Tag: Rulemaking
On May 11, 2020 the Centers for Medicare and Medicaid Services (CMS) published the FY 2021 Proposed Rules for the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System. The proposed rule would ...
On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) published the CY 2020 final rules for the Medicare Physician Fee Schedule (PFS), Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payme...
The Centers for Medicare and Medicaid Services (CMS) released the CY 2020 Proposed Rule for the Medicare Physician Fee Schedule (PFS). As part of the proposed rule, CMS is proposing 10 episode-based cost measures and revisions to the current Medicare...
The Centers for Medicare and Medicaid Services (CMS) will host a series of webinars on recently released payment and quality regulations.
On June 24, President Trump signed the executive order “Improving Price and Quality Transparency in American Health Care to Put Patients First.” The executive order, which is consistent with previous Administration policies and priorities, focuse...
On May 16, 2018, CMS released the final Part D and Medicare Advantage rule aimed at lowering drug prices. On May 16, 2018, the Centers for Medicare and Medicaid Services (CMS) released the final Part D and Medicare Advantage (MA) rule aimed at low...
The Centers for Medicare and Medicaid Services (CMS) released the Final Rule on requiring list prices to be included in direct-to-consumer television advertisements for prescription drug that are reimbursable under Medicare or Medicaid. List price is...
Read our rule summary and key takeaways here....
CMS issues pair of final rules addressing line item extension drugs. The Centers for Medicare and Medicaid Services (CMS) has issued an interim final rule revising the calculation of rebates for line item extension drugs and a final rule declining...
On March 5, 2019, the Centers for Medicare and Medicaid Services (CMS) will host a listening session on the Interoperability and Patient Access Proposed Rule. This proposed rule outlines opportunities to make patient data more useful and transferable...
On February 11, 2019, the Office of the National Coordinator for Health Information Technology (ONC) released a proposed rule to implement certain provisions of the 21st Century Cures Act, including conditions and maintenance of certification require...
On February 4, 2019 the Centers for Medicare and Medicaid Services issued proposed rule that would, if finalized, make changes to certain proficiency testing requirements under the CLIA program. Comments are due April 5, 2019....
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Today the Centers for Medicare and Medicaid Services released the Medicare Shared Savings Program; Accountable Care Organizations Pathways to Success and Extreme and Uncontrollable Circumstances Policies for Performance Year 2017 (CMS-1701-F2 and CM...
On November 26, 2018, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would allow for changes in 2020 to coverage of protected class drugs, establish new requirements for when MA plans may apply step therapy as a ut...
The Centers for Medicare and Medicaid Services (CMS) will host a webinar on November 19, 2018 from 2 to 3:30 pm ET on the Medicare Physician Fee Schedule (PFS) Final Rule. During this call, CMS ex...
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Today the Centers for Medicare and Medicaid Services (CMS) posted the CY 2019 Physician Fee Schedule (PFS) Final Rule (CMS-1693-F). The PFS is an annual update of the Medicare payment policies and rates for services provided by physicians and a varie...
The Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would implement certain provisions of the Bipartisan Budget Act (BBA) of 2018. Specifically, the BBA allows Medicare Advantage (MA) plans to provide certain addition...
The Centers for Medicare & Medicaid Services (CMS) released a long-awaited proposed rule that would revamp the Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs). Among key changes, the rule reduces the amount of time ...
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Frequently Asked Questions, CMS 1621 F, Medicare Program – Medicare Clinical Diagnostic Laboratory Tests Payment System, Final Rule....
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Register Today for a Live Webinar – Overview and Analysis of the CY 2018 QPP Final Rule Thursday November 16, 2017 12:30 – 1:45 PM ET Click here to register On November 2, 2017 the...
On June 20, 2017, the Centers for Medicare and Medicaid Services (CMS) posted the 2018 Quality Payment Program (QPP) Proposed Rule (CMS-5522-P). Established through the Medicare Access and CHIP Reauthorization Act (MACRA), the QPP established two tra...
This week the Centers for Medicare Medicaid Services (CMS) sent the 2018 Quality Payment Program (QPP) Proposed Rule (CMS-5522-P) to the Office of Management of Budget (OMB) for review. Established through the Medicare Access and CHIP Reauthorization...
On Tuesday, December 20, 2016 the Centers for Medicare and Medicaid Services (CMS) finalized several new Innovation center models expanding the agency’s footprint in the value based payment model space. While these models are primarily focused on f...
On Friday, October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released the highly anticipated Medicare Access and CHIP Reauthorization Act (MACRA) final rule. The final rule can be downloaded here. McDer...
On Wednesday, September 14, 2016 the Centers for Medicare & Medicaid Services (CMS) sent the highly anticipated Medicare Access and CHIP Reauthorization Act (MACRA) final rule to the Office of Management a...
Codes subject to reporting during the first reporting period (January 1 – March 30, 2017) File requires WinZIP to open. Download files....
On July 25, 2016 the Centers for Medicare and Medicaid Services (CMS) released a Proposed Rule for a new mandatory bundled payment model for cardiac care, an expansion of the Comprehensive Care for Joint Replacement (CJR) model and a Cardiac Rehabili...
On May 11, 2016 the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) in Medicare Fee-for-Service (CMS-5517-P) was published in the Federal Register and is available here. This Proposes Rule implements the Medicare Ac...
On May 9, 2016 the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 Proposed Rule was published in the Federal Register. Unfortunately, it was published with a very limited table of contents (TOC) to help guide you through the over 400-pa...
CMS posted the proposed rule to implement the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The proposed rule can be found here. ...
The Centers for Medicare & Medicaid Services (CMS) has sent the proposed rule on the Merit Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) to the Office of Management and Budget (OMB) for review. The OMB review typical...
On November 10, CMS posted a request for comment on episode groups, and clinical criteria and patient characteristics to classify patients into care episode and patient condition groups. CMS developed these episode groups pursuant to section 3003 of ...
