Articles and Blogs

CMS Releases 2019 Proposed Medicare’s Physician Fee Schedule  On July 12, the Centers for Medicare & Medicaid Services (“CMS”) announced numerous new policy proposals in a proposed rule to update payment policies, payment rates and quality provisions for services furnished under the Medicare Physician Fee Schedule (“PFS”) for 2019. The annual update reduces payments... READ MORE

On June 12, 2018, the Wisconsin Court of Appeals (“Court”) affirmed a decision by a Wisconsin circuit court and held that a family planning clinic with multiple locations in Wisconsin (“Provider”) was not required to repay the Wisconsin Department of Health Services (“DHS”) a total of $185,074.80 related to Medicaid fee-for-service claims submitted for... READ MORE

CMS Issues RFI for Stark Law On June 20, CMS released a request for information (“RFI”) seeking feedback on ways to improve the Stark Law, which limits how doctors can refer patients to businesses in which they have a financial interest. Largely seen as a barrier to value-based care arrangements, the agency is asking for information... READ MORE

Senate and House Work to Combat the Opioid Crisis On June 13, Energy and Commerce Committee Chairman Greg Walden (R-OR), Ways and Means Committee Chairman Kevin Brady (R-TX), Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ) and Ways and Means Committee Ranking Member Richard Neal (D-MA) introduced H.R. 6, the Substance Use-Disorder... READ MORE

Senate HELP Committee Takes Another Look at 340B The Senate Health, Education, Labor, and Pensions Committee held its second hearing on the 340B program. Representatives from two major government watchdogs, the Government Accountability Office and the HHS Office of the Inspector General, testified at the hearing. The testimony focused on oversight reports related to... READ MORE

Azar Pushes Value-Based Care Approach  During the annual policy conference for the Federation of American Hospitals, Health and Human Services (“HHS”) Secretary Alex Azar laid out an agenda for a more cost-effective and transparent health care system. Azar said HHS is focused on four key priorities: giving consumers greater control over health information through... READ MORE

As we noted in a previous article, significant Medicare payment cuts for certain 340B-participating hospitals[1] (“Covered Entities”) went into effect as of January 1, 2018 after a federal district court judge declined to take action to prevent implementation of certain 2018 Outpatient Prospective Payment System (“OPPS”) final rule (“Final Rule”) provisions. These changes represent... READ MORE