Accountable Care Organizations
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Requests for comment regarding certain aspects of the policies and standards that will apply to accountable care organizations participating in Medicare's Shared Savings Program under section 3021 or 3022 of the Affordable Care Act.
(Request for Information) Publication Date: November 17, 2010
Clinical Integration and Antitrust
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Employers and Employees
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Discusses key Publications such as the administration of the program, eligibility and enrollment, benefits, premiums, funding, and appeals and oversight rules.
(Interim Final Rule) Publication Date: July 30, 2010
Announces the Early Retiree Reinsurance Program which provides reimbursement to participating employment-based plans for a portion of the cost of health benefits for early retirees and their spouses, surviving spouses and dependents.
(Interim Final Rule) Publication Date: May 5, 2010
Announces the requirements for group health plans and health insurance Issuers in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding dependent coverage of children who have not attained age 26.
(Interim Final Rule) Publication Date: May 13, 2010
Announces the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan.
(Interim Final Rule) Publication Date: June 17, 2010
Announces the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preexisting condition exclusions, lifetime and annual dollar limits on benefits, rescission, and patient protections.
(Interim Final Rule) Publication Date: June 28, 2010
Announces the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.
(Interim Final Rule) Publication Date: July 19, 2010
Announces the interim final regulations which implement the requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets under the Patient Protection and Affordable Care Act.
(Interim Final Rule) Publication Date: July 23, 2010
Announces the availability of guidance detailing
interim procedures for the Federal external review process and model notices both for internal claims and appeals and for external review processes under the Patient Protection and Affordable Care Act.
(Interim Final Rule) Publication Date: August 26, 2010
Fraud and Abuse/Compliance
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Health Information Technology
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Incentive payments to eligible professionals, eligible hospitals, and critical access hospitals participating in Medicare and Medicaid programs that adopt and successfully demonstrate meaningful use of certified electronic health record technology. (Final Rule) Publication Date: July 28, 2010
Hospitals and Health Systems
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This rule proposes new statutory requirements regarding the release and use of standardized extracts of Medicare claims data to measure the performance of providers and suppliers in
ways that protect patient privacy.
This rule describes proposed changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS payable on or after January 1, 2012; and for proposed relative payment weights and payment amounts for services furnished in ASCs on or after January 1, 2012. This proposed rule also revises the requirements for the Hospital Outpatient Quality Reporting (IQR) Program, adds new requirements for ASC Quality Reporting System, and makes additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program. This proposed rule also allows eligible hospitals and CAHs participating in the Medicare Electronic Health Record (EHR) Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot. This proposed rule also makes changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements.
Addresses annual payment policy and payment rate updates including certain provisions required under the Affordable Care Act. (Final Rule and Interim Final Rule) Publication Date: August 16, 2010
Revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes required under the Affordable Care Act.
(Final Rule and Interim Final Rule) Publication Date: November 24, 2010
Long-Term Care
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Physicians and Physician Organizations
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Addresses changes to the physician fee schedule and other Medicare Part B payment policies including Affordable Care Act provisions related to the Physician Quality Reporting System and Value-based payment modifier among others.
(Final Rule) Publication Date: November 29, 2010
Quality, Reimbursement and Reporting
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This rule proposes new statutory requirements regarding the release and use of standardized extracts of Medicare claims data to measure the performance of providers and suppliers in
ways that protect patient privacy.
This rule describes proposed changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS payable on or after January 1, 2012; and for proposed relative payment weights and payment amounts for services furnished in ASCs on or after January 1, 2012. This proposed rule also revises the requirements for the Hospital Outpatient Quality Reporting (IQR) Program, adds new requirements for ASC Quality Reporting System, and makes additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program. This proposed rule also allows eligible hospitals and CAHs participating in the Medicare Electronic Health Record (EHR) Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot. This proposed rule also makes changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements.
Revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes required under the Affordable Care Act. (Final Rule and Interim Final Rule) Publication Date: November 24, 2010
Addresses annual payment policy and payment rate updates including certain provisions required under the Affordable Care Act. (Final Rule and Interim Final Rule) Publication Date: August 16, 2010
Tax & Tax Exempt Organizations
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Announces the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services. (Interim Final Rule) Publication Date: July 19, 2010
Announces the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preexisting condition exclusions, lifetime and annual dollar limits on benefits, rescission, and patient protections. (Interim Final Rule) Publication Date: June 28, 2010
Announces the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan. (Interim Final Rule) Publication Date: June 17, 2010
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