Articles and Blogs

On November 1, 2017, the Centers for Medicare & Medicaid Services (“CMS”) released its Calendar Year 2018 Hospital Outpatient Prospective Payment System (“OPPS”) final rule. Among many other changes, CMS finalized its proposal to remove total knee arthroplasty (“TKA”) from the CMS inpatient-only (“IPO”) list. Effective January 1, 2018, CMS will no longer require that…Read More

This is another article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for States and Long-Term Care Facilities (“Final Regulations”) by the Centers for Medicare & Medicaid Services (“CMS”). BACKGROUND On September 28, 2016, CMS released a complete overhaul of Part 483…Read More

Bill Introduced to Prevent 340B Cuts On November 14, a bipartisan bill was introduced to prevent CMS from implementing the $1.6 billion cut to the 340B drug discount program. The legislation, introduced by Reps. David McKinley (R-WV) and Mike Thompson (D-CA), pushes HHS to maintain the current 340B discount rate of Average Sales Price (“ASP”)…Read More

NATIONAL How are states faring with value-based payment initiatives? AMA launches efforts to help physicians harness health data VA moves to digitize health records with $158M contract Amazon to regulators: We won’t use state licenses to sell prescription drugs MACRA: The Yardstick for Quality that Health Systems Need AMGA: 10 median salaries by medical specialty…Read More

The opioid crisis has been declared a national emergency. This crisis presents a variety of legal issues and questions, including the extent to which health care providers can disclose a patient’s protected health information (“PHI”) under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). When a patient is incapacitated due to an opioid…Read More

House Advances Tax Reform Legislation On November 9, the House Ways and Means Committee advanced legislation that would overhaul the nation’s tax code for the first time since 1986. The next day, the Senate Finance Committee released its tax reform proposal, which Chairman Orin Hatch (R-UT) said would be advanced by the committee next week….Read More

NATIONAL Surviving in limbo: 3 takeaways from physician execs on the transition to value-based care Bipartisan bill looks to change physician anti-kickback law CMS holds value-based purchasing adjustment steady for 2018 Healthcare reacts to 2018 final rule for MACRA’s Quality Payment Program CVS to offer nationwide next-day delivery in preemptive shot at Amazon Study: 4…Read More

On November 1, the Centers for Medicare & Medicaid Services (“CMS”) surprisingly finalized a proposal to reduce reimbursement by almost 27 percent for separately payable drugs purchased at reduced prices under the 340B drug discount program (“340B Program”). Currently, all 340B-participating hospitals (“Covered Entities”) except for critical access hospitals (“CAHs”) receive Medicare OPPS payments of 6…Read More

On Thursday, November 2, 2017, Republicans in the House of Representatives released the text and summary of H.R.1, their promised tax reform bill. The short title of the bill is the “Tax Cuts and Jobs Act.” It is the first substantive shot fired in the tax reform war that the Republican leadership intends to wage to…Read More

CMS Drastically Cuts 340B Payments in 2018 OPPS/ASC Final Rule On November 1, CMS released the final rule updating the hospital Outpatient Prospective Payment System (“OPPS”) rates by 1.35 percent in CY 2018 compared to 2017. This is down from 1.75 percent in the proposed rule. In addition, CMS removed total knee replacements from the…Read More