Articles and Blogs

Wisconsin Physician Services, Inc. (“WPS”), the Medicare Administrative Contractor (“MAC”) for J5 (Iowa, Kansas, Missouri and Nebraska) and J8 (Indiana and Michigan) recently issued a local coverage determination (“LCD”), LCD (L36839), revising accreditation requirements for polysomnography and other sleep studies. Historically, the LCD stated that a hospital could use The Joint Commission (“TJC”) accreditation... READ MORE

In the March 14, 2017 Federal Register, the Food and Drug Administration (“FDA”) announced that it is considering establishing a new Office of Patient Affairs (“Office”). This consideration results from FDA’s intention to “enhance future patient engagement by providing a more transparent, accessible, and robust experience for patient communities.”1 The Federal Register notice outlined... READ MORE

On April 14, 2017, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule addressing several potential changes to the health care delivery system, including physician-owned hospitals (“Proposed Rule”). As a part of this Proposed Rule, CMS is also seeking comment regarding the current restrictions on physician-owned hospitals and how these restrictions affect... READ MORE

CMS issued a survey and certification letter, dated April 16, 2017, announcing their intention to publish proposed changes on April 28, 2017 that will require accreditation organizations (“AOs”) (i.e., TJC, DNV, HFAP and CIHQ) to post provider/supplier survey reports and plans of corrections from CMS-approved accreditation programs on their website. CMS is also proposing... READ MORE

Ordinarily, CMS will calculate the MIPS final score for a practice group’s physicians on an individual or group basis.[1] However, physicians participating in a “MIPS APM” are subject to a significantly different scoring methodology – the “APM scoring standard.” This article: (1) outlines CMS’s “snapshot” process for determining which physicians CMS will score using... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) announced that it will delay enforcement of its final rule (“Final Rule”) requiring physicians and other prescribing health care clinicians to either enroll in or opt out of Medicare in order for the prescriptions they write to be covered by any Medicare Part D prescription drug benefit... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently updated its Voluntary Self-Referral Disclosure Protocol (“SRDP”) when it posted a new form to be used as part of the SRDP process (“SRDP Form”). According to CMS, the SRDP Form is an attempt to “streamline and simplify” the SRDP process. CMS originally proposed the new SRDP... READ MORE

This is the final article in a series covering the behavioral health sections of the 21st Century Cures Act (the “Cures Act”), which was signed into law on December 13, 2016. The articles in our series are located here.  As with many of the behavioral health sections of the Cures Act, Title XIV also provides for... READ MORE

On March 13, 2017, twelve hearing impaired individuals filed suit in federal district court in Arizona against a large health system (the “System”) alleging discrimination under Section 1557 of the Affordable Care Act. In the complaint, the plaintiffs allege that the System discriminated against them by “refusing to provide effective auxiliary aids and services, despite... READ MORE

This is the sixth article in a series on the 21st Century Cures Act (the “Cures Act”), which was signed into law on December 13, 2016. We will continue publishing a series of articles summarizing various components under the Cures Act. The articles in our series are located here.  This article highlights the provisions... READ MORE