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Feb 07, 2019

Stark and Antikickback Statute Reforms on the Way?

At a Brookings Institution event last month, Eric Hargan, Deputy Secretary of the Department of Health and Human Services (HHS), announced that the agency will be issuing proposed rules to revise federal fraud and abuse regulations that are seen as hampering care coordination and the transformation to a value-based health care system.» Read More

Feb 05, 2019

Hospital Price Transparency Rules Now in Effect

Starting January 1, 2019, hospitals have been reporting their standard charges online in an easily accessible format, due to a new rule from the Centers for Medicare and Medicaid Services (CMS).

With the passage of the Affordable Care Act, hospitals were required to release a list of prices for their items and services to the public; however, the initial rulemaking required that either the charges themselves be made public, or the hospital’s policy for allowing public review of the hospital’s charges upon request be made public. » Read More

Aug 31, 2018

ACOs Generate $313 Million in Savings to CMS

The Centers for Medicare & Medicaid Services (CMS) released new data showing that it made a $313 million gain from the Medicare Shared Savings Program in 2017.  The 472 Medicare Accountable Care Organizations (ACOs) collectively generated savings of $1 billion and CMS paid $780 million in bonuses to the ACOs.» Read More

Aug 23, 2018

CMS Proposes New Rules to Combat Opioid Crisis

In response to the President’s Commission on Combatting Drug Addiction and the Opioid Crisis, Centers for Medicare & Medicaid Services (CMS) has proposed new rules in an effort to curb the ongoing problem.  Click here to view the CMS Fact Sheet detailing the proposals.» Read More

Jul 19, 2018

CMS Proposes Overhaul of Billing Rules and Pays for Telehealth

On July 12, 2018, The Centers for Medicare & Medicaid Services (CMS) proposed a major overhaul of the way doctors have billed Medicare for patient visits for two decades. Some of the key provisions in the lengthy proposed rule include:

  • simplifying the billing process to require less documentation that must be submitted by collapsing four separate levels of documentation requirements into one;
  • allowing physicians to use their medical decision making or time spent with the patient to designate the level of patient care needed in lieu of using the traditional evaluation and management codes;
  • paying physicians for certain telemedicine services; and
  • continuing the site-neutral policy that pays off-campus facilities 40% of the outpatient rates for the services they provide to encourage “fairer competition between hospitals and physician practices by promoting greater payment alignment between outpatient care settings.”

If you have any questions concerning the proposed regulations, please contact me at sjarvaweiss@nmmlaw.comRead More

Mar 12, 2018

Stark and Payment Reform in 2018?

The Centers for Medicare and Medicaid Services (“CMS”) Administrator Seema Verma on January 18, 2018, identified as agency priorities the modernization of the Stark Statute to reflect the move from a fee-for-service to a value and outcomes based payment under Medicare and the review of barriers created by the Stark Statute. » Read More

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