On February 12, 2016, CMS published the Reporting and Returning of Overpayments Final Rule (Final Rule). The Final Rule takes effect on March 14, 2016. Overall, CMS appears to have listened to stakeholders and acknowledged...more
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
11/2/2015
/ Bipartisan Agreement ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Health Care Providers ,
Healthcare ,
Medicare ,
MedPAC ,
Obama Administration ,
OIG ,
OPPS ,
Pending Legislation ,
Pharmaceutical Industry ,
Physician Fee Schedule ,
Prescription Drugs ,
Section 340B
In This Issue:
- Top News
..Congress Passes Omnibus Spending Package
..HRSA Cancels Plan for 340B ‘Mega Reg’; Congress Weighs Options
..Supreme Court to Hear Challenge to ACA...more
12/22/2014
/ Affordable Care Act ,
Appropriations Bill ,
Centers for Medicare & Medicaid Services (CMS) ,
Halbig v Burwell ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
HRSA ,
King v Burwell ,
Legislative Agendas ,
Medicare ,
Medicare Shared Savings Program ,
Physicians ,
SCOTUS ,
Section 340B ,
Subsidies
Polsinelli presents Crisis Management: a multi-part series (culminating in a webinar on 11.20.2014) on what companies must know to stay ahead of external interruption that risks serious impact to their business concerns....more
In This Issue:
- Top News
..The Congressional Agenda is Light as the Focus Shifts to the Midyear Elections
..Physician Supervision Requirement for Small and Rural Hospitals
..CMS Offers Hospitals...more
9/29/2014
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Healthcare ,
Healthcare Reform ,
Hospitals ,
HRSA ,
Medicaid ,
Medicare ,
Medicare Part B ,
MedPAC
Enrollment in Health Plans under ACA Exceeds Projected Number of 7 Million -
The White House announced on April 1 that 7.1 million Americans had enrolled in health plans under the Affordable Care Act ("ACA"). ...more
In This Issue:
- Top News
..Sebelius: No More Health Law Delays; No Enrollment Extension
..CMS Announces Innovative Hospice Care Model
- State News
..17 States and D.C. Implementing SHOP Health Insurance...more
In This Issue:
- Top News
..Congress Approves Budget Deal with Short-Term ‘Doc Fix'
..CMS “Two-Midnight” Rule delayed until March 31, 2014
..Individuals with Canceled Insurance Policies May Apply for...more
1/24/2014
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
EHR ,
Exempt Organizations ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Fraud ,
Healthcare Reform ,
Hospitals ,
Medicare ,
Misbranding ,
OCR ,
OIG ,
Prescription Drugs ,
Tax Exemptions
In This Issue:
- Top News
..CMS Releases Payment Rules for the Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System, Renal Dialysis and Home Health
..President Signs the Drug Quality...more
In This Issue:
- Top News
..HHS Gives Mixed Messages Regarding Federal Health Care Program-Status of Qualified Health Care Plans (QHPs)
..HHS Issues Health Insurance Marketplace Enrollment Report...more
In This Issue:
- Top News
..Deal to Raise Debt Ceiling, End Shutdown Yields No Major Changes to Health Care Law
..Problems with HealthCare.gov Website Continue; HHS Working to Fix Issues
..Kaiser Study...more
11/1/2013
/ Abortion ,
Affordable Care Act ,
Debt Ceiling ,
Department of Health and Human Services (HHS) ,
Fraud ,
Government Shutdown ,
Health Insurance Exchanges ,
Healthcare ,
Healthcare.gov ,
Insurance Industry ,
Medicaid ,
Medical Devices ,
OIG ,
Premiums ,
Subsidies
In This Issue:
- Top News
..Judge Orders $237.4 Million Penalty Against Tuomey for Stark Law and False Claims Act Violations
..Glitches and Demand Lead to Marketplace Frustration
..HHS Delays Small...more
10/16/2013
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Health Insurance Exchanges ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Open Enrollment ,
Pharmacies ,
Physician Medicare Reimbursements ,
Stark Law
In This Issue:
- What Providers Should Know
- Requirements for Inpatient Admissions and Payment Under Medicare Part A
- New Rules Permitting Re-billing Under Medicare Part B for Denied Admissions
- New HAC...more
In This Issue:
- Top News
..Obama Administration Delays Employer Mandate One Year
..House Energy and Commerce Committee Releases Draft Legislation for SGR Fix
..CMS Proposes Payment Changes for Medicare...more
7/11/2013
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Competitive Bidding ,
Contraceptive Coverage Mandate ,
Contraceptives ,
Delays ,
Department of Health and Human Services (HHS) ,
Drug Distribution ,
Food and Drug Administration (FDA) ,
Healthcare ,
Healthcare Reform ,
Home Health Care ,
Medicaid ,
Medical Devices ,
Medicare ,
OIG ,
Over-the-Counter Sales ,
Pay or Play ,
Pharmaceutical Industry ,
Prescription Drugs
In This Issue:
- Top News
..CMS Finalizes MLR Rule for Plans, Maintaining Application to Part D Sponsors
..Early State Filings Show Premium Reductions under ACA
..HHS Received More Than 830 Letters of...more
6/11/2013
/ Abortion ,
Affordable Care Act ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Food and Drug Administration (FDA) ,
Health Insurance Exchanges ,
Healthcare ,
Medicaid Expansion ,
Medicare ,
Preexisting Conditions ,
State Health Plans ,
Wellness Programs
In This Issue:
- Top News
..Tavenner Wins Senate Confirmation to Head CMS
..US Charges 89 in Nationwide Medicare Fraud Crackdown
- State News
..Vermont Becomes Fourth State to Allow Physician-Assisted...more
5/30/2013
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Labor (DOL) ,
Fraud ,
Healthcare ,
Medicaid ,
Medical Loss Ratio ,
Medicare ,
OIG ,
Physician-Assisted Suicide ,
Prescription Drugs ,
Supply Chain
In This Issue:
- Top News
..HHS Releases Hospital Pricing Data in Transparency Effort; Results Show Significant Variation
..States Divided on Medicaid Expansion
..CMS Issues FY 2014 Proposed Rules for...more
5/13/2013
/ Centers for Medicare & Medicaid Services (CMS) ,
Contraceptives ,
Department of Health and Human Services (HHS) ,
Health Insurance Exchanges ,
Hospice ,
Hospitals ,
Long-Term Care ,
Medicaid ,
Medicaid Expansion ,
Nurses ,
Proposed Regulation
In this Issue:
- Top News
..Large Hospital Systems Settles for $25.5 Million for False Claims Act Allegations
..Catholics’ Challenge to Contraceptive Coverage Mandate Dismissed As Not Ripe
- States...more
4/17/2013
/ Centers for Medicare & Medicaid Services (CMS) ,
Contraceptive Coverage Mandate ,
False Claims Act (FCA) ,
Healthcare ,
Hospitals ,
IRS ,
Medicaid Expansion ,
Medicare Advantage ,
Physician Payments ,
Physicians ,
Subcontractors ,
Sunshine Act ,
Supervision ,
Sustainability
In This Issue:
- Top News
..CMS Announces Round 2 Competitive Bidding Single Payment Amounts
..CBO Lowers SGR Repeal Cost by $100 Billion
..Republicans Press HRSA on 340B Audits
..HHS Proposes...more
In This Issue:
- Top News
..CMS, IRS Issue Proposed Rules on Health Insurance Mandate, Minimum
- Essential Coverage
..Insurers Weigh Options for Exchange Participation
..Quality Improvements in Care...more
In This Issue:
- OMB Directs Department Heads to Prepare for Sequestration
- HHS Finalizes Omnibus HIPAA Rule, Enhances Privacy Requirements
- SCOTUS Says Equitable Tolling Not a Factor in DSH Case
- Report...more
1/25/2013
/ Data Protection ,
DSH ,
Equitable Tolling ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Omnibus Rule ,
HITECH Act ,
Hospitals ,
Medicaid ,
Medicare ,
OMB ,
Pay-For-Delay ,
Pharmaceutical Industry ,
SCOTUS ,
Sequestration
In response to the government’s continued focus on improving quality of care through payment policy, several changes to new and existing regulatory requirements recently came about through the 2013 Inpatient Prospective...more
In This Issue:
- Fiscal Cliff Deal Lengthens Medicare Overpayment Recovery Period
- Cutting Medicaid Provider Tax May Shift Costs to States, CRS Finds
- MedPAC Finalizes Payment Recommendations, GAO Solicits...more
1/18/2013
/ American Taxpayer Relief Act ,
Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Fiscal Cliff ,
GAO ,
Medicaid ,
Medicare ,
MedPAC ,
OIG ,
Overpayment ,
SMART
In This Issue:
- CMS Releases FY 2012 Financial Report; Misses Target forReductions in Improper Payments
- CMS Releases Guidance on Medicaid/CHIP Issues
- HHS Secretary Extends Deadline for Decision on...more