Articles and Blogs

Medicare

CMS Proposes Major Overhaul to Incorporate Payer Pricing into Medicare Cost Report Data and MS-DRG System

[05/19/20]

Posted on May 19, 2020 in Health Law News

Published by: Hall Render

On May 11, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). One of the most significant updates is the proposed addition of a new requirement to the Medicare cost report submission process. Specifically, hospitals would be required to provide the median... READ MORE

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CMS Activates Accelerated Payment Program Nationwide as Part of COVID-19 Response

[03/29/20]

Posted on March 29, 2020 in Health Law News

Published by: Hall Render

On March 28, 2020, CMS published a Press Release announcing an expansion of its existing accelerated payment program (“APP”) to help providers and suppliers access emergency funding needed to support operations during the COVID-19 pandemic. The Press Release includes a Fact Sheet with details about eligibility, funding amounts, processing and how the funds are... READ MORE

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Latest Stimulus Bill Includes Over $100 Billion in Health Care Industry Relief: Providers Should Start Preparing Now

[03/27/20]

Posted on March 27, 2020 in Health Law News

Published by: Hall Render

On March 25, 2020, the Senate passed the Coronavirus Aid, Relief, and Economic Security Act (H.R. 748) (“CARES Act” or “Act”). The CARES Act contains numerous provisions aimed at the response to the Coronavirus or COVID-19 pandemic, including $100 billion in reimbursement to hospitals and other health care entities for COVID-19-related expenses and lost... READ MORE

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CMS Confirms Provider’s Home Acceptable for Distant Site Telehealth Services

[03/24/20]

Posted on March 24, 2020 in Health Law News

Published by: Hall Render

As part of its recent round of FAQs related to COVID-19, CMS clarified that distant site practitioners may furnish Medicare telehealth services from their homes.  However, these distant site providers, and the clinics/group practices to whom they reassign benefits, must update their Medicare enrollment with the provider’s home location. The FAQ reads: Can the... READ MORE

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Can Individuals and Hospitals Sue Wrongdoers Under the Medicare Secondary Payer Act?

[09/17/19]

Posted on September 17, 2019 in Health Law News

Published by: Hall Render

In a recent Sixth Circuit decision,[1] the Court concluded that an individual Medicare beneficiary, who had successfully sued a tortfeasor for personal injuries he suffered, did not have the right to bring a cause of action under the Medicare Secondary Payer Act (“MSPA”).[2] In effect, the Court concluded that the MSPA did not provide rights... READ MORE

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CMS Finalizes New Anti-Fraud Tools Aimed at Affiliations

[09/10/19]

Posted on September 10, 2019 in Health Law News

Published by: Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) could revoke or deny a provider’s or supplier’s Medicare enrollment if it determines that any of its affiliations pose an “undue risk” under a Final Rule announced on September 5, 2019 (“Enrollment Rule”). Also under the Enrollment Rule, providers and suppliers (“Providers”) selected by CMS will... READ MORE

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Reminder: Many Hospitals Will Be Required to Report Lab Price Data as Part of PAMA Changes

[09/03/19]

Posted on September 3, 2019 in Health Law News

Published by: Hall Render

In 2014, Congress enacted the Protecting Access to Medicare Act (“PAMA”), changing the landscape of Medicare reimbursement for lab services. PAMA required the Centers for Medicare & Medicaid Services (“CMS”) to establish a single, national Clinical Laboratory Fee Schedule (“CLFS”) based on current charges in the private health care market. Below, we provide background... READ MORE

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CMS Finalizes Changes for Low Wage Hospitals and Rural Floor

[08/19/19]

Posted on August 19, 2019 in Health Law News

Published by: Hall Render

On August 16, 2019, the Federal Fiscal Year (“FFY”) 2020 Medicare Inpatient Prospective Payment System (“IPPS”) final rule (“IPPS Final Rule”) was published in the Federal Register. In the IPPS Final Rule, the Centers for Medicare & Medicaid Services (“CMS”) finalized several changes announced in the proposed rule, including several changes to address disparities between high... READ MORE

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Hall Render’s This Week in Washington – June 28, 2019

[06/28/19]

Posted on June 28, 2019 in Federal Advocacy

Published by: Hall Render

Senate Committee Advances Major Health Legislative Package The Senate Health, Education, Labor, and Pensions (“HELP”) Committee passed a wide-ranging bill focusing on lowering health care costs to the chamber’s floor. This legislation is one of the only major health care bills that stands a chance at passing Congress this year. The measure aims to... READ MORE

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Medicare Hospital Co-Location Fix? Not There Yet…

[05/07/19]

Posted on May 7, 2019 in Health Law News

Published by: Hall Render

On May 3, 2019, CMS released its long-awaited guidance on hospital co-location and shared service arrangements in the form of a draft survey memo (“Memo”), which is available here. The Memo clarifies how a hospital can co-locate with other health care entities without violating the Medicare Conditions of Participation (“CoPs”). CMS has been promising... READ MORE

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