News & Analysis as of

Payment Systems Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS)

McDermott+

CMS Releases CY 2025 Hospital Outpatient Prospective Payment and ASC Payment Systems Proposed Rule

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On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more

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

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | November 2023 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for November 2023. We discuss several US Department of Health and Human Services (HHS) agency actions, including the new General...more

McDermott+

CMS Giveth and Taketh Away: The Long-Term Impact of the 340B Remedy Policy

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In the buffet of regs (and eggs) released a couple of weeks ago, the fried egg served up by the Centers for Medicare & Medicaid Services (CMS) was the 340B Remedy Final Reg. Unlike the other final regs that will affect...more

Holland & Knight LLP

CMS Releases CY 2024 OPPS and ASC Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2024 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule (CMS-1786-P),...more

McDermott+

Breaking Down the CY 2024 Hospital Outpatient Proposed Reg

McDermott+ on

As most of you already know, the Centers for Medicare & Medicaid Services (CMS) recently released two Medicare payment regulations: the Calendar Year (CY) 2024 Physician Fee Schedule (PFS) proposed reg and the CY 2024...more

McDermott+

Policy Update - CMS Releases CY 2024 Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed...

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On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule [CMS-1786-P],...more

Verrill

CMS Proposes to Make Lump-Sum Payments to Hospitals for Underpayments for Drugs Purchased Through the 340B Program During...

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Last week CMS issued its anticipated proposed rule to implement the Supreme Court’s decision last year which ruled that CMS’ reduction in Medicare payments for Part B outpatient drugs purchased through the 340B program...more

McDermott+

Healthcare Preview for the Week of: July 10, 2023

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We hope that you, like Congress, enjoyed some time off last week and are ready to dive in—for a few days at least. As we previously reminded you, the House is only in session 12 days in July, then away for August recess, and...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2023

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On November 1, 2022, CMS published a final rule to update the payment policies, payment rates, and other provisions for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory...more

McDermott Will & Emery

CMS Finalizes 340b Payment Provisions in 2023 OPPS Final Rule

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Consistent with the US Supreme Court’s ruling in AHA v. Becerra and its statements in the 2023 Outpatient Prospective Payment System (OPPS) Proposed Rule, the Centers for Medicare & Medicaid Services (CMS) has finalized its...more

Foley Hoag LLP - Medicaid and the Law

HHS Ordered to Correct Medicare Payments to 340B Hospitals for Remainder of 2022

We have noted before the link between the Medicaid prescription drug rebate program and the 340B program. As we wrote in an earlier Client Alert, in June 2022, the U.S. Supreme Court struck down HHS’s Medicare payment cuts to...more

Bass, Berry & Sims PLC

CMS Proposes New Stark Law Exception for Rural Emergency Hospitals

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On July 15, the Centers for Medicare & Medicaid Services (CMS) published the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System proposed rule...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2022

King & Spalding on

On November 2, 2021, CMS published the final rule to update the payment policies and rates for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more

Baker Donelson

Supreme Court Agrees to Hear Two Medicare Payment Cases Next Term with Significant Financial Implications for Hospitals

Baker Donelson on

On July 2, 2021, the U.S. Supreme Court granted petitions to hear two cases related to Medicare payments for health care providers. The Court will consider a hospital appeal of a Ninth Circuit decision that vacated part of a...more

King & Spalding

CMS Proposes Quality Program Changes, Increased OPPS and ASC Medicare Payments for 2021

King & Spalding on

On August 4, 2020, CMS proposed its annual rule adjusting the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, as well as changes to quality reporting...more

Holland & Knight LLP

CMS Releases 2020 Hospital OPPS and ASC Payment System Proposed Rule

Holland & Knight LLP on

• The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule. •...more

King & Spalding

CMS Releases Proposed Rule for 2019 Hospital Outpatient Prospective Payment System, Includes Major Proposals on Site Neutrality

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On July 25, 2018, CMS proposed a rule (Proposed Rule) revising factors for determining Medicare payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more

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