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Medicare › Outpatient Prospective Payment System (OPPS) › Healthcare Facilities

Parker Poe Adams & Bernstein LLP

How the Centers for Medicare and Medicaid Services 2025 Payment System Final Rule Impacts Ambulatory Surgical Centers

Parker Poe Adams & Bernstein LLP on

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the 2025 hospital outpatient prospective payment system and ambulatory surgical centers (ASC) rule. The rule updates Medicare payment rates for...more

Bass, Berry & Sims PLC

Behavioral Health: Momentum Continues in the CY 2024 Medicare Physician Fee Schedule

Bass, Berry & Sims PLC on

On November 16, the Centers for Medicare & Medicaid Services (CMS) published its Medicare Physician Fee Schedule (PFS) final rule for calendar year 2024 (PFS Final Rule). According to the CMS press release, the PFS Final Rule...more

Arnall Golden Gregory LLP

CMS Expands Access to Behavioral Health Outpatient Services

Arnall Golden Gregory LLP on

The Centers for Medicare & Medicaid Services (“CMS”) announced it is expanding access to behavioral health services for Medicare beneficiaries through intensive outpatient services coverage. In general, Medicare will cover...more

McDermott+

The CY 2024 Physician Fee Schedule Proposed Reg: The Good, the Bad and the Ugly

McDermott+ on

Last week, the Centers for Medicare & Medicaid Services (CMS) released the two major regulations we all were waiting for: the Calendar Year (CY) 2024 Physician Fee Schedule (PFS) proposed reg and the CY 2024 Outpatient...more

Foley & Lardner LLP

Healthcare Law Review: Overview of the U.S. Healthcare System

Foley & Lardner LLP on

The U.S. healthcare industry remains at a crossroads. The healthcare reform legislation passed under President Barack Obama in 2010, officially called the Patient Protection and Affordable Care Act (ACA) but widely referred...more

K&L Gates LLP

K&L Gates Triage: Activation of Validation Edits for OPPS Providers with Multiple Service Locations

K&L Gates LLP on

The Centers for Medicare and Medicaid Services (CMS), recently announced that it plans to activate systematic validation edits for Outpatient Prospective Payment System (OPPS) providers with multiple service locations that...more

Bricker Graydon LLP

Could relief from the Medicare cuts in reimbursement for 340B drugs be coming soon for hospitals?

Bricker Graydon LLP on

Relief for hospitals that have endured drastic cuts in Medicare reimbursement for the majority of drugs they purchase under the 340B drug discount program may be coming soon. A federal judge recently affirmed his prior...more

Robinson+Cole Health Law Diagnosis

2019 Physician Fee Schedule Rule Review: Off-Campus Provider-Based Hospital Departments

Robinson+Cole Health Law Diagnosis on

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) released a final rule (Rule), which includes modifications to Medicare payment policies and rates....more

Foley & Lardner LLP

CMS Continues to Tighten the Belt on Hospital Off-Campus Provider-Based Departments

Foley & Lardner LLP on

Hospitals with off-campus provider-based departments (PBDs) may want to rethink their end of summer vacation plans in order to focus on a recent slate of proposed regulations from the Center for Medicare and Medicaid Services...more

Bricker Graydon LLP

Off-campus provider-based hospital outpatient departments: Challenges and options in 2018

Bricker Graydon LLP on

2017 was another challenging year for hospitals grappling with site-neutral payment changes for off-campus provider-based hospital outpatient departments (OCPBDs). ...more

Sheppard Mullin Richter & Hampton LLP

The 340B Drug Pricing Program: New CMS Final Rule Draws a Motion for Preliminary Injunction from Hospital Groups

Sheppard Mullin Richter & Hampton LLP on

On November 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the final rule, “Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting...more

Baker Donelson

CMS Proposes to Reduce Facility Payment for Non-Excepted Provider-Based Outpatient Department Services by 50 Percent

Baker Donelson on

CMS recently proposed to reduce the facility fee for non-excepted off-campus provider-based hospital departments (OPBDs) from 50 percent of the Medicare Physician Fee Schedule (MPFS) amount to 25 percent of the MPFS amount....more

Sheppard Mullin Richter & Hampton LLP

The Opportunities and Challenges of Freestanding Emergency Departments

Sheppard Mullin Richter & Hampton LLP on

Following our blog post regarding the retail clinic movement, “Patient Check-Ups Before Checking Out: Partnering to Bring Health Care into the ‘One-Stop Shopping’ Sector” (April 19, 2017), we continue our examination of...more

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