Centers for Medicare & Medicaid Services to Release Proposed Rule Relating to Accountable Care Organizations (ACOs) in Medicare

The Centers for Medicare & Medicaid Services (CMS) is expected to release a proposed rule relating to Accountable Care Organizations (ACOs) in Medicare in the near future. In order to prepare for the release of this rule, we wanted to provide you with a broad review of the legislative authority and...

Fulbright & Jaworski : "Telemedicine Amidst Healthcare Reform: Avoiding Legal Pitfalls"

By Mark Anthony Kadzielski , Kristina Pervi Ayers and Jee-Young Kim The United States Supreme Court's recent decision upholding the Patient Protection and Affordable Care Act underscores the need to deliver and make accessible quality healthcare to patients throughout the United States in an efficient...

Williams Mullen Health Care Fraud and Abuse Alert: What CMS’s New Billing Requirement For ‘Incident To” Services Means For Medicare Providers

By Brian C. Vick In the final Medicare Physician Fee Schedule for 2014 (“2014 PFS”), CMS implemented a new condition of payment for “incident to” services that has significant fraud and abuse implications for any Medicare provider who relies on reimbursement revenue from these...

Norton Rose Fulbright: CMS Offers New Resources and Guidance on 2-Phase Approach to Sunshine Act Reporting

By: Benjamin Koplin , Selina Coleman and R. Jeffrey Layne The Centers for Medicare & Medicaid Services (CMS) has posted new resources to its "Open Payments" website to clarify its recently announced two-stage approach to registration and data submission. These resources include: ...

Williams Mullen: CMS Proposes Rule That Would Expand Its Authority To Audit Medicare Advantage Plans

By Brian C. Vick O n April 30, 2014, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule to update payment policies and rates for inpatient hospitals (the “Proposed Rule”) that includes a provision with significant future implications for sponsors...

Norton Rose Fulbright: Physicians Payments Sunshine Act Data 33 Percent Unpublishable, Penalties Next?

By Benjamin Koplin , Selina Coleman and R. Jeffrey Layne Despite extending the dispute-and-resolution deadline to account for the days that the Centers for Medicare & Medicaid Services (CMS) pulled down the reporting system, the public Physician Payments Sunshine Act website is still expected...

Steptoe & Johnson PLLC: CMS Final IPPS Rule Effective Oct. 1, 2014

By Jami K. Suver, Of Counsel In August 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final inpatient prospective payment system (IPPS) rule for fiscal year 2015, applicable to inpatient stays at general acute care and long-term care hospitals (LTCH). The rule applies to discharges...

Norton Rose Fulbright: CMS Offers Settlement Of Inpatient RAC Denials

By Mark Faccenda On August 29, 2014, the Centers for Medicare and Medicaid Services (“ CMS ”) announced that certain providers with pending appeals of specified inpatient-status claims denied by Medicare contractors may elect to receive partial payment on those claims in exchange for the...

Ballard Spahr LLP: Health Plan ID Program Suspended

By Edward I. Leeds Late on October 31, the Centers for Medicare and Medicaid Services (CMS) Office of E-Health Standards and Services announced that it was suspending the program that required all health plans to register for a health plan ID number to be used in certain electronic transactions. This...