Articles and Blogs

AHCA Passes the House On May 4, the American Health Care Act (“AHCA”) passed the House of Representatives by a vote of 217 to 213. The bill now moves to the Senate where lawmakers have already indicated that they intend to write their own bill instead of taking up what passed in the House. The…Read More

Wisconsin Physician Services, Inc. (“WPS”), the Medicare Administrative Contractor (“MAC”) for J5 (Iowa, Kansas, Missouri and Nebraska) and J8 (Indiana and Michigan) recently issued a local coverage determination (“LCD”), LCD (L36839), revising accreditation requirements for polysomnography and other sleep studies. Historically, the LCD stated that a hospital could use The Joint Commission (“TJC”) accreditation to…Read More

In the March 14, 2017 Federal Register, the Food and Drug Administration (“FDA”) announced that it is considering establishing a new Office of Patient Affairs (“Office”). This consideration results from FDA’s intention to “enhance future patient engagement by providing a more transparent, accessible, and robust experience for patient communities.”1 The Federal Register notice outlined FDA’s…Read More

House Delays AHCA Vote On April 27, House leadership delayed a vote on the American Health Care Act (“AHCA”) until at least next week. As of last night, at least 15 House Republicans remain opposed with another 20 undecided. Without Democratic support, House Republicans can only lose 22 votes. Earlier in the week, a number…Read More

On April 14, 2017, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule addressing several potential changes to the health care delivery system, including physician-owned hospitals (“Proposed Rule”). As a part of this Proposed Rule, CMS is also seeking comment regarding the current restrictions on physician-owned hospitals and how these restrictions affect the…Read More

CMS issued a survey and certification letter, dated April 16, 2017, announcing their intention to publish proposed changes on April 28, 2017 that will require accreditation organizations (“AOs”) (i.e., TJC, DNV, HFAP and CIHQ) to post provider/supplier survey reports and plans of corrections from CMS-approved accreditation programs on their website. CMS is also proposing to…Read More

Ordinarily, CMS will calculate the MIPS final score for a practice group’s physicians on an individual or group basis.[1] However, physicians participating in a “MIPS APM” are subject to a significantly different scoring methodology – the “APM scoring standard.” This article: (1) outlines CMS’s “snapshot” process for determining which physicians CMS will score using the…Read More

AHCA Negotiations Continue Ahead of Lawmakers’ Return to Washington In an effort to produce a victory on health care in President Trump’s first 100 days in office, House Republicans renewed discussions this week on the American Health Care Act (“AHCA”), the bill designed to repeal and replace much of the Affordable Care Act (“ACA”). Moderate…Read More

The Centers for Medicare & Medicaid Services (“CMS”) announced that it will delay enforcement of its final rule (“Final Rule”) requiring physicians and other prescribing health care clinicians to either enroll in or opt out of Medicare in order for the prescriptions they write to be covered by any Medicare Part D prescription drug benefit plan….Read More

Congress Remains Divided on ACA Repeal Bill Although Republican leadership in the House raised the prospect of lawmakers returning early from the current two-week Easter recess to pass the American Health Care Act, it appears Congress will remain out of session until the week of April 24. And, once the House is back in session,…Read More