Like it or not, the Centers for Medicare & Medicaid Services (CMS) is expanding its strong commitment to focus on quality and care improvement as the basis for payment throughout the continuum of care.

CMS has proposed a rule to require Medicare prior authorization for certain items that the agency characterizes as "frequently subject to unnecessary utilization."

A quick, timely update for our reader. As reported in our previous posts on the recently approved Tennessee waiver...

CMS announced key shared savings and losses results of Accountable Care Organizations that began participating in the Medicare Shared Savings Program in 2012 or 2013.

Open Payments is the website through which pharmaceutical and medical device manufacturers report payments and transfers of value to physicians.

In Haro v. Sebelius1, the U.S. District Court for the District of Arizona (the "Court") recently ordered the Centers for Medicare and Medicaid Services (CMS) to limit its collection practices and procedures for recovering Medicare Secondary Payer (MSP) reimbursement claims from beneficiaries and/or their attorneys.

Though these expectations were first set out in the CY 2013 Call Letter and supplemental guidance, the CY 2019 notice proposes new strategies to manage chronic overuse.

CMS is particularly focused on staffing levels and added new requirements for surveyors to incorporate the use of Payroll Based Journal staffing data for their inspections.

CMS has proposed a series of complex and detailed revisions to Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) policies for 2017, ..

The Centers for Medicare & Medicaid Services has proposed requiring all off-campus outpatient departments to submit provider-based attestations through a new centralized electronic system before receiving Hospital Outpatient Prospective Payment System payment. The proposed rule implements Section 6225 of the Consolidated Appropriations Act of 2026 and introduces a risk-based oversight approach with reduced documentation requirements. Providers with existing CMS provider-based status determinations may quali

The Centers for Medicare & Medicaid Services (CMS) recently published the fiscal year ("FY") 2026 proposed rule for Hospital Inpatient Prospective Payment Systems...

On July 10, 2024, the Centers for Medicare & Medicaid Services ("CMS") issued a proposed rule ("Proposed Rule") in which it outlined proposed amendments to the suspension provisions and deadlines...

Effective October 15, a new Final Rule issued by the Centers for Medicare & Medicaid Services (CMS) will allow the Medicare Shared Savings Program (MSSP) to adjust calendar year (CY) 2023 benchmark.

This Spring, CMS informed MAOs that offer Medicare Advantage EGWPs (employer group waiver plans) that they were no longer required to submit annual bids for EGWPs.

On January 13, 2022, the Supreme Court of the United States issued an opinion staying preliminary injunctions issued in cases filed in Missouri and Louisiana challenging the Centers for Medicare...

Today the Centers for Medicare & Medicaid Services (CMS) published an interim final rule with comment period that will provide a temporary Medicare rate hike for certain durable medical equipment (DME) and enteral nutrition furnished in rural and non-contiguous areas of the country (Alaska, Hawaii, and U.S. territories) that are not included in competitive bidding.

The Centers for Medicare & Medicaid Services (CMS) has released its final rule to update Medicare acute hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) payments and policies for fiscal year (FY) 2017.

On August 1, 2012, the Centers for Medicare & Medicaid Services posted the Inpatient Prospective Payment System final rule for fiscal year 2013.

On September 14, 2020, the Centers for Medicare & Medicaid Services ("CMS") issued the Advance Notice of Methodological Changes for Calendar Year (CY) 2022 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies – Part I.

The Centers for Medicare & Medicaid Services (CMS) has issued its annual proposed update to Medicare skilled nursing facility (SNF) PPS rates and policies for fiscal year (FY) 2019.