Articles and Blogs

Trump Administration Proposes Cost-Cutting Package On May 8, the Trump administration proposed an extensive packing of $15.4 billion spending cuts. The administration seeks to cut funds from 38 programs that “are just sitting in accounts” and not being used. Almost half of the proposed cuts, $6.96 billion, would come from the Children’s Health Insurance Program…Read More

Recently providers have had success challenging CMS rules, as well as its failure to properly promulgate them. In Ruling 1727-R, issued April 23, 2018, CMS acquiesced to the decision in Banner Heart v. Burwell, invalidating CMS’s regulation prohibiting appeals unless they stemmed from a cost report adjustment or a protested item. In Banner, the court…Read More

NATIONAL Payer Roundup—CMS delays 340B rule … again A Collaboration to Keep Physicians at the Center of Healthcare ManorCare Mega-Deal Blurs Care Lines, But Will Doctors Buy In? CMS Chief Fires Back at Critics FDA chief Gottlieb to pharma: Those rebates you love to hate may soon count as kickbacks Healthcare a bright spot in…Read More

On May 7, 2018, CMS published its inpatient prospective payment system (“IPPS”) proposed rule (“Proposed Rule”). The Proposed Rule addresses a variety of provider topics, and this article discusses three noteworthy issues related to graduate medical education (“GME”). First, CMS announced the next two rounds of GME slot redistribution through the closed hospital slot redistribution…Read More

On April 24, 2018, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule for the CY 2019 Inpatient Prospective Payment System (“Proposed Rule”). Among many other changes, one very important change stands out in the Proposed Rule, specifically eliminating the requirement that providers record a written inpatient admission order in the medical record…Read More

NATIONAL There’s an acute nursing shortage, but schools are rejecting thousands of applicants Joint Commission wants increased focus on workplace violence in healthcare Health IT Trade Groups Push CMS for MIPS 90-Day Reporting Period FDA chief moves to promote artificial intelligence in health care Expert tips for incentivizing physicians to embrace value-based care Where are…Read More

The FFY 2019 IPPS Proposed Rule (“Proposed Rule”) was released on April 24, 2018, and CMS published the associated tables on its website. It is expected that the Proposed Rule will be published in the Federal Register on May 7. The release of the Proposed Rule and the accompanying tables triggers the start to several…Read More

CMS Releases Proposed Inpatient Prospective Payment Rule On April 24, CMS issued its annual hospital inpatient prospective payment system proposed rule for fiscal year 2019. Under the proposed rule, hospitals would get a $4 billion increase for inpatient services next year, which includes a $1.5 billion hike in uncompensated care payments. Acute care hospitals will…Read More

NATIONAL Joint Commission wants increased focus on workplace violence in healthcare Health IT Trade Groups Push CMS for MIPS 90-Day Reporting Period HHS auditors seek industry input on meshing cybersecurity needs with HIPAA compliance AAOS raises major concerns over BPCI Advanced model Hospitals and device makers still struggle to rid medical scopes of infectious bacteria…Read More

In the continually evolving world of Medicare coverage and payment rules, hospital compliance personnel must look broadly to identify potential risk areas to be addressed within their organization. Based on the facts alleged in two recent False Claims Act qui tam cases, with one of those cases currently proceeding through the federal courts, hospitals should…Read More