News & Analysis as of

Department of Health and Human Services (HHS) Inpatient Prospective Payment System (IPPS)

Holland & Knight LLP

CMS Releases CY 2025 OPPS and ASC Final Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule with comment...more

Ropes & Gray LLP

Hospital and Health Systems Reimbursement Check - NOVEMBER 2024

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Ropes & Gray attorneys share their analysis of administrative and court litigation, regulatory developments, key developments affecting federal program payments to hospitals and health systems, and other reimbursement-related...more

McDermott+

Medicare FFS Regs: Thrills and Chills Under the Trump and Biden Administrations

McDermott+ on

Happy Halloween! In the health policy world, there are two things on everyone’s mind this spooky season: the upcoming election and the major calendar year (CY) 2025 Medicare fee-for-service (FFS) final regs that should be...more

Alston & Bird

Health Care Week in Review: HHS Released Final Guidance for the Second Cycle of Medicare Drug Price Negotiations; CMS Released...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott+

Reviews Are Mixed for Proposed Obstetrical Services CoP: Right Problem, Flawed Solution

McDermott+ on

As I mentioned last week, comments are in on major calendar year (CY) Medicare payment regulations. Besides the CY 2025 physician fee schedule, another big reg is the CY 2025 Outpatient Prospective Payment System (OPPS)...more

Nelson Mullins Riley & Scarborough LLP

FY 2025 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS)...

On August 1, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to increase Medicare inpatient prospective payment system rates for certain acute care hospitals by a net 2.9% in fiscal year 2025, compared...more

King & Spalding

CMS Issues IPPS and LTCH Final Rule for FY 2025

King & Spalding on

On August 1, 2024, CMS filed a display copy of its final rule for Fiscal Year (FY) 2025 pertaining to the Inpatient Prospective Payment Systems (IPPS) for general acute care hospitals and long-term care hospitals (LTCHs) (the...more

McDermott+

Breaking Down Federal Policies to Address Drug Shortages

McDermott+ on

In the wake of persistent drug shortages that compromise patient care and safety, the Biden administration and Congress have proposed policies to strengthen the pharmaceutical supply chain. Using authorities under both...more

McDermott+

HHS Releases New Proposal to Address Drug Shortages

McDermott+ on

A few weeks ago, Regs & Eggs focused on nine health-related issues that were not included in the Fiscal Year (FY) 2025 President’s Budget. Another policy absent from the budget was the Administration’s plan to address drug...more

Holland & Knight LLP

Holland & Knight Health Dose: April 9, 2024

Holland & Knight LLP on

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

McDermott+

REGS & TURKEY LEGS: The Regs We’re Thankful For

McDermott+ on

It’s Thanksgiving week, so instead of eating eggs with your regs, you should sit back, relax and reflect on the regs you are thankful for as you eat your turkey legs (or whatever you enjoy on Thanksgiving). Many of the...more

King & Spalding

Court Finds Hospitals’ Lawsuit Challenging HHS’s Calculation of the IPPS Standardized Amount Was Premature and Remands to the PRRB

King & Spalding on

On September 27, 2023, Judge Royce Lamberth of the United States District Court for the District of Columbia dismissed a lawsuit challenging HHS’s calculation of the standardized amount used in calculating Medicare Inpatient...more

King & Spalding

CMS Issues IPPS and LTCH PPS Final Rule for FY 2024

King & Spalding on

On August 1, 2023, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule for FY 2024 (the Final Rule). In the Final Rule, CMS,...more

Alston & Bird

Health Care Week In Review: CMS and HHS Issue Proposed Rules

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Baker Donelson

HHS Agency Financial Report Provides Insight Into "Improper" Payments

Baker Donelson on

The Department of Health and Human Services (HHS) recently issued its 2021 Agency Financial Report (AFR), summarizing HHS' fiscal and high-level program results to allow assessment of the agency's performance over the prior...more

Alston & Bird

Alston & Bird Health Care Week in Review - August 2021 #1

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in healthcare regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies, and...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 8. News Briefs: March 2021

Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more

Verrill

Hospital Price Transparency Rule: Full Steam Ahead

Verrill on

Neither COVID-19 nor continued legal challenges appear likely to derail the Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule from going into effect on January 1, 2021. Hospitals therefore should...more

Foley & Lardner LLP

COVID-19: OIG Announces Review of Hospital Payment Increase

Foley & Lardner LLP on

The Office of Inspector General (OIG) for the Department of Health and Human Services recently announced a new addition to its work plan: auditing whether payments made by Medicare for COVID-19 inpatient discharges billed by...more

Bricker Graydon LLP

Increased reimbursement for hospital stays for Medicare beneficiaries with COVID-19 diagnosis likely to lead to audits and False...

Bricker Graydon LLP on

Section 3710 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act directs the Secretary of the Department of Health and Human Services (HHS) to increase the weighting factor for payments under the Inpatient...more

Foley & Lardner LLP

COVID-19: Telehealth Takeaways from the CARES Act

Foley & Lardner LLP on

On March 27th, Congress passed and the President signed the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act). On both the federal and state levels we have seen efforts to support social distancing in the...more

Foley & Lardner LLP

CARES Act - New Group Health Plan Rules and Relief

Foley & Lardner LLP on

The Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which was signed by the President on March 27, 2020, includes several provisions affecting group health plans, as discussed below. Health Plan Rules and...more

Akin Gump Strauss Hauer & Feld LLP

CARES Act Summary – Health Care

As the number of COVID-19 cases in the U.S. continues to grow, the CARES Act makes a number of changes to support the ability of the health care system to respond to the crisis over the coming months. In addition, the package...more

Alston & Bird

CMS and OIG Release Proposed Rules on Stark Law and Anti-Kickback Statute Reforms

Alston & Bird on

The Department of Health and Human Services is seeking comments on proposed rules to implement part of its Regulatory Sprint to Coordinated Care....more

King & Spalding

CMS Finalizes Rule to Require Hospitals to Disclose Negotiated Rates

King & Spalding on

The Department of Health and Human Services (HHS), and the Trump Administration as a whole, has placed a particular focus on the promotion of price transparency as a tool to control the costs of healthcare. In June, the...more

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