Sheree Kanner on Centers for Medicare & Medicaid Services (CMS)

CMS Radiation Oncology Model proposed rule – summary and early insights

Last week, the Centers for Medicare & Medicaid Services (CMS) announced new details of a proposed bundled payment model for radiation oncology services (RO Model), which would make fundamental (but temporary) changes to the...more

7/19/2019 / Bundled Payments , Cancer , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Health Insurance , Life Sciences , Medicare , Physician Medicare Reimbursements , Proposed Rules , Rulemaking Process

CMS proposes long-awaited draft guidance on co-located hospitals

On May 3, 2019, the Centers for Medicare & Medicaid Services (CMS) issued draft manual guidance for surveyors evaluating whether hospitals that are co-located with other hospitals (or with other health care entities) meet the...more

5/17/2019 / Centers for Medicare & Medicaid Services (CMS) , Draft Guidance , Healthcare Facilities , Hospitals , Life Sciences , Rulemaking Process

CMS proposes changes to new-technology add-on payment amounts and criteria in the inpatient prospective payment system proposed...

On 23 April 2019 the Centers for Medicare & Medicaid Services (CMS) issued the inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system proposed rule for fiscal year (FY) 2020...more

4/29/2019 / Add-ons , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Inpatient Prospective Payment System (IPPS) , Life Sciences , Long Term Care Facilities , Medical Devices , Payment Systems , Regulatory Agenda , Request For Information , Rulemaking Process

Medicare further expands payment for and coverage of telehealth and similar services

Through several recently published rules, the Centers for Medicare & Medicaid Services (CMS) is making it possible for Medicare beneficiaries to have greater access to health care services provided remotely through telehealth...more

11/8/2018 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Health Information Technologies , Medical Reimbursement , Medicare , Medicare Advantage , Physician Fee Schedule , Telehealth , Telemedicine

Bundle Up: CMS Releases Request for Applications for New Version of Bundled Payments for Care Improvement Model

This week, the Centers for Medicare & Medicaid Services (CMS) released details on the much-anticipated new version of the Bundled Payments for Care Improvement (BPCI) payment model, which will be known as BPCI Advanced. Like...more

1/12/2018 / BPCI , Bundled Payments , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Provider Payments

CMS Proposes Key Changes to the Medicare Advantage Program

On November 16, 2017, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that would revise regulations and clarify requirements for the Medicare Advantage (MA) and Medicare Prescription Drug Benefit...more

11/28/2017 / Centers for Medicare & Medicaid Services (CMS) , Cost-Sharing , Medicare , Medicare Advantage , Medicare Part D , Pharmaceutical Industry , Prescription Drug Coverage , Prescription Drugs , Star Ratings

CMS Releases Major MA/Part D Proposed Rule

CMS released the first major MA/Part D rulemaking in several years, proposing a number of significant changes to the Part D program, including required pass-through of pharmaceutical company rebates to lower patient...more

11/27/2017 / Biologics , Centers for Medicare & Medicaid Services (CMS) , Generic Drugs , Health Insurance , Medicare , Medicare Part D , Pharmacies , Prescription Drug Coverage , Prescription Drugs

Slow but Steady: CMS Proposes to Simplify and Slow Down the Quality Payment Program Rollout

On Tuesday, June 20, the Centers for Medicare & Medicaid Services (CMS) released a Proposed Rule to continue the rollout of the Quality Payment Program (QPP), an initiative to adjust Medicare payments to eligible clinicians...more

6/26/2017 / Alternative Payment Models (APM) , CEHRT , Centers for Medicare & Medicaid Services (CMS) , Electronic Health Record Incentives , Medicare Access and CHIP Reauthorization (MACRA) , MIPS , Quality Payment Program (QPP)

CMS request for information presents rare opportunity for medicare stakeholder engagement

On 14 April 2017, the Centers for Medicare & Medicaid Services (CMS) published the fiscal year (FY) 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective...more

4/24/2017 / Centers for Medicare & Medicaid Services (CMS) , Comment Period , Health Care Providers , Inpatient Prospective Payment System (IPPS) , Long Term Care Facilities , Medicaid , Medicare , Request For Information , Stakeholder Engagement

Calling for Ideas—CMS Releases Final 2018 Medicare Advantage and Part D Rate Announcement and Call Letter

On 3 April 2017, the Centers for Medicare & Medicaid Services (CMS) released its final Medicare Advantage (MA) and Part D Rate Announcement and Call Letter (Call Letter) for calendar year 2018. The Call Letter is part of...more

4/7/2017 / Call Letter , Centers for Medicare & Medicaid Services (CMS) , Cost-Sharing , Health Care Providers , Medicare , Medicare Advantage , Medicare Part D , Opioid , Physician Medicare Reimbursements , Substance Abuse

Trump administration issues proposed health insurance market stabilization rule: Will it be enough to stabilize exchange...

On 15 February 2017, the Centers for Medicare & Medicaid Services (CMS) took a step toward addressing concerns about the stability of the individual and small group health insurance markets by proposing a modicum of...more

2/21/2017 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Certification Requirements , Comment Period , Employer Group Health Plans , Federal Register , Health Insurance , Health Insurance Exchanges , Insurance Industry , Open Enrollment , Trump Administration , Verification Requirements

Trump Administration Issues Proposed Health Insurance Market Stabilization Rule: Will It Be Enough to Stabilize Exchange...