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Proposed Rules Centers for Medicare & Medicaid Services (CMS) Payment Systems

King & Spalding

Physician Fee Schedule Proposed Rule Proposes New Quality-Driven Payment Policies

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Within its proposed CY 2025 Physician Fee Schedule (PFS) rule (the Proposed Rule), CMS is proposing to implement new payment policies intended to advance health equity and support whole-person care. CMS expects these new...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

King & Spalding

CMS Issues IPPS and LTCH Proposed Rule for FY 2025

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On April 10, 2024, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Proposed Rule for Fiscal Year (FY) 2025 (the Proposed Rule). In...more

ArentFox Schiff

The 2024 Proposed Hospital Outpatient Prospective Payment System and Physician Fee Schedule Rules: What Pharma Stakeholders Need...

ArentFox Schiff on

It is the annual summer pastime for the pharmaceutical community. Time to review the Centers for Medicare & Medicaid Services (CMS) release of the 2024 proposed Hospital Outpatient Prospective Payment System (HOPPS) and...more

Holland & Knight LLP

CMS Releases CY 2024 OPPS and ASC Proposed Rule

Holland & Knight LLP on

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

Arnall Golden Gregory LLP

Medicare Looks to Expand Substance Use Disorder Treatment and Mental Health Services

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) announced proposed Medicare payment rates for hospital outpatient and Ambulatory Surgical Center (“ASC”) services. In the Calendar Year 2024 Hospital...more

McDermott+

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

McDermott+ on

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

Nelson Mullins Riley & Scarborough LLP

Payment Cuts and Program Changes: CMS Issues Calendar Year 2024 Home Health Prospective Payment System Proposed Rule

On June 30, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule for the Home Health Prospective Payment System for the 2024 calendar year. The proposed rule aims to permanently update the payment...more

McDermott+

End-Stage Renal Disease Prospective Payment System CY 2024 Rule Update

McDermott+ on

On June 26, 2023, the Centers for Medicare & Medicaid Services (CMS) released the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Calendar Year (CY) 2024 Proposed Rule (CMS-1782-P). The proposed rule would...more

King & Spalding

CMS Issues Proposed Rules to Update Medicare Payment Rates and Policies for Skilled Nursing Facilities and Inpatient Psychiatric...

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On April 4, 2023, CMS issued proposed rules for Fiscal Year (FY) 2024 to update Medicare payment policies for skilled nursing facilities (SNFs) and inpatient psychiatric facilities (IPFs). CMS notes these rules are intended...more

King & Spalding

CMS Proposes Rule to Require Certain Health Plans to Electronically Share Data with Providers Regarding Prior Authorization...

King & Spalding on

On December 13, 2022, CMS is set to publish in the Federal Register a proposed rule (Proposed Rule) requiring certain Medicare, Medicaid, Children’s Health Insurance Program, and Qualified Health Plan fee-for-service and...more

McDermott Will & Emery

CMS Clarifies Coverage and Payment for Remote Therapeutic Monitoring Services

McDermott Will & Emery on

On November 1, 2022, the US Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2023 final rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS) (the Final Rule). The Final...more

ArentFox Schiff

CY 2023 Proposed HOPPS Rule– What Drug Manufacturers Need To Know

ArentFox Schiff on

The Centers for Medicare & Medicaid Services (CMS) issued its annual proposed rule related to the Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems for 2023 (the HOPPS Proposed Rule) on...more

King & Spalding

CMS Issues CY 2023 Physician Fee Schedule Proposed Rule

King & Spalding on

On July 7, 2022, CMS released the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) proposed rule (the Proposed Rule). The Proposed Rule includes proposed policy changes for Medicare payments under the Physician Fee...more

McDermott Will & Emery

Biden Administration Takes Action to Improve Competition, Transparency and Quality for Hospitals and Nursing Homes

McDermott Will & Emery on

The Centers for Medicare & Medicaid Services (CMS) recently published detailed databases summarizing changes of ownership of Medicare-enrolled hospitals and skilled nursing facilities (SNFs). The databases currently include...more

King & Spalding

CMS Seeks Feedback on FY 2023 SNF Prospective Payment System Proposed Rule

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On April 11, 2022, CMS issued its FY 2023 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule updating Medicare payment policies and rates for SNFs. The proposed rule also includes proposals for the...more

King & Spalding

CMS Issues Proposed Rules for Fiscal Year 2022 SNF and Hospice Payments

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On April 8, 2021, CMS issued proposed rules for the Fiscal Year (FY 2022) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) and FY 2022 hospice payments. CMS estimates that the aggregate impact of the payment...more

King & Spalding

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

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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

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

Holland & Knight LLP

CMS Releases Fiscal Year (FY) 2020 Inpatient Prospective Payment System (IPPS) Final Rule

Holland & Knight LLP on

On August 2, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital Prospective Payment System...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

Wilson Sonsini Goodrich & Rosati

CMS Proposes New Add-On Payment Pathway for Breakthrough Medical Devices

On April 23, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule, which describes CMS' efforts to transform "the healthcare delivery system through competition and innovation to provide patients...more

McDermott Will & Emery

CMS Proposed Rule Implements Limitations on Medicare Payments for Off-Campus Outpatient Hospital Departments

McDermott Will & Emery on

In Depth - Background - On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) released the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule, which includes proposed regulations to...more

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