Articles and Blogs

Brady Working on Bill to Reverse Some Site-Neutral Pay Cuts On May 2, House Ways and Means Chairman Kevin Brady (R-TX) announced his intention to introduce bipartisan legislation that exempts some off-campus hospital outpatient departments from the site-neutral payment cuts that were part of the Bipartisan Budget Act of 2015. According to Brady, the... READ MORE

CMS Issues Proposed Rule on Quality-Based Payment Program On April 27, CMS released a notice of proposed rulemaking to update how Medicare payments are linked to the quality and cost of care provided to beneficiaries. Hall Render has published a summary of the key provisions on its website. The proposal is the first step... READ MORE

CMS Releases IPPS and LTCH Proposed Payment Rule that Ends Negative Payment Impact from Two-Midnight Policy On April 18, CMS issued its proposed payment rule covering inpatient hospital stays and long-term acute care hospitals. The inpatient hospital measure would increase rates by 0.85 percent in FY 2017, compared to FY 2016, after accounting for... READ MORE

Senators Call on CMS to Delay Star Ratings for Overall Hospital Quality On April 11, 60 senators sent a letter to CMS Acting Administrator Andy Slavitt urging the agency to delay the release of the overall hospital quality star ratings to provide more time to analyze the methodology of the star ratings, examine its... READ MORE

CMS Begins Testing of Bundled Payment Program for Joint Replacement On April 1, CMS launched a bundled payment demonstration for inpatient knee and hip surgeries. The agency will pay nearly 800 hospitals across 67 metro areas bundled payments for joint replacement procedures, which is expected to save Medicare $343 million over the course of... READ MORE

Ways and Means Committee Urges CMS to Delay CLFS Implementation On March 29, 26 members of the House Ways and Means Committee sent a letter to CMS urging the agency to delay its implementation of the new Clinical Laboratory Fee Schedule (“CLFS”), which changes the way that clinical laboratory tests are paid for under... READ MORE

Legislation to Delay Bundled Payments Program Introduced On March 23, Rep. Tom Price, M.D., (R-GA) introduced a bill (H.R. 4848) that would delay the Comprehensive Care for Joint Replacement (“CJR”) program set to go into effect next week. The bundled payment program, which CMS finalized via administrative rule in November, requires hospitals in nearly... READ MORE

HELP Committee Passes Mental Health Legislation On March 16, the Senate Health, Education, Labor and Pensions (“HELP”) Committee passed a set of bipartisan mental health and opioid abuse bills that include provisions relating to access to care, early intervention and shortages in the behavioral health workforce. READ MORE

CMS Proposes Overhaul of Part B Drug Payments On March 8, CMS announced a proposed rule to change the way it pays for billions of dollars of drugs covered by Medicare. The new project, run through the Center for Medicare and Medicaid Innovation (“CMMI”), would allow the government to vary what it spends on... READ MORE

House Approves Legislation to Reduce Medicaid Fraud On March 2, the House of Representatives unanimously passed a bill to improve program integrity in Medicaid and CHIP. The Ensuring Removal of Terminated Providers from Medicaid and CHIP Act (H.R. 3716) would help states identify health care providers whose participation in Medicaid or CHIP was terminated... READ MORE