”) officially published a proposed rule (“Proposed Rule”) in the Federal Register that would significantly alter the Medicare Shared Savings Program...more

McDermott Will & Schulte

Top 5 Takeaways: CMS’s Proposed Overhaul of the MSSP ACOs

McDermott Will & Schulte on

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule on August 17, 2018, that would make sweeping changes to the Medicare Shared Savings Program (MSSP), a federal program that incentivizes integrated...more

K&L Gates LLP

K&L Gates Triage: ACO Improvements in the Bipartisan Budget Act of 2018

K&L Gates LLP on

The Bipartisan Budget Act of 2018 recently introduced three noteworthy program improvements for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) aimed at increasing program...more

Polsinelli

Continuing Resolution Creates Significant Changes to Medicare and Medicaid Policies

Polsinelli on

The Bipartisan Budget Act of 2018, commonly referred to as the “Continuing Resolution,” was recently signed into law, creating a short-term fix to funding the federal government for six weeks while also raising the debt...more

Dorsey & Whitney LLP

Significant Changes in Healthcare Laws Enacted Through the Bipartisan Budget Act of 2018: Stark, Civil and Criminal Penalties,...

Dorsey & Whitney LLP on

On February 9, President Trump signed the Bipartisan Budget Act of 2018 (“BBA”) into law. The BBA funds the federal government through March 23 and included a bipartisan agreement to increase annual spending authority for a...more

Benesch

Hospitals & Physician Organizations Summary Report - November 2017

Benesch on

Uncertainty and pressures continue to mount for healthcare providers, creating a new operating environment – Uncertainty around Medicaid and other programs, the shift to value-based care, margin pressures, the need to search...more

Polsinelli

CMMI Requests Ideas to Spur Innovation and Reduce Burden

Polsinelli on

The Center for Medicare & Medicaid Innovation (CMMI) is seeking ideas on how to better drive change and reduce regulatory burden. CMMI solicited ideas to shape the agency’s future activities through a September 2017 “request...more

Pierce Atwood LLP

CMMI Focuses on Behavioral Health

Pierce Atwood LLP on

CMS recently announced that the Center for Medicare and Medicaid Innovation (CMMI) is interested in lowering the cost of care for Medicare and Medicaid beneficiaries with behavioral health conditions while improving the...more

Downs Rachlin Martin PLLC

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017 #3

Downs Rachlin Martin PLLC on

Act 188 Plans On Hold as New Chemical Bill is Introduced - Nearly three years after the legislature passed a law to regulate children’s products containing chemicals of high concern, a web site intended to inform the...more

Downs Rachlin Martin PLLC

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017 #2

Downs Rachlin Martin PLLC on

Governor’s $35 Million Housing Bond Discussed in Ways and Means Committee - Executive Director Gus Selig of the Vermont Housing and Conservation Board revealed some of the details this week behind the $35 million bond...more

Polsinelli

Making Sense of the MACRA Final Rule, Part 2 of 3: Alternative payment Models

Polsinelli on

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

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