News & Analysis as of

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

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

McDermott+ on

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

King & Spalding

CMS Issues Proposed Rule for Skilled Nursing Facilities

King & Spalding on

On March 28, 2024, CMS issued a proposed rule (Proposed Rule) for fiscal year (FY) 2025 that would update Medicare payment policies and rates for skilled nursing facilities (SNFs) under the SNF Prospective Payment System...more

King & Spalding

CMS Issues Proposed PPS Rule for Inpatient Rehabilitation Facilities

King & Spalding on

On March 29, 2024, CMS published its fiscal year (FY) 2025 prospective payment system (PPS) proposed rule for inpatient rehabilitation facilities (IRFs). Comments are due by 5 pm ET on May 28, 2024. In the IRF PPS proposed...more

Holland & Knight LLP

CMS Releases FY 2023 IPPS and LTCH Proposed Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on April 18, 2022, published its annual proposed rule for the federal fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH)...more

ArentFox Schiff

CMS Proposes Rate Changes and New Nursing Staffing Rules That Will Significantly Impact Skilled Nursing Facilities

ArentFox Schiff on

- CMS estimates its proposal will result in a decrease of $320 million in Medicare Part A payments to skilled nursing facilities. - CMS is seeking stakeholder input on the effects of direct-care staffing requirements for...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

Baker Donelson

FY 2020 SNF PPS Rule Provides Opportunity for Comments

Baker Donelson on

Comments are due on June 18 for the FY2020 skilled nursing facility prospective payment system (SNF PPS) proposed rule. The rule, which was published on April 25, includes discussion of the standard annual payment updates. In...more

McDermott Will & Emery

2018 Digital Health Data Developments – Navigating Change in 2019

Data privacy and security legislation and enforcement saw significant activity in 2018 and early 2019. McDermott’s 2018 Digital Health Year in Review: Focus on Data report – the first in a four-part series – highlights...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

Holland & Knight LLP

CMS Proposes Changes to ESRD Prospective Payment System and DMEPOS Fee Schedule Amounts

Holland & Knight LLP on

On July 19, 2018, The Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2019, and would update the...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

McDermott Will & Emery

Rethinking Transparency – Inpatient Prospective Payment System Final Rule Rescinds Proposed Survey Disclosure Rule

The 2018 IPPS/LTCH PPS proposed rule contained a provision that would have required AOs to make survey reports and acceptable plans of correction publicly available within approximately three months of issuance. The Final...more

King & Spalding

CMS Issues Proposed Payment Rules for Skilled Nursing Facilities

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In a recently announced proposed rule (CMS-1679-P), CMS proposes to increase aggregate pay by $390 million in fiscal year (FY) 2018 for skilled nursing facilities (SNFs). In a separate notice (CMS-1686-ANPRM), CMS is...more

King & Spalding

CMS Proposes Rule to Update Prospective Payment Rates for Inpatient Rehabilitation Facilities

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CMS recently proposed a rule that it estimates would increase payment to inpatient rehabilitation facilities (IRFs) by $80 million during fiscal year (FY) 2018 (discharges occurring between October 1, 2017 and September 30,...more

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