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Health Law News

CMS Releases FFY 2021 Preliminary Public Use File and Wage Index Development Timetable

[05/22/19]

Posted on May 22, 2019 in Health Law News

Published by: Hall Render

On May 17, 2019, CMS released the preliminary FY 2021 Worksheet S-3, Parts II and III wage index Public Use File (“PUF”). The PUF contains wage data based on FFY 2017 hospital cost reports – that is, cost reports with fiscal year begin dates of on or after October 1, 2016 and on or before September 30, 2017. The... READ MORE

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GAO Lab Report – Sound Analysis? Criticism from Senator Grassley and Others and CMS’s Response

[05/20/19]

Posted on May 20, 2019 in Health Law News

Published by: Hall Render

In November 2018, the Government Accountability Office (“GAO”) released a report (“Report”) on new laboratory payment rates established by CMS under the Protecting Access to Medicare Act (“PAMA”). In the Report, the GAO analyzed Medicare claims data to assess how CMS’s implementation of these new rates will impact Medicare expenditures and recommended CMS take... READ MORE

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Hall Render’s This Week in Washington – May 17, 2019

[05/17/19]

Posted on May 17, 2019 in Health Law News

Published by: Hall Render

Lawmakers Seriously Pursuing “Surprise Medical Bill” Fix Continuing the bipartisan interest in addressing the issue of surprise medical billing, also known as balance billing, a group of bipartisan senators led by Sens. Bill Cassidy (R-LA) and Maggie Hassan (D-NH) introduced legislation on Thursday. The legislation states that providers would be prohibited from balance billing... READ MORE

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Health Provider News – May 17, 2019

[05/17/19]

Posted on May 17, 2019 in Health Law News

Published by: Hall Render

 NATIONAL States inch forward on nurse staffing laws Bill backed by generic drug companies gets PhRMA endorsement at Senate hearing As MACRA Implementation Turns 2, Industry Leaders Call for Change Best & worst states for physicians to practice, ranked by Medscape Some hospitals turn away ambulances when the patients are more likely to be... READ MORE

Department of Justice Updates Compliance Program Guidance

[05/13/19]

Posted on May 13, 2019 in Health Law News

Published by: Hall Render

On April 30, 2019, the U.S. Department of Justice (“DOJ”) released an updated version of is guidance known as “The Evaluation of Corporate Compliance Programs” (“2019 Guidance Document”). This document provides actionable guidance for health care providers seeking to assess and enhance their compliance programs. The DOJ’s updates emphasize the government’s view that not... READ MORE

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CMS Updates Preclusion List Requirements for Medicare Advantage and Part D

[05/10/19]

Posted on May 10, 2019 in Health Law News

Published by: Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) recently published a final rule (“Final Rule”) revising the procedures that CMS uses to administer its Preclusion List. As outlined below, CMS now requires Medicare Advantage, Medicare Part D and other designated plans to deny payment for items or services provided by or prescribed by a... READ MORE

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Health Provider News – May 10, 2019

[05/10/19]

Posted on May 10, 2019 in Health Law News

Published by: Hall Render

NATIONAL Costs for the same medical procedures show wide variation between hospitals CBO: HHS’ rebate rule would boost federal spending by $177B, lead to higher Part D premiums Trump administration announces ‘conscience rule’ for health care providers CMS lays out strategy to foster medical innovation in Medicare CVS exec: ‘We don’t discount Amazon’ Hospitals... READ MORE

CMS Announces New Primary Cares Initiative

[05/10/19]

Posted on May 10, 2019 in Health Law News

Published by: Hall Render

On April 22, 2019, the Centers for Medicare & Medicaid Services (“CMS”) announced a new set of value-based payment models for reimbursement of primary care services. CMS has coined the new models its “Primary Cares Initiative.” Although participation in the models is currently voluntary, CMS hopes the initiative will accelerate the nationwide transition of... READ MORE

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Is It Fee-for-Service or Managed Care? CMS Launches Direct Contracting Models

[05/10/19]

Posted on May 10, 2019 in Health Law News

Published by: Hall Render

In keeping with the trends of the commercial market, on April 22, 2019, the Centers for Medicare & Medicaid Services (“CMS”) announced opportunities to participate in new direct contracting models under Medicare’s Part A and Part B fee-for-service program. CMS intends to focus these models particularly on primary care coordination for medically complex and... READ MORE

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D.C. Court Decides Medicare 340B Program Payment Reduction Lawsuit Remedy: Spoiler Alert – The End Is Not Here

[05/08/19]

Posted on May 8, 2019 in Health Law News

Published by: Hall Render

On May 6, 2019, the United States District Court in Washington, D.C. issued its opinion on the appropriate remedy to address the invalidated payment cuts set forth in the 2018 and 2019 Outpatient Prospective Payment System final rules (“2018 and 2019 OPPS Rules”) for drugs purchased under the 340B drug discount program (“340B Program”).... READ MORE

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