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Prospective Payment System (PPS) Centers for Medicare & Medicaid Services (CMS) Medicare

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

McDermott+

McDermottPlus Check-Up: April 12, 2024

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Senate Finance Health Subcommittee Holds Roundtable on Substance Use Disorder Care. Panelists and members discussed how to improve treatment in federal health programs. House Energy & Commerce Health Subcommittee Holds...more

McDermott+

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

McDermott+ on

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 FY 2024 IPPS Final Rule

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The Centers for Medicare & Medicaid Services (CMS) on Aug. 1, 2023, published its final rule for the federal fiscal year (FY) 2024 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective...more

King & Spalding

CMS Issues FY 2024 Final Rule Updating Medicare Payment and Policies for Inpatient Rehabilitation Facilities

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On July 27, 2023, CMS issued a final rule updating Medicare payments and policies under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the IRF Quality Reporting Program for FY 2024 (Final IRF...more

Venable LLP

A Proposed New Regulatory Environment for Medicare Hospice Providers: Application of the 36-Month Rule, Increasing Enrollment...

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On July 10, 2023, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) that would (i) include hospices in the 36-month rule ownership transfer restrictions that currently exist for home...more

Robinson+Cole Health Law Diagnosis

CMS Issues Calendar Year 2023 Home Health Final Rule

On November 4, 2022, the Centers for Medicare & Medicaid Services (CMS) published the calendar year 2023 Home Health Prospective Payment System Rate final rule, which updates Medicare payment policies and rates for home...more

McGuireWoods LLP

CMS Issues ESRD Prospective Payment System Final Rule for 2023

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Rule Addresses Rate Increases, Outlier, Add-On and ETC Model Payments, Oral-Only Drugs and QIP Reporting - On Oct. 31, 2022, the Centers for Medicare & Medicaid Services issued a final rule implementing an increase in...more

King & Spalding

CMS Issues Three Payment Rules for FY 2023

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On July 27, 2022, CMS issued final rules for FY 2023 in its yearly update to Medicare payment policies and rates under the Inpatient Rehabilitation Facilities (IRFs) prospective payment system (PPS) and the Inpatient...more

King & Spalding

CMS Declines to Adopt Policy Reducing Reimbursement for “Medicare” Organs for Transplant Hospitals and Organ Procurement...

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On December 17, 2021, CMS issued a final rule with comment period addressing certain provisions of the fiscal year 2022 IPPS/LTCH PPS proposed rule that were designated to be addressed in “future rulemaking,” including...more

King & Spalding

CMS Issues Medicare IPPS and LTCH Final Rule for FY 2022

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On August 2, 2021, CMS published the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule for federal fiscal year (FY) 2022. The final...more

King & Spalding

CMS Issues Four Payment Rules for FY 2022

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On July 29, 2021, CMS issued final rules for FY 2022 in its yearly update to Medicare payment policies under the Skilled Nursing Facility (SNF) prospective payment system (PPS), Inpatient Rehabilitation Facilities (IRFs) PPS,...more

Baker Donelson

CMS SNF PPS Proposed FY 2022 Rule – An Overview

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On April 15, 2021, Centers for Medicare & Medicaid Services (CMS) published its Proposed Rule for the Medicare Program Prospective Payment System (PPS) and Consolidated Billing for Skilled Nursing Facilities (SNF) and Updates...more

King & Spalding

CMS Proposes an Increase in Medicare Payment Rates for Inpatient Rehabilitation and Psychiatric Hospitals for Fiscal Year 2022

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On April 7, 2021, CMS issued a proposed rule for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and a proposed rule for the Inpatient Psychiatric Facility (IPF) PPS for fiscal year (FY) 2022. ...more

Baker Donelson

CY 2021 Home Health PPS Final Rule Adds New Payment Rates, Wage Indices and the Home Infusion Services Benefit

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The Calendar Year (CY) 2021 final rule updating the Home Health Prospective Payment System (HH PPS) includes increases in the national, standardized 30-day period payment and per-visit payment for home health agencies (HHAs)...more

Baker Donelson

CY 2021 ESRD PPS Final Rule Includes Policy Changes to Promote In-Home Dialysis

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The Calendar Year (CY) 2021 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Final Rule, CMS-1732-F (Final Rule) was published in the Federal Register on November 9, 2020. The Final Rule includes payment...more

King & Spalding

CMS Final Rule Updates Medicare Payment Rates and Quality Programs for SNFs

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On July 31, 2020, CMS issued Final Rule CMS-1737-F for fiscal year 2021, in its yearly update to Medicare payment policies for SNFs (the Final Rule). In addition to updating Medicare payment rates under the SNF prospective...more

King & Spalding

CMS Issues Final Rule for CY 2020 Home Health Payments, CY 2021 Home Infusion Therapy Benefit

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On October 31, 2019, CMS issued a final rule with comment period (Final Rule), CMS-1711-FC, updating the payment rates for home health agencies (HHAs) for calendar year (CY) 2020...more

Mintz - Health Care Viewpoints

CMS Proposes Changes to the Home Health Agency Prospective Payment System

On July 11, 2019, the Centers for Medicare and Medicaid Services (CMS) issued its Home Health Prospective Payment System proposed rule for 2020. The proposed rule implements a previously finalized reimbursement methodology...more

King & Spalding

CMS Issues Home Health Prospective Payment System Final Rule

King & Spalding on

On October 31, 2018, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule (CMS-1689-FC) (the “Final Rule”) that makes significant changes to the Home Health Prospective Payments System (“PPS”). These...more

Alston & Bird

Alston & Bird Healthcare Week in Review

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Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Baker Donelson

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

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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

Baker Donelson

CMS Refines Proposed Changes to SNF Reimbursement with Patient-Driven Payment Model

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On May 8, 2018, in its Fiscal Year 2019 (FY 2019) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Proposed Rule, Centers for Medicare & Medicaid Services (CMS) proposed a new case-mix classification system...more

Bradley Arant Boult Cummings LLP

CMS Continues Shift toward Value-Based Payments with New Home Health Groupings Model in Proposal - Healthcare Alert

On July 2, 2018, the Centers for Medicare & Medicaid Services (CMS) published its annual proposed rule outlining both payment and policy changes for home health agencies. In a press release announcing the proposed rule, CMS...more

Arnall Golden Gregory LLP

CMS Proposes Overhaul of SNF Reimbursement System, Increases FY 2019 Payments

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on April 27, 2018 to overhaul the payment system for skilled nursing facilities (SNFs). Specifically, the rule would “update the payment rates used...more

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