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LEGISLATIVE UPDATES This Week: Senate to Release First Spending Bills and Healthcare Activity in the House This is the last week before Congress heads out for a two-week Fourth of [...]

Highlights 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 [...]

In March, the Medicare Payment Advisory Commission (MedPAC) released its biannual report to Congress on matters affecting the Medicare program. MedPAC is an independent congressional agency that advises Congress on [...]

The opioid crisis continues to be a focus for Congressional committees. The House Energy and Commerce Committee held hearings on prevention and public health solutions to the opioid crisis, along [...]

Despite some initial difficulty in gaining momentum, the use of value-based payment methodologies will likely increase across all provider niches. This change is partly a function of cost savings driven [...]

The passage of the Medicare Access and CHIP Reauthorization Act of 20151 (MACRA), and implementing regulations promulgated in 2016,2 focused on reforming physician Medicare reimbursement with an eye towards incentivizing [...]

CMS has issued a final rule with comment period making changes to the Quality Payment Program (QPP) for 2018, the second performance year for the reformed physician payment framework mandated [...]

The final CMS calendar year (CY) 2018 Medicare home health prospective payment system (HH PPS) rule cuts Medicare payments by 0.4% ($80 million) in 2018 compared to 2017 levels, but [...]

As we reported last month, CMS' proposed rule updating MACRA's Quality Payment Program ('QPP') for CY 2018 would extend and expand exceptions that would allow many practitioners to avoid participating [...]

Rule Would Delay Appropriate Use Criteria Requirement until 2019, Cut Rates for Off-Campus Hospital Departments The Centers for Medicare & Medicaid Services (CMS) has published its proposed rule to update [...]

In Short The Situation: Recently, a leading electronic health records ('EHR') vendor entered into a $155 million settlement with the government to resolve allegations under the False Claims Act, and [...]

In a recent post, we provided additional details on the structure, funding, and evaluation of the Maternal, Infant, Early Childhood, Home Visiting (MIECHV) program. In this post we will go [...]

In the final months of the Obama administration, CMS released rules of significant import to healthcare providers, including a final rule explaining how the Quality Payment Program mandated by the [...]

CMS has scheduled an April 25, 2017 call to discuss new data reporting requirements for clinicians in selected states who furnish global surgery services, as authorized by the Medicare Access [...]

On November 14, 2016, CMS published its final rule implementing the physician payment provisions of the Medicare Access and CHIP Reauthorization Act ('MACRA'). The rule became effective January 1, 2017. [...]

Much is still unknown about the impact of the election on healthcare. But one thing is certain: As health care costs continue to rise and the baby boomer generation ages, [...]

When Tom Price assumes the top post at the U.S. Department of Health and Human Services (HHS) later this month (subject to Senate confirmation), the ink will barely be dry [...]

Digital health-the intersection of health care related software applications, analytical tools, medical device technology and electronic data assets that are enabled and achieved through the use of the internet and [...]

Last week, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services released a report analyzing CMS' readiness to implement major parts of the Medicare [...]

The Centers of Medicare and Medicaid Services (CMS) released the much-anticipated Medicare Access and CHIP Reauthorization Act (MACRA) final rule this month. The rule makes extensive changes to traditional Medicare [...]

Eric Fader was quoted in an article,'Trump Era Likely Will Increase Collections From Patients But Won't End MACRA,' in the December 5 issue of Part B News. In the article, [...]

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the October 14, 2016 final rule from the Centers for Medicare & Medicaid Services (CMS) that implemented it (the [...]

The Children's Health Insurance Program ('CHIP'), created in 1997, helps states provide health care coverage to low-income children up to age 19 whose families fall above the Medicaid eligibility threshold [...]

The Centers for Medicare & Medicaid Services (CMS) has issued its final Medicare physician fee schedule (MPFS) for calendar year (CY) 2017. In addition to updating MPFS rates and policies, [...]

Most of the post-election discussion of the ACA has focused on how promises to repeal the law could impact the newly insured. But one priority area of the ACA that [...]

The Affordable Care Act (ACA) and the Medicare and CHIP Reauthorization Act (MACRA) provided the Centers for Medicare & Medicaid Services (CMS) and the newly created Center for Medicare and [...]

Bracing for the Medicare Part B Overhaul: Pick a Path, Pick a Pace The countdown has begun for the momentous Part B payment reforms created by the Medicare Access and [...]

On October 14, 2016, the Centers for Medicare and Medicaid Services ('CMS') released a pre-publication version of the final rule with comment period ('Final Rule') implementing the Medicare Access and [...]

The Strategic Planning Committee should be made aware of three important legal developments arising in October that may have direct implications on the organization's strategic plans with respect to physician [...]

CMS has adopted a number of changes to its Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) policies for 2017, including new competitive bidding program (CBP) requirements and revisions [...]

Temporary Transition Policies Reduce Threat of Negative Adjustments in 2019, But Adds to Complexity On November 4, 2016, the Centers for Medicare & Medicaid Services (CMS) is publishing a sweeping [...]

The Centers for Medicare & Medicaid Services (CMS) has finalized sweeping reforms of the Medicare physician fee schedule (MPFS) update framework, as mandated by Congress last year. While CMS transition [...]

On Friday, October 14, 2016, CMS released the much-anticipated final rule (the 'Final Rule') implementing the Quality Payment Program (QPP), mandated by the Medicare Access and CHIP Reauthorization Act of [...]

In a rare example of bipartisanship in health care policy, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (Pub. L. 114-10) was passed by Congress and signed into [...]

On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The final rule [...]

Significant changes to the Medicare payment system are underway. The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) is set to take effect January 1, 2017. MACRA represents a [...]

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Physician-Focused Payment Model Technical Advisory Committee (PTAC) to provide recommendations on arrangements that meet the criteria for a [...]

It's now nearly two years since we published our report Healthcare and Life Sciences Predictions 2020: A bold future? Since then we have had numerous conversations with clients and other [...]

In a blog post last week, CMS acting administrator Andy Slavitt said that physicians will have the ability to choose among several options to report data to Medicare under the [...]

The Committee's interest in the Stark Law and receptiveness to feedback from industry leaders may indicate that significant changes to the law are in the pipeline. As the healthcare industry [...]

CMS is building momentum with its bundled payment programs and upping the stakes for hospitals. The Centers for Medicare & Medicaid Services (CMS) recently published a proposed rulethat furthers the [...]

President Obama signed into law the Medicare Access and CHIP Reauthorization Act ('MACRA') on April 16, 2015. One year later, on April 27, 2016, the Department of Health and Human [...]

On June 30, 2016, the Senate Finance Committee's Republican staff issued a 20-page report discussing comments made by industry stakeholders after a December 2015 round-table on the future of the [...]

CMS has proposed a series of complex and detailed revisions to Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) policies for 2017, including changes to the competitive bidding program [...]

CMS has published corrections to its November 16, 2015 Medicare physician fee schedule final rule with comment period for 2016, applicable beginning January 1, 2016. Among other things, CMS is [...]

Miranda A. Franco is a senior public affairs advisor in our Washington D.C. office. HIGHLIGHTS: The Centers for Medicare & Medicaid Services (CMS) released a proposed rule to implement major [...]

The Centers for Medicare & Medicaid Services (CMS) has proposed regulations to implement major reforms of the Medicare physician fee schedule (MPFS) update framework that were mandated by the Medicare [...]

The Medicare Access and CHIP Reauthorization Act (MACRA) proposes a new approach, with new branding labels, to paying clinicians for the value and the quality of care that they provide [...]

On April 27, 2016, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would put in place key parts of the Medicare Access and CHIP Reauthorization [...]