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  • Article

    CMS Doubles Down On Targeting Part D Enrollee Prescription Drug Abuse, But Will Stakeholders Agree?

    With the release of its 2017 draft call letter, CMS continues its push to curb opioid dependence, overdose and death among Medicare Part D enrollees.
    United StatesFood, Drugs, Healthcare, Life Sciences
    BakerHostetler
    BakerHostetler
  • Article

    CMS Expands DMEPOS Items Subject To Prior Authorization Due To "Unnecessary Utilization"

    The Centers for Medicare & Medicaid Services (CMS) is expanding the types of durable medical equipment (DME), prosthetic, orthotics, supplies (DMEPOS)
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Extends and Expands Moratoria on Enrollment of Home Health Agency, Ambulance Suppliers in Designated Areas

    Citing significant potential for fraud and abuse, CMS has announced that it is temporarily suspending new home health agency and ground ambulance enrollment in Medicare, Medicaid, and the Children’s Health Insurance Program in several geographic areas, and it is extending the current enrollment moratoria for these provider types in separate areas.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Finalizes 2018 Medicare Advantage/Part D Policies, Seeks Ideas for Improving Programs

    CMS has released its 2018 Medicare Advantage (MA) and Part D Rate Announcement and Call Letter. CMS estimates that plan revenues will increase by 0.45 percent in 2018; when coding acuity is considered, plans can expect a total revenue change of 2.95 percent
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Fingerprint-Based Background Checks are Underway - Impacting "High-Risk" Providers and Suppliers

    CMS's long-awaited fingerprint-based background check screening process is underway for certain "high-risk" providers and suppliers participating in federal health care programs (specifically, Medicare, Medicaid, and the Children’s Health Insurance Program).
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Issues Final FY 2018 Medicare Hospice Payment Update

    CMS has finalized fiscal year (FY) 2018 Medicare hospice reimbursement rates and other updates to Medicare hospice policies.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Issues Memo Regarding Spread Of Coronavirus In Nursing Homes

    In addition, CMS encouraged all nursing homes to monitor the CDC website for information, and to contact their local health department if they have questions or suspect a case of COVID-19.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Lewis Brisbois Bisgaard & Smith LLP
    Lewis Brisbois Bisgaard & Smith LLP
  • Article

    CMS Proposes Discontinuing 2 HCPCS Codes Under New Demonstration

    CMS is conducting a "limited demonstration" of an internet-based notice and comment mechanism on internally-generated requests to discontinue Level II HCPCS codes.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Proposes FY 2016 Update To SNF PPS Rates, Policies

    On April 20, 2015, CMS published its proposed rule updating Medicare skilled nursing facility (SNF) PPS rates and policies for FY 2016.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Proposes Removing Two NCDs Under Expedited Process

    In 2013, CMS adopted an expedited administrative process to remove certain national coverage determinations older than 10 years since their most recent review.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Publishes RADV Medical Reviewer Guidance

    In the Medicare Advantage (MA) context, "risk adjustment" is the process by which the Centers for Medicare & Medicaid Services (CMS) reimburses Medicare Advantage Organizations (MAOs)...
    United StatesFood, Drugs, Healthcare, Life Sciences
    Dentons
    Dentons
  • Article

    CMS Reducing "Off-Cycle" CMS Healthcare Worker COVID-19 Vaccine Surveys

    On June 14, 2022, CMS released QSO-22-17-ALL - Surveys for Compliance with Omnibus COVID-19 Health Care Staff Vaccination Requirements"
    United StatesFood, Drugs, Healthcare, Life Sciences
    Katten
    Katten
  • Article

    CMS Releases Medicare Advantage/Drug Plan Quality Data, Enforcement Statistics

    CMS has posted the 2015 Medicare Star Ratings for Medicare Advantage (MA) and Medicare Part D prescription drug plans (PDPs).
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    CMS Starts COVID-related Accelerated Or Advance Payment Program Recoupments

    As of March 30, 2021, if, as a Medicare provider or supplier you received an accelerated or advance payment (AAP) from the Centers for Medicare and Medicaid Services (CMS), ...
    United StatesFood, Drugs, Healthcare, Life Sciences
    Winston Taylor
    Winston Taylor
  • Article

    CMS Takes Another Step Toward Achieving Price And Quality Transparency

    On November 20, 2006, as part of its Health Care Consumer Initiatives, CMS posted to its website detailed Medicare payment information for certain common services provided by physicians and outpatient hospital departments.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Foley & Lardner LLP
    Foley & Lardner LLP
  • Article

    CMS To Distribute Disclosure Of Financial Relationships Report

    Hospitals should review the information and documents that would be required to respond to CMS and notify physicians of the potential need for their cooperation and assistance.
    United StatesFood, Drugs, Healthcare, Life Sciences
    McDermott Will & Emery
    McDermott Will & Emery
  • Article

    CMS Updates Off-The-Shelf (OTS) Orthotics Listing For 2014

    CMS has updated its list of Healthcare Common Procedures Coding System Codes codes that it considers to be off-the-shelf orthotics – and therefore subject to inclusion in a future round of the DMEPOS competitive bidding program.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    Recent EHR Meaningful Use Program Updates

    CMS recently announced important changes to the hardship exception application process for the Medicare Meaningful Use Program.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Foley & Lardner LLP
    Foley & Lardner LLP
  • Article

    CMS Extends Timeline Of Section 111 Civil Monetary Penalties Final Rule

    On February 18, 2023, the Centers for Medicare and Medicaid Services (CMS) extended the timeline for publishing the Medicare Secondary Payer and Certain Civil Monetary Penalties final rule...
    United StatesFood, Drugs, Healthcare, Life Sciences
    McDermott Will & Emery
    McDermott Will & Emery
  • Article

    CMS Increases Scrutiny Of Emergency Medicaid Coverage For Noncitizens

    On May 27, CMS circulated a Dear Colleague letter to states announcing that it would be "ramping up financial oversight activities" ...
    United StatesImmigration
    Manatt, Phelps & Phillips, LLP
    Manatt, Phelps & Phillips, LLP

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