Archive for: Final Rule

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Health Policy Breakroom: Episode 2, OPPS Prior Auth

Mara McDermott and Jessica Roth join Emma Zimmerman to discuss changes in the 2020 Hospital Outpatient Prospective Payment System final rule related to prior authorization and the landscape of utilization management policy more broadly.

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CMS Releases CY 2020 Medicare OPPS and ASC Payment System Final Rule

On November 1, 2019, CMS released the CY 2020 Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment Systems effective for services on January 1, 2020.

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CMS Releases Final Rule for CY 2020 Physician Fee Schedule

On November 1, 2019, CMS released the CY 2020 Revisions to Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies, which includes changes related to Medicare physician payment and the Quality Payment Program effective for services on January 1, 2020.

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CMS Releases Final Rule Aimed at Lowering Drug Prices and Reducing Out-of-Pocket Spending

Since mid-2018, the Centers for Medicare and Medicaid Services has been implementing sections of the American Patients First Blueprint, President Trump’s plan to lower drug prices and reduce patient out-of-pocket spending.

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McDermottPlus Check-Up: May 10, 2019

This Week’s Dose: Another busy week for prescription drug pricing. Two more hearings took place on the subject, and a handful of bills passed out of the House. Now we watch the Senate to see how it packages and advances prescription drug bills that have moved through the House.

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MSSP Final Rule Seeks to Accelerate Move to Performance-Based Risk in Traditional Medicare

On December 31, 2018 CMS published the Medicare Shared Savings Program; Accountable Care Organizations—Pathways to Success and Extreme and Uncontrollable Circumstances Policies for Performance Year 2017 final rule.

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Top 10 Takeaways: 2019 Medicare Physician Fee Schedule

On November 1, 2018, the Centers for Medicare & Medicaid Services released the CY 2019 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B [CMS-1693F] Final Rule, which includes policies related to Medicare physician payment and the Quality Payment Program (QPP). The regulations will be published in the…

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MACRA Final Rule Released: CMS Establishes 2017 as Transition Year for QPP

CMS finalized policies for 2017 that will offer providers more flexibility and opportunity to meet requirements under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.

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