News & Analysis as of

Physician Fee Schedule Medicare Provider Payments

Maynard Nexsen

Senate Finance Committee Explores Policy Solutions for Medicare’s Physician Fee Schedule

Maynard Nexsen on

On April 11, 2024, the Senate Finance Committee met to address declining doctors’ pay related to Medicare’s Physician Fee Schedule (“PFS”) and Medicare fee-for-service. Physician groups have estimated physicians “were...more

Manatt, Phelps & Phillips, LLP

Senate Finance Explores Medicare Physician Payment and Graduate Medical Education Reform

On May 17, the Senate Finance Committee released a long-awaited white paper describing its legislative effort focused on bolstering chronic care through physician payment. Following a committee hearing April 11, the white...more

McDermott+

Overall Medicare Hospital Payments Will Increase in FY 2024, but Some Hospitals Could See a Decrease

McDermott+ on

Congress may be on summer break, but reg season is in full swing. Last week, the Centers for Medicare & Medicaid Services (CMS) released a final reg that will impact Medicare hospital payments in fiscal year (FY) 2024, which...more

McDermott+

The CY 2024 Physician Fee Schedule Proposed Reg: The Good, the Bad and the Ugly

McDermott+ on

Last week, the Centers for Medicare & Medicaid Services (CMS) released the two major regulations we all were waiting for: the Calendar Year (CY) 2024 Physician Fee Schedule (PFS) proposed reg and the CY 2024 Outpatient...more

Health Care Compliance Association (HCCA)

CMS offers correct billing tips for nonphysician outpatient services provided before or during inpatient stays

Compliance Today (March 2021) - The Centers for Medicare & Medicaid Services (CMS) has provided the following compliance notice: “In a recent report, the Office of Inspector General (OIG) determined that Medicare made...more

Health Care Compliance Association (HCCA)

With Telehealth on OIG Work Plan, Beware Pitfalls; CMS Proposes HHA Telehealth Past PHE

Report on Medicare Compliance 29, no. 25 (July 13, 2020)  - When a physician’s telehealth visit with a Medicare patient on FaceTime cut out after five minutes, they shifted to an audio-only visit, with the physician and...more

Baker Donelson

Administration Drug Pricing Proposals Could Reduce Provider Payments

Baker Donelson on

As the Trump Administration moves forward with proposed policy changes to address high drug prices, a common theme is emerging: a number of the proposals have the potential to reduce Medicare reimbursement to hospitals and...more

Baker Donelson

Proposed 2019 Payment Rules Contain Notable Changes to Medicare's Telehealth Policy

Baker Donelson on

CMS has issued proposed payment rules for CY 2019 that hold significant implications for telehealth coverage and reimbursement. In the Proposed 2019 Home Health Prospective Payment System Rule (Proposed HH PPS Rule),...more

Bricker Graydon LLP

Off-campus provider-based hospital outpatient departments: Challenges and options in 2018

Bricker Graydon LLP on

2017 was another challenging year for hospitals grappling with site-neutral payment changes for off-campus provider-based hospital outpatient departments (OCPBDs). ...more

Baker Donelson

CMS Proposes to Reduce Facility Payment for Non-Excepted Provider-Based Outpatient Department Services by 50 Percent

Baker Donelson on

CMS recently proposed to reduce the facility fee for non-excepted off-campus provider-based hospital departments (OPBDs) from 50 percent of the Medicare Physician Fee Schedule (MPFS) amount to 25 percent of the MPFS amount....more

Baker Donelson

CMS Releases Proposed 2018 Medicare Payment Regulations

Baker Donelson on

On July 13, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2018 Physician Fee Schedule that would update payment policies, payment rates and quality provisions for physicians and other medical...more

Baker Donelson

Final Rule Implements Quality Payment Program under MACRA

Baker Donelson on

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

Baker Donelson

Outpatient Therapy Providers - Location Matters

Baker Donelson on

Included in its publication announcing changes for outpatient therapy services in the 2016 Medicare Physician Fee Schedule (MPFS), CMS announced a new requirement for Medicare-certified outpatient therapy providers (e.g.,...more

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