News & Analysis as of

Medicare Alternative Payment Models (APM) Comment Period

Holland & Knight LLP

CMS Releases CY 2026 Medicare Physician Fee Schedule Proposed Rule

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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

Miles & Stockbridge P.C.

CMS Innovation Center Requests Comments for New Episode-Based Payment Model

The Centers for Medicare & Medicaid Services (CMS) published a Request for Information (RFI) on July 18 regarding the design of a future, episode-based payment model on behalf of CMS’s Center for Medicare and Medicaid...more

Holland & Knight LLP

CMS Issues 2023 Medicare Physician Fee Schedule Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Proposed Rule on July 7, 2022, which impacts Medicare Part B payments starting Jan. 1,...more

Holland & Knight LLP

CMS Releases CY 2022 OPPS and ASC Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) on July 19, 2021, released its calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed...more

Robinson+Cole Health Law Diagnosis

CMS Announces New Direct Contracting Care Models

On April 22, 2019, the Centers for Medicare and Medicaid Services (CMS) announced two new voluntary risk-sharing payment models—Professional Population-Based Payment (PBP) and Global PBP. ...more

Holland & Knight LLP

CMS Issues Proposed Rule on Medicare Physician Payment in 2019

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The Centers for Medicare & Medicaid Services (CMS) on July 12, 2018, published the CY 2019 Proposed Rule for the Medicare Physician Fee Schedule (PFS). While in previous years regulations for the Quality Payment Program (QPP)...more

Mintz - Health Care Viewpoints

CMS Focuses on a Modern Medicare

Earlier this month, CMS proposed changes to the Medicare Physician Fee Schedule and Quality Payment Program with the goal of “modernizing Medicare and restoring the doctor-patient relationship.” The proposed changes achieve...more

Holland & Knight LLP

CMS Seeks Stakeholder Input on Easing Stark Law Requirements

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• In order to encourage value-based reimbursement and care delivery, the Centers for Medicare & Medicaid Services (CMS) has published a Request for Information (RFI) seeking public input on how to address any undue regulatory...more

Bradley Arant Boult Cummings LLP

CMS Releases Innovation Center New Direction RFI Feedback and Issues New RFI for Direct Provider Contracting

Last fall, the Centers for Medicare & Medicaid Services (CMS) announced a new direction for its Center for Medicare & Medicaid Innovation, CMS’s platform for testing innovative models for delivering high-quality care at lower...more

Seyfarth Shaw LLP

CMS Publishes Final Rule to Cancel Medicare Episode Payment and Cardiac Rehab Incentive Payment Models, and to Cut Back Joint...

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This is the first in a series of alerts from Seyfarth’s Health Law practice highlighting significant changes in health care regulations and policy as providers and other industry participants enter 2018. ...more

Polsinelli

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

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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

Proskauer Rose LLP

The Future of Medicare Physician Reimbursement: 10 Major Takeaways from the MACRA Proposed Rule

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On April 27, 2016, just over a year after the Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law, the Department of Health and Human Services (HHS) unveiled the long-awaited proposed rule to begin its...more

Polsinelli

CMS Publishes Proposed Rule Implementing MACRA Physician Payment Model

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On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) posted a pre-publication version of a proposed rule implementing changes to Medicare payment for physician services authorized under the bipartisan...more

Foley & Lardner LLP

CMS Proposed Rule Reduces Drug Payments & Requires Implementation of Value-Based Purchasing Tools

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Proposed Rule - Recently, CMS published a Proposed Rule seeking to test a new model for how Medicare pays for drugs and biologicals paid under the Medicare Part B program. With the goals of determining whether...more

King & Spalding

Also In The News - Health Headlines - October 2015 #4

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Quality Improvement Organization Releases Guidance on Short-Stay Reviews – As previously reported, in July 2015, CMS announced that Quality Improvement Organizations (QIOs) would begin conducting reviews of certain inpatient ...more

King & Spalding

Also In The News - Health Headlines - October 2015 #3

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CMS Announces Part D Enhanced Medication Therapy Management Model Demonstration – On September 28, 2015, CMS announced a Part D Enhanced Medication Therapy Management Model (Enhanced MTM Model) that is designed to assess...more

King & Spalding

CMS Issues FY 2016 IPPS and LTCH Final Rule

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On July 31, 2015, CMS issued its final rule to update the fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective...more

King & Spalding

CMS Proposes to Revise Payment System for Joint Replacements

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On July 9, 2015, CMS released a proposed rule to revise how it pays for joint replacement procedures like hip and knee replacements, also known as lower extremity joint replacements (LEJR). This payment structure, called the...more

King & Spalding

CMS Issues CY 2016 Medicare Physician Fee Schedule Proposed Rule

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On July 8, 2015, CMS issued its annual proposed rule outlining payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) for CY 2016. In the proposed rule,...more

Mintz - Health Care Viewpoints

Delivery System Reform 2.0: Scaling Alternative Payment Models is the New Normal

For some health care providers, a pair of recent announcements made by the Obama Administration to implement mandatory alternative payment models (APMs) for home health value-based purchasing and bundled payments for hip and...more

Morgan Lewis

CMS Releases 2016 Physician Fee Schedule

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Major changes to Stark law are ahead, including new exceptions for timeshare arrangements and employment of NPPs. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule on July 8 for the 2016...more

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