Articles and Blogs

Summary On February 14, 2019, the U.S. Department of Health and Human Services (“HHS”) Center for Medicare and Medicaid Innovation (“CMMI”) launched a new five-year payment model for emergency ambulance services named the Emergency Triage, Treat and Transport Model (“ET3”). ET3 will enable participating ambulance providers and suppliers (“Ambulance Providers”) to partner with qualified... READ MORE

Congressional Leaders Discuss Health Care Priorities Congress’ top leaders, Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Nancy Pelosi (D-CA), announced they are not embracing “Medicare for All” as a priority at the American Hospital Association’s annual Washington conference. Both leaders reinforced that each chamber will pursue largely separate health care agendas in... READ MORE

Conversation Shifts Back to Health Care in Washington Health care became a major discussion point for lawmakers after this week started with the Trump administration’s declaration that it supports a federal judge’s ruling that the entire Affordable Care Act (“ACA”) should be thrown out. This signals a shift in the Justice Department’s prior position... READ MORE

During a speech on March 4, 2019, Secretary of Health and Human Services Alex Azar announced that the Trump administration plans to overhaul the Medicare payment system for certain dialysis services provided to patients with end-stage renal disease. The overhaul, as envisioned, would incentivize moving the place of treatment from outpatient clinics to home... READ MORE

Government Funded After Congress Borders on Another Shutdown Congressional negotiators have reached an agreement on a funding deal that avoids another partial government shutdown that would have occurred at midnight tonight. The measure would fund nine out of fifteen federal departments through September 30, 2019. President Trump is expected to sign the legislation into... READ MORE

Congress Passes Two-Week Stopgap Funding Measure On December 6, Congress passed a continuing resolution that extends current funding for select federal agencies for two weeks. The extension became necessary after the services for former President George H.W. Bush halted almost all legislative activity on Capitol Hill this week. Lawmakers will now have until December... READ MORE

In September 2018, HHS Office of Inspector General (“OIG”) issued audit Report No. A-01-15-00500 (the “Report”) finding that out of 220 randomly sampled inpatient rehabilitation facility (“IRF”) stays from 2013, nearly 80 percent did not meet Medicare coverage and documentation requirements. Specifically, for 175 of the 220 sampled stays at 135 IRFs, the medical record... READ MORE

Hospitals Release Voluntary 340B Principles as Alternative to Legislation The battle over 340B continued this week as hospital groups announced a new voluntary 340B reporting program as an alternative to congressional legislation that would further regulate the program. Under the American Hospital Association-led initiative, hospitals would commit to publicly disclosing their 340B savings annually.... READ MORE

Senate and House Appropriators Nail Down HHS Funding Bill On September 13, a conference committee of House and Senate appropriators finalized details of the fiscal year 2019 Health and Human Services (“HHS”) spending bill, H.R. 6157, which was combined with legislation to fund the Department of Defense. The conference agreement paves a path for... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) announced its long-awaited “BPCI Advanced” model on January 9. The model – which is voluntary – will initially include 29 inpatient clinical episodes and 3 outpatient clinical episodes (a list of the 32 clinical episodes can be found here). BPCI Advanced Participants must elect to be... READ MORE