News & Analysis as of

Payment Systems Beneficiaries

King & Spalding

CMS Issues Proposed Rule Updating Payment Rates and Policies for End Stage Renal Disease and Acute Kidney Injury Dialysis...

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On June 27, 2024, CMS issued a proposed rule updating payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services provided to Medicare beneficiaries on or...more

King & Spalding

OIG Recommends CMS Use OIG Hospital Compliance Audits to Enhance its Medicare Oversight

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On October 26, 2022, OIG published a report summarizing the results of 12 OIG hospital compliance audits covering Medicare claims paid from 2016 through 2018. OIG recommends, among other things, that CMS follow up on...more

King & Spalding

CMS Issues Proposed Rule for ESRD Prospective Payment System

King & Spalding on

On July 6, 2020, CMS issued a proposed rule under the End Stage Renal Disease (ESRD) Prospective Payment System (PPS). The rule proposes to update payment policies and rates for renal dialysis services furnished to...more

Chambliss, Bahner & Stophel, P.C.

Proposed New Medicare Payment System May Affect Beneficiaries

Medicare is proposing a new flat rate reimbursement system for doctors who treat Medicare patients. Some worry that the plan may reduce payments to specialists and cause fewer doctors to accept Medicare patients....more

King & Spalding

OIG Recommends Reevaluation of Medicare Payment System for Skilled Nursing Facilities

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The HHS Office of Inspector General (OIG) released a report on September 30, 2015 finding that Medicare payments for therapy services provided at skilled nursing facilities (SNFs) greatly exceeded the cost of such services. ...more

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