News & Analysis as of

Medicare Medicare Part B Accountable Care Organizations

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

Bass, Berry & Sims PLC

New CMS Policies Position the MSSP for Expansion and Increased Savings

Bass, Berry & Sims PLC on

New policies tucked into the Centers for Medicare and Medicaid Services’ (CMS) 2025 Medicare Physician Fee Schedule Rule (Final Rule) will likely spur increased Accountable Care Organization (ACO) participation in the...more

K&L Gates LLP

Urinary Catheter Fraud Sparks Proposed Medicare Payment Changes for ACOs

K&L Gates LLP on

Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program got good news from The Centers for Medicare and Medicaid Services (CMS) related to widespread fraud involving urinary catheters that...more

Holland & Knight LLP

CMS Issues 2023 Medicare Physician Fee Schedule Final Rule

Holland & Knight LLP on

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

Greenbaum, Rowe, Smith & Davis LLP

COVID-19 And Medicare Alternate Payment Programs

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

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

Baker Donelson

Key Health Care Provisions of Bipartisan Budget Act of 2018

Baker Donelson on

The wide-reaching Bipartisan Budget Act of 2018 (BBA), passed by Congress and signed by the President on February 9, 2018, extends and modifies dozens of health care programs, including extending funding for two years for...more

Baker Donelson

OIG Unveils New Work Plan Process: Assessing the Impact on Compliance Risk Assessment

Baker Donelson on

On June and July 17, 2017, the Department of Health and Human Services, Office of Inspector General (OIG) released new Work Plan initiatives and, in doing so, announced its intent to update its Work Plan monthly, in lieu of a...more

Akerman LLP - Health Law Rx

The AHA’s Letter to Santa Claus

The American Hospital Association, after having been “nice” all year, penned its letter to Santa Claus with its wish list for Christmas. Its four page letter (actually addressed to President-Elect Donald Trump at 1717...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

Jackson Walker

MACRA will change the way you practice

Jackson Walker on

A recent rule proposed by the Centers for Medicare and Medicaid Services (CMS) will bring far-reaching changes to payment models for physicians and other clinicians (including nurse practitioners, physician assistants,...more

McCarter & English, LLP

Health Law Insights Newsletter - Issue 9 - May 2016

NATIONAL - Medicare Proposes New Part B Payment System - The Center for Medicare and Medicaid Services (CMS) on April 27 proposed a new rule that would transform Medicare Part B reimbursement to practitioners into...more

Mintz

CMS Releases Final Rule for the Medicare Shared Savings Program

Mintz on

On June 4, 2015, the Center for Medicare & Medicaid Services ("CMS") released the highly anticipated Final Rule ("Final Rule") updating the Medicare Shared Savings Program ("Shared Savings Program"). One of the few provisions...more

King & Spalding

CMS Finalizes Rule Concerning ACOs and the Medicare Shared Savings Program

King & Spalding on

On June 4, 2015, CMS issued final regulations revising the Medicare Shared Savings Program, including changes to provisions relating to the payment of Accountable Care Organizations (ACOs) participating in the Medicare Shared...more

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