Alissa Fleming on Health Care Providers

Significant Changes Affecting Hospitals in CMS's FY 2025 IPPS Final Rule

CMS published its FY 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) final rule on August 1, 2024. Under this final rule, CMS is implementing several changes to its Hospital Inpatient Quality Reporting...more

9/6/2024 / Centers for Medicare & Medicaid Services (CMS) , Final Rules , Health Care Providers , Healthcare , Healthcare Facilities , Hospitals , Inpatient Prospective Payment System (IPPS) , Medicare , Payment Systems , Safety Standards , Social Security Act

CMS Proposes Significant Changes to the Medicare Shared Savings Program and 60-Day Rule

Under the CY 2025 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposes several modifications to the Medicare Shared Savings Program (MSSP) that would become effective in performance year 2025. CMS also proposed...more

8/9/2024 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medical Reimbursement , Medicare , Overpayment , Physician Fee Schedule , Physicians

CMS Proposes Extending COVID-Era Telehealth and Supervision Flexibilities through CY 2025

The Centers for Medicare & Medicaid Services (CMS) proposed to extend a number of COVID-era regulatory flexibilities related to telehealth, remote services, and supervision in the CY 2025 Medicare Physician Fee Schedule (PFS)...more

7/30/2024 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Healthcare , Medicare , Mental Health , Physician Fee Schedule , Physicians , Proposed Rules , Substance Abuse , Telehealth , Telemedicine

"Let's Stay Together" - Managing The Changing Relationships Between Hospitals and Skilled Nursing Facilities

Skilled nursing facilities (SNFs) owned or operated by hospitals (hospital-owned SNFs) have a demonstrated track record of delivering positive outcomes for post-acute care patients. Such success, however, has not been without...more

4/30/2024 / Critical Access Hospitals , Health Care Providers , Healthcare Facilities , Hospitals , Long Term Care Facilities , Medicare , Skilled Nursing Facility

Recent $345 Million Settlement Underscores Critical Importance of Appropriate Physician Compensation

In a settlement larger than Halifax and Tuomey combined, an Indianapolis-based health system recently settled with the Department of Justice for $345 million to resolve Stark Law and False Claims Act allegations relating to...more

1/22/2024 / Anti-Kickback Statute , Compensation , Department of Justice (DOJ) , False Claims Act (FCA) , Health Care Providers , Physicians , Qui Tam , Settlement , Stark Law

2024 Medicare Physician Fee Schedule Final Rule Extends COVID-19 Telehealth Policies and Includes Bonus Extension

The CY 2024 Medicare Physician Fee Schedule Final Rule (Final Rule) implemented several statutory extensions to COVID-19 telehealth waivers and flexibilities, finalized proposed policies, and extended an important telehealth...more

11/15/2023 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Health Care Providers , Hospitals , Medicare , Physician Fee Schedule , Physicians , Reimbursements , Telehealth

Significant 2024 Medicare Physician Fee Schedule Rule Proposals: E/M, Social Determinants of Health, and Behavioral Health

In this article, we highlight a number of policy proposals in the current year (CY) 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule that have significant health care delivery and operational implications. These...more

8/14/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Physician Fee Schedule , Physicians , Proposed Rules , Risk Assessment , Telehealth

CY 2024 Medicare Physician Fee Schedule: Extending Telehealth Flexibilities and Seeking Future Policy Input

CMS recently released the CY 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule (Proposed Rule), which included many noteworthy proposals and clarifications related to Medicare telehealth services and other remote...more

7/24/2023 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Health Care Providers , Medicare , Physician Fee Schedule , Physicians , Telehealth , Telemedicine

FY 2024 Hospice Payment Rate Updated Proposed Rule

On April 4, 2023, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule for FY 2024 addressing the Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice...more

5/8/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Home Health Care , Hospice , Medicare

Tips for Long Term Care Providers' Prevention of and Defending Against Quality of Care Allegations

Quality of care allegations against long term care providers are a focus for the Biden administration, the Department of Justice (DOJ), and the HHS-OIG – all of whom are targeting providers whom they deem to be providing...more

3/6/2023 / Compliance , Department of Justice (DOJ) , Health Care Providers , Long Term Care Facilities , Long-Term Care , Nursing Homes , Quality of Care Standards

CMS Proposes Amendment to 60-Day Overpayment Rule that Would Remove "Reasonable Diligence" Standard and Replace with False Claims...

On December 27, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would, among other things, amend the existing regulations for Medicare Parts A, B, C, and D regarding the standard for an...more

2/13/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Overpayment , Reimbursements

Alissa Fleming

Baker Donelson

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