Articles and Blogs

CMS Releases Proposed Outpatient Pay Rule On July 25, the Centers for Medicare & Medicaid Services (“CMS”) issued the Medicare hospital Outpatient Prospective Payment System (“OPPS”) and Ambulatory Surgical Center (“ASC”) proposed rule for Calendar Year 2019, which contains an annual payment rate increase of 1.25 percent. Most significantly, the proposed rule would expand the... READ MORE

Major Spending Bill Passes Congress Congress passed a major $1.3 trillion spending bill this week, which keeps the government funded through September. The bill passed the House 256-167 and the Senate 65-32. In both bodies, the measure received the support of a majority of members from each party. In the Senate, unanimous consent was... READ MORE

Eligible Professionals participating in the Medicare Meaningful Use Electronic Health Record Incentive Program have until October 1, 2017 to submit a hardship application to avoid a downward payment adjustment in 2018. A participant may submit a hardship application if the Eligible Professional: Is a first-time Eligible Professional who intends to participate in the advancing care information performance... READ MORE

The Cures Act addresses certain electronic health record (“EHR”) difficulties faced by physicians who practice primarily in ambulatory surgery centers (“ASCs”). Section 16003 explicitly excludes physicians who furnish substantially all of their Medicare services at ASCs from the penalties imposed under various programs for failure to adopt a certified EHR. Under the current Medicare... READ MORE

On December 20, CMS posted for public inspection a final rule establishing three new Episode Payment Models (“EPMs”). Two of the EPMs pertain to cardiac care. The third EPM pertains to orthopedic care.  CMS will officially publish the rule on January 3, 2017. The Cardiac-Related EPMs The first cardiac-related EPM is for episodes of... READ MORE

Today, the Centers for Medicare & Medicaid Services (“CMS”) published the much-anticipated Final Rule for the new Merit-Based Incentive Payment System (“MIPS”) and Advanced Alternative Payment Models (“AAPMs”) pathways to payment pursuant to the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). A copy of the Final Rule can be found here, and... READ MORE