Articles and Blogs

Senate Approves ACA Repeal On December 3, the Senate approved a bill (H.R. 3762) that repeals major provisions of the Affordable Care Act (“ACA”) by a vote of 52-47. The Senate used a budget rule known as reconciliation to pass the bill without the usual 60-vote threshold. The bill would repeal the ACA’s Medicaid... READ MORE

CMS Issues Final Joint Replacement Payment Rule On November 16, CMS released a final payment rule that creates bundled payments for hip and knee replacement surgery performed at most acute care hospitals in 67 geographic areas of the country. Under a model known as Comprehensive Care for Joint Replacement (“CJR”), a hospital where a... READ MORE

CMS Makes Changes to RAC Program Processes On November 6, CMS announced that the number of medical records a recovery audit contractor (“RAC”) can request from health care providers to support audits is 0.5 percent of a facility’s total amount of paid Medicare claims from the previous year. Currently, the limit on the amount of... READ MORE

CMS Issues Final Regulations for Stark Law Modifications Late on October 30, CMS issued the CY 2016 Physician Payment final rule. The comprehensive rule provides clarification and establishes two new exceptions to the Stark Law in regards to the Self-Referral Disclosure Protocol, which should ease the compliance burden for hospitals. The compliance revisions in... READ MORE

Congress Passes Budget Bill – Targets Off-Campus Hospital Departments Around 3 AM on October 30, the Senate passed a sweeping two-year budget deal that also extends the federal debt limit to March 2017. The agreement, which passed the House on Thursday, October 29, helps avert a government shutdown and a default on the nation’s... READ MORE

House Passes Reconciliation Bill On October 23, the House moved forward a reconciliation bill that repeals major provisions of the Affordable Care Act (“ACA”) and defunds Planned Parenthood for one year.  Reconciliation, which is a complicated budget procedure that allows the Senate to pass legislation with a simple majority, repeals the individual and employer... READ MORE

OMB Begins Review of 2016 Medicare Payment Rules On October 13, the Office of Management and Budget (“OMB”) began its review of four separate 2016 Medicare payment rules. Each rule is required to be released by November 1. The first three rules under review would revise Medicare Part A payment rates for hospital outpatient departments... READ MORE

McCarthy Quits Race for House Speaker On October 8, House Majority Leader Kevin McCarthy (R-CA) withdrew his name from consideration for the Speaker of the House of Representatives moments before House Republicans were expected to formally nominate him. Retiring House Speaker John Boehner (R-OH) will remain speaker until the House votes to elect a... READ MORE

Senate Finance Committee Holds Hearing on Improper Payments On October 1, the Senate Finance Committee held a hearing to examine how improper health care payments, including overpayments and underpayments, are problematic to the federal government.  More specifically, those stemming from Medicare, Medicaid and the Earned Income Tax Credit, which account for over 76 percent of... READ MORE

House Speaker John Boehner Announces Retirement from Congress In a meeting with House Republicans early September 25, Speaker John Boehner (R-OH) announced that he will give up the speakership and resign his seat in Congress effective at the end of October.  The move comes in the midst of a contentious debate between Boehner and... READ MORE