On December 7, 2016, the US Congress enacted the 21st Century Cures Act, substantial legislation intended to accelerate “discovery, development and delivery” of medical therapies by encouraging biomedical research investment,...more
1/21/2017
/ 21st Century Cures Act ,
Ambulatory Surgery Centers ,
Digital Health ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Hospitals ,
Long Term Care Facilities ,
Manufacturers ,
Medical Devices ,
Medicare ,
Medicare Advantage ,
MedPAC ,
Mental Health ,
Mental Health Parity Rule ,
National Institute of Health (NIH) ,
Off-Campus Departments ,
Opioid ,
Patients ,
Pharmaceutical Industry ,
Research and Development ,
Small Business ,
Substance Abuse ,
Telehealth ,
Transparency
McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and care delivery...more
The 21st Century Cures Act encourages biomedical research investment and facilitates innovation review and approval processes, but also serves as a vehicle for a wide variety of other health-related measures, including...more
President-elect Donald Trump has vowed to repeal and replace the Affordable Care Act (ACA). This campaign promise, which echoes a familiar refrain from Republicans since ACA’s passage, is more complex than it may seem....more
In Depth -
The Medicare Physician Fee Schedule proposed rule released by the Centers for Medicare & Medicaid Services (CMS) on July 7, 2016, (the Proposed Rule) requires certain providers and suppliers furnishing health...more
7/26/2016
/ Centers for Medicare & Medicaid Services (CMS) ,
Enrollment ,
General Services Administration (GSA) ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Medicare Part D ,
OIG ,
Physician Fee Schedule ,
Prescription Drug Coverage
In Depth -
The final Medicaid managed care rule issued by the Centers for Medicare & Medicaid Services (CMS) on April 25, 2016, (the Final Rule) establishes a new federal medical loss ratio (MLR) standard for Medicaid...more
In Depth -
On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule regarding updates to fiscal year (FY) 2017 Medicare payment rates and the wage index for hospices serving Medicare...more
In Depth -
The Centers for Medicare & Medicaid Services has enacted significant changes to Medicare Advantage (MA) payment methodologies that will shift payment towards MA organizations (MAOs) enrolling significant...more
More than a year ago, the U.S. Centers for Medicare & Medicaid Services (CMS) proposed significant regulatory changes to the Medicare Advantage (MA) and Part D Programs, many of which were the subject of significant...more
The federal government will soon kick off the all-important annual sub-regulatory cycle for the Medicare Advantage (MA) and Part D programs, issuing proposed policy changes and payment rates for calendar year (CY) 2017. The...more
The United States Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) published its update to the home health prospective payment system (HHPPS) for fiscal year (FY) 2016 in the August...more
CMS seeks to impose more rigorous program integrity requirements for contractors and states.
This article is part of a series that takes an in-depth look at several proposals that would affect managed care organizations,...more
More than a year ago, the U.S. Centers for Medicare & Medicaid Services (CMS) proposed significant regulatory changes to the Medicare Advantage (MA) and Part D Programs, many of which were the subject of significant...more
Acknowledging concerns regarding some proposals in the January 2014 proposed rule for the Medicare Advantage and Part D Programs, the Centers for Medicare & Medicaid Services states it does “not plan to finalize” certain...more
The Centers for Medicare & Medicaid Services proposes significant changes to several key Medicare Part D Program components, such as the “any willing pharmacy” contracting requirement, that will affect all industry...more
Addressing issues ranging from participation in Part D Plan pharmacy networks to compliance training for so-called first-tier, downstream and related entities, the Proposed Rule covers numerous topics with varying degrees of...more