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Medicaid › Healthcare › Physician Fee Schedule

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 -
BakerHostetler

Analysis of Healthcare Changes Under the 2025 Tax Legislation

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The Legislation combines spending and policy priorities from 11 congressional committees and will reshape federal policy across nearly every sector of the U.S. economy. With respect to healthcare, more than 35 provisions...more

Alston & Bird

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

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

Lathrop GPM

Where To, Medicaid? House Legislation Makes Significant Changes; Senate Future is Uncertain

Lathrop GPM on

On May 22, 2025, after a marathon markup session, the U.S. House of Representatives passed a bill containing significant proposed changes to the Medicaid program....more

McDermott+

Healthcare Preview for the Week of: April 7, 2025

McDermott+ on

Final Week Before Easter Recess - Focus this week on Capitol Hill will remain on reconciliation, as Republicans aim to pass the unified budget resolution in the House before leaving on Thursday for the two-week Easter...more

McDermott+

Regulatory Implications of the Continuing Resolution Healthcare Package

McDermott+ on

Earlier this week, Congress released the text of a continuing resolution that includes a more-robust-than-anticipated healthcare package. While the bill’s primary purpose is to keep the government open through March 14, 2025,...more

Snell & Wilmer

Deadline Approaches for Expiring Medicare Telehealth Waivers: What Providers Should Know

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During the COVID-19 pandemic, both federal and state governments enacted a host of laws and implemented flexibilities to ensure health care providers, hospitals, and health systems could move traditional brick-and-mortar care...more

Bass, Berry & Sims PLC

CMS Bolsters Primary Care with Advanced Primary Care Management Coverage

Bass, Berry & Sims PLC on

On November 1, the Centers for Medicare & Medicaid Services (CMS) filed its Medicare Physician Fee Schedule (PFS) final rule (Final Rule) for calendar year (CY) 2025. As part of the Final Rule, CMS finalized Medicare coverage...more

McDermott+

President Biden Releases FY 2025 Budget: What’s NOT in It?

McDermott+ on

Earlier this week, President Biden released his Fiscal Year (FY) 2025 President’s Budget. As a reminder, every year, the White House releases a budget that serves as its official funding request to Congress for the following...more

McDermott+

Looking Forward: Top Policy Areas for 2024

McDermott+ on

Happy New Year! As we enter 2024, we want to lay out some of the main regulatory issues (both new and old) that McDermott+Consulting will be tracking over the next year. While these may evolve, we think they are still...more

McDermott+

Healthcare Preview for the Week of: November 6, 2023

McDermott+ on

GOVERNMENT FUNDING EXPIRES SOON - The government will run out of funding in 11 days, on November 17. The House will continue to work to advance annual appropriations bills this week. However, a continuing resolution (CR)...more

Foley & Lardner LLP

Key Takeaways from the Foley/PYA “Let’s Talk Compliance” 2-Day Virtual Conference

Foley & Lardner LLP on

Session #1: State of the Healthcare Industry Effective Compliance Plans and Enforcement Trends - In their discussion of compliance program effectiveness and enforcement, attorneys Kolarik and Waltz and Ms. Sumner...more

Epstein Becker & Green

2023 Physician Fee Schedule Final Rule Supports Health Equity Through Investments in Accountable Care Organizations

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The Centers for Medicare & Medicaid Services (CMS) recently issued its Medicare Physician Fee Schedule (PFS) final rule (the “final rule”), with most changes becoming effective January 1, 2023....more

Polsinelli

Health Care Reimbursement and Payor Dispute Update Special Edition - Year End Regulatory Review

Polsinelli on

The end of 2021 brings positive indications of the continued acceptance of telehealth as an important clinical care approach post public health emergency (“PHE”). The Centers for Medicare and Medicaid Services (“CMS”), like...more

Burr & Forman

Health Care E-Note - November 2021

Burr & Forman on

Helpful hints - OIG Updates Health Care Fraud Self-Disclosure Protocol (“SDP”)  - On November 8, 2021, the OIG issued an updated SDP to providers, which included clarifications of existing guidance and increased the minimum...more

McDermott Will & Emery

Congress Take Step Toward Site-Neutral Medicare Payments in Bipartisan Budget Act of 2015

McDermott Will & Emery on

On October 28, 2015, the U.S. House of Representatives approved legislation that, if enacted, would, among other things, substantially alter how and how much Medicare pays for outpatient services furnished by hospitals. The...more

Polsinelli

CMS Proposes Overhaul of Clinical Lab Payment Methodology: What You Need To Know

Polsinelli on

On Friday, the Centers for Medicare & Medicaid Services (“CMS”) issued a long-awaited proposed rule that would drastically change the payment rates for clinical laboratory services beginning January 1, 2017 (the “Proposed...more

Poyner Spruill LLP

Proposed Changes to Stark Rule Would Create New Hospital Exceptions and Lessen Burden of Self-Disclosures

Poyner Spruill LLP on

In a development that is limited in scope but still welcomed by hospitals, the proposed 2016 Physician Fee Schedule proposes a number of new exceptions to the physician self-referral or Stark law and other refinements that...more

Saul Ewing Arnstein & Lehr LLP

Proposed 2016 Medicare Physician Fee Schedule Includes Changes to Stark Regulations

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The Centers for Medicare & Medicaid Services ("CMS") recently released the proposed 2016 Medicare Physician Fee Schedule (the "Proposed Rule"), which includes a number of proposed revisions to the regulations under the...more

Robinson & Cole LLP

Health Law Pulse - August 2015

Robinson & Cole LLP on

The Office of the Inspector General (OIG) recently issued a favorable advisory opinion (Advisory Opinion) to a nonprofit health system (System) and a nonprofit psychiatric hospital (Center) regarding a proposal whereby the...more

Davis Wright Tremaine LLP

Recent Stark Developments: A Moving Target Where a Miss is as Good as a Mile

Davis Wright Tremaine LLP on

The federal physician self-referral ban or Stark law has been a part of the legal landscape for almost 25 years. The breadth of the law’s prohibitions, its strict liability formulation and draconian remedies have made it the...more

BakerHostetler

Proposed Rule Aims to Refine Stark Regulations and Clarify “Incident To”

BakerHostetler on

On July 15, 2015, the Centers for Medicare and Medicaid Services (CMS) published the calendar year (CY) 2016 Physician Fee Schedule Proposed Rule. In addition to updating several traditional Part B payment policies, the...more

K&L Gates LLP

Potential Stark Changes Ahead

K&L Gates LLP on

On July 15, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published proposed regulations governing policies and payments made under the Physician Fee Schedule for calendar year 2016 (the “Proposed Rule”). In...more

K&L Gates LLP

Non-Stark Law Proposed Changes to Policies and Payments under the Physician Fee Schedule for CY 2016

K&L Gates LLP on

On July 15, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published proposed regulations governing policies and payments made under the Physician Fee Schedule (“PFS”) for calendar year 2016 (the “Proposed...more

Arnall Golden Gregory LLP

CMS Proposes to Establish Separate Payment for End of Life Planning Services

Arnall Golden Gregory LLP on

On July 8, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that updates payment rates and related reimbursement and quality policies for physician services furnished under the Medicare...more

Foley & Lardner LLP

Can My Hospital Bill Medicare for Telehealth Chronic Care Management?

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CMS just introduced proposed rules to clarify the requirements and payment opportunities when hospitals want to bill Medicare for Chronic Care Management (“CCM”) services. CCM is an exciting service covered by Medicare...more

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