News & Analysis as of

Medicare Office of the Inspector General Physician Fee Schedule

Orrick, Herrington & Sutcliffe LLP

Opportunities and Risks in Remote Patient Monitoring and Remote Therapeutic Monitoring for 2026

The Calendar Year 2026 Medicare Physician Fee Schedule (PFS) proposed rule (see Orrick’s analysis of the proposed rule here) contains important signals for the future of remote patient monitoring (RPM) and remote therapeutic...more

Benesch

Dialysis & Nephrology Digest - November 2024

Benesch on

RPA Perspective: 2025 Medicare Fee Schedule and ESRD PPS Final Rules—Highlights for Nephrology - The final rule for the 2025 Medicare Physician Fee Schedule was released on November 1, and the highlights from the rule...more

Holland & Knight LLP

Holland & Knight Health Dose: July 11, 2023

Holland & Knight LLP on

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...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

Womble Bond Dickinson

Opportunity Economy: Telehealth in the Pandemic - and Beyond

Womble Bond Dickinson on

Takeaways: ..Telehealth greatly expanded during the COVID-19 pandemic, in large part due to regulatory waivers. Those regulatory waivers aren’t permanent, but lawmakers are evaluating ways to permanently expand some...more

McGuireWoods Consulting

Washington Healthcare Update - August 2021 #2

This week in Washington: House in recess, Senate continues to debate bipartisan infrastructure bill, Senate to pass a budget resolution with reconciliation instructions before they leave for recess....more

Health Care Compliance Association (HCCA)

CMS offers correct billing tips for nonphysician outpatient services provided before or during inpatient stays

Compliance Today (March 2021) - The Centers for Medicare & Medicaid Services (CMS) has provided the following compliance notice: “In a recent report, the Office of Inspector General (OIG) determined that Medicare made...more

Health Care Compliance Association (HCCA)

With Telehealth on OIG Work Plan, Beware Pitfalls; CMS Proposes HHA Telehealth Past PHE

Report on Medicare Compliance 29, no. 25 (July 13, 2020)  - When a physician’s telehealth visit with a Medicare patient on FaceTime cut out after five minutes, they shifted to an audio-only visit, with the physician and...more

Dorsey & Whitney LLP

CMS Finalizes Changes to the Stark Advisory Opinion Regulations; 2020 DHS Code List and CPI-U Updates

Dorsey & Whitney LLP on

In the calendar year 2020 Medicare physician fee schedule final rule (“PFS”), which was published in the Federal Register on November 15, 2019 (available here), CMS finalized changes to the advisory opinion process under 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

Holland & Knight LLP

Healthcare Law Update: September 2018

Holland & Knight LLP on

Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

Holland & Knight LLP

Federal Telehealth Policies Summary

Holland & Knight LLP on

On Feb. 9, 2018, Congress passed and President Donald Trump signed into law the Bipartisan Budget Act of 2018 (BBA). This wide-reaching legislation enacts major changes for telehealth policy in Medicare by incorporating...more

McGuireWoods LLP

Practical Considerations for Medical Practices Considering Converting Their Vascular Access Centers Into Medicare-Certified...

McGuireWoods LLP on

On November 2, 2016 the Centers for Medicare & Medicaid Services (CMS) released the 2017 Medicare Physician Fee Schedule (MPFS) Final Rule. Although the impact of the Final Rule on nephrology reimbursement is projected to be...more

McDermott Will & Schulte

New Medicare Enrollment Requirements for MA Providers

In Depth - The Medicare Physician Fee Schedule proposed rule released by the Centers for Medicare & Medicaid Services (CMS) on July 7, 2016, (the Proposed Rule) requires certain providers and suppliers furnishing health...more

McDermott Will & Schulte

CMS Proposed Rule Implements Limitations on Medicare Payments for Off-Campus Outpatient Hospital Departments

In Depth - Background - On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) released the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule, which includes proposed regulations to...more

Polsinelli

Provider-Based Status: A Quiet Casualty of the Bipartisan Budget Act

Polsinelli on

Without fanfare or any significant discussion, the Bipartisan Budget Act (Act) contains the first legislative action related to provider-based status—and it is a sweeping action with negative financial consequences to many...more

Foley & Lardner LLP

Budget Bill Aims to Kill Any New Off-Campus Provider-Based Facilities

Foley & Lardner LLP on

Legislation being drafted as part of a budget deal between members of Congress and the White House includes language that will significantly alter the future of hospital-based outpatient care. The “discussion draft” of the...more

McGuireWoods LLP

Washington Healthcare Update

McGuireWoods LLP on

Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...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

McDermott Will & Emery

CMS Addresses Current Position on Supervision and Practitioner Qualifications Under ‘Incident-To’ Billing Rules

McDermott Will & Emery on

Among the proposed changes to Medicare regulatory requirements related to billing and coverage of physician services set forth in the 2016 Medicare Physician Fee Schedule Proposed Rule (the Proposed Rule), the Centers for...more

Mintz - ML Strategies

Health Care Update - July 2015

Mintz - ML Strategies on

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Williams Mullen

Health Care Fraud and Abuse Alert: What CMS’s New Billing Requirement For “Incident To” Services Means For Medicare Providers.

Williams Mullen on

In the final Medicare Physician Fee Schedule for 2014 (“2014 PFS”), CMS implemented a new condition of payment for “incident to” services that has significant fraud and abuse implications for any Medicare provider who relies...more

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