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Medicare Price Transparency Centers for Medicare & Medicaid Services (CMS)

Sheppard Mullin Richter & Hampton LLP

Proposed Medicare Payment Policies for Hospital Outpatient and Ambulatory Surgery Center Services

The Centers for Medicare & Medicaid Services recently published the calendar year (“CY”) 2026 proposed rule for Medicare payment for services provided in hospital outpatient departments under the Outpatient Prospective...more

King & Spalding

CMS Issues CY 2026 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed...

King & Spalding on

On July 15, 2025, CMS issued a proposed rule with updates to the Medicare payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for...more

Holland & Knight LLP

CMS Releases CY 2026 Outpatient Prospective, ASC Payment System Proposed Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on July 15, 2025, issued the Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment Systems proposed rule, which proposes updates to the...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, V 2, Issue 6, June 2025

Welcome to our sixth issue of 2025 of The Health Record -- our healthcare law insights e-newsletter. In this edition, we look at the impact of supply chain and tariff issues on the industry, the veto of Florida's...more

Goodwin

Health Headlines: March 2025

Goodwin on

Welcome to the third issue of Health Headlines, a newsletter created by lawyers in our Healthcare practice....more

McDermott+

Price Transparency: A Regulatory Priority

McDermott+ on

The Trump administration is beginning to lay out its regulatory (and deregulatory) priorities, and on February 25, 2025, the administration spotlighted one of those priorities in an executive order on price transparency....more

Snell & Wilmer

Healthcare Price Transparency Executive Order Mandates Enforcement

Snell & Wilmer on

On Tuesday, February 25, 2025, President Trump signed an Executive Order aimed at promoting healthcare price transparency (the 2025 Executive Order).1 The 2025 Executive Order mandates that certain federal departments must...more

Saul Ewing LLP

2024 Health Care Predictions

Saul Ewing LLP on

Happy 2024!  The entire Saul Ewing Health Law Practice Group wishes you and yours a healthy and prosperous new year and successful (and compliant) activities in the health care delivery system this year and beyond....more

Nelson Mullins Riley & Scarborough LLP

Expanded Behavioral Health Access, Enhanced Price Transparency, and the 340B Remedy in the CY 2024 Hospital Outpatient and...

The Centers for Medicare & Medicaid Services (CMS) has announced new measures to enhance access to behavioral health services for Medicare beneficiaries and improve hospital price transparency as part of the final rule for...more

McDermott+

Previewing the Final Hospital Outpatient Medicare Payment Reg

McDermott+ on

Sharpen your pencils and locate your reading glasses: the final Medicare payment regulations for calendar year (CY) 2024 will be released within the next week. In the last Regs & Eggs blog post, I discussed a major issue...more

McDermott+

Breaking Down the CY 2024 Hospital Outpatient Proposed Reg

McDermott+ on

As most of you already know, the Centers for Medicare & Medicaid Services (CMS) recently released two Medicare payment regulations: the Calendar Year (CY) 2024 Physician Fee Schedule (PFS) proposed reg and the CY 2024...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2022

King & Spalding on

On November 2, 2021, CMS published the final rule to update the payment policies and rates for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more

Sheppard Mullin Richter & Hampton LLP

CMS Backs Off Price Transparency for Providers and Plans

On August 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued its hospital inpatient prospective payment system (“IPPS”) final rule (“Final Rule”) for fiscal year 2022. In addition to a number of other...more

Epstein Becker & Green

CMS Proposes to Increase Significantly Hospital Penalties for Price Transparency Violations

Epstein Becker & Green on

On July 19, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposal that would significantly increase the fines that would be imposed on hospitals for price transparency violations. This proposal,...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Proposed Rule for CY 2022

King & Spalding on

On July 19, 2021, CMS published a proposed rule to update the payment policies, payment rates and other provisions for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory...more

King & Spalding

Court of Appeals Upholds CMS Rule Requiring Public Disclosure of Prices Negotiated Between Hospitals and Insurance Companies

King & Spalding on

On December 29, 2020, the U.S. Court of Appeals for the District of Columbia Circuit upheld a CMS final rule promulgated in November 2019 that requires hospitals to disclose various forms of pricing information related to the...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 45. News Briefs: December 2020 #2

Report on Medicare Compliance 29, no. 45 (December 21, 2020) - CMS said Dec. 18 it will audit a sample of hospitals for compliance with price transparency requirements, which take effect Jan. 1, according to MLN Connects....more

Verrill

Hospital Price Transparency Rule: Full Steam Ahead

Verrill on

Neither COVID-19 nor continued legal challenges appear likely to derail the Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule from going into effect on January 1, 2021. Hospitals therefore should...more

Husch Blackwell LLP

The Price Transparency Rule Goes Into Effect January 1, 2021 – Is Your Hospital Ready?

Husch Blackwell LLP on

Effective on January 1, 2021, the Price Transparency Rule (the “Rule”) requires all hospitals operating within the United States to make public a list of their standard charges for items and services via the Internet in a...more

Sheppard Mullin Richter & Hampton LLP

CMS Finalizes Medicare Advantage Price Transparency Requirements, Despite Industry Criticism

On September 2, 2020, the Centers for Medicare and Medicaid Services (“CMS”) filed the unpublished version of the forthcoming Inpatient Prospective Payment Systems (“IPPS”) Final Rule for 2021. One of the more controversial...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 24. News Briefs: June 2020 #3

Report on Medicare Compliance 29, no. 24 (June 29, 2020) - CMS said June 23 it has created an Office of Burden Reduction and Health Informatics to “unify the agency’s efforts to reduce regulatory and administrative burden...more

Bricker Graydon LLP

The new price transparency rule: Are you ready?

Bricker Graydon LLP on

On November 27, 2019, the Centers for Medicare and Medicaid Services (CMS) published its final rule outlining new price transparency requirements as part of the 2020 update to the Outpatient Prospective Payment System....more

Health Care Compliance Association (HCCA)

CY 2020 Hospital Outpatient Prospective Payment System (OPPS) policy changes: Hospital price transparency requirements

Compliance Today (January 2020) - A Centers for Medicare & Medicaid Services (CMS) Fact Sheet issued November 15, 2019, “finalized policies that follow directives in President Trump’s Executive Order, entitled ‘Improving...more

King & Spalding

CMS Publishes Final Rule for CY 2020 Hospital Outpatient Prospective Payment System

King & Spalding on

n November 1, 2019, CMS posted the final rule establishing the payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment System for calendar year (CY) 2020...more

Polsinelli

CMS Delays Price Transparency, Doubles Down on Site-Neutral and 340B Payment Policies in CY 2020 OPPS Final Rule

Polsinelli on

Late last week, the Centers for Medicare & Medicaid Services (“CMS”) released the CY 2020 Hospital Outpatient Prospective Payment System (“OPPS”) final rule [CMS-1717-FC]. While many hospitals had hoped for relief from recent...more

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