The Centers for Medicare & Medicaid Services has been granted unprecedented authority to exclude individuals and entities from federal healthcare programs, a power previously held exclusively by the HHS Office of Inspector General. This expansion raises critical questions about how the two agencies will coordinate exclusion decisions, particularly in False Claims Act settlements, and what criteria CMS will apply when wielding this significant enforcement tool. Healthcare providers and entities now face unce

According to the CDC, on January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization ("WHO") ...

The Centers for Medicare & Medicaid Services (CMS) has announced a new Medicare Part D Payment Modernization Model (Part D Model), which will be tested by the CMS Center for Medicare and Medicaid Innovation.

On February 9, 2023, the Centers for Medicare & Medicaid Services (CMS) released initial program guidance on the inflation rebate provisions of the Inflation Reduction Act of 2022 (IRA).

The COVID-19 vaccine mandate implemented by the Centers for Medicare and Medicaid Services (CMS) has affected investor interest in non-acute care providers and suppliers, including home care providers.

The U.S. Centers for Medicare & Medicaid Services (CMS) further revised its physician supervision policy by finalizing the federal Advisory Panel on Ambulatory Payment Classification Groups as the independent review body to evaluate and recommend physician supervision levels to CMS, and by defining personal supervision and general supervision for all hospital outpatient therapeutic services.

The Centers for Medicare & Medicaid Services (CMS) recently proposed the Transforming Episode Accountability Model (TEAM) – a new, mandatory...

The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (MPFS) and Other Revisions to Medicare

The Centers for Medicare and Medicaid Services (CMS) released, on August 25, 2015, the quality and financial performance results for Medicare Accountable Care Organizations for 2014.

The Centers for Medicare & Medicaid Services (CMS) has published its long-awaited final rule entitled "Medicare Program: Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal."

On November 1, 2017, CMS announced that it is in fact cutting Medicare Part B reimbursement for 340B drugs to the tune of $1.6 billion.

On April 10, 2024, CMS published the fiscal year (FY) 2025 Medicare Hospital Inpatient Prospective Payment Systems (IPPS) Proposed Rule, which contains several key proposals...

This blog is to highlight some key provisions and changes as MA and Part D plans prepare and finalize comments.

CMS has published its proposed rule to update the Medicare acute hospital inpatient prospective payment system and long-term care hospital prospective payment system for fiscal year 2017.

People are sometimes surprised to learn that the U.S. Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) do not coordinate their decisions on whether a medical device can be marketed and whether the government’s insurance programs will pay for it.

As our readers know, the Centers for Medicare & Medicaid Services ("CMS") prohibits certain marketing communications, materials, and activities.

The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2024 Revisions to Payment Policies Under the Physician Fee Schedule (MPFS) and Other Revisions to Medicare Part B...

On June 17, 2016 the Centers of Medicare & Medicaid Services (CMS) issued the long awaited Medicare Clinical Diagnostic Laboratory Tests Payment System Final Rule.

On April 30, 2020, the Centers for Medicare & Medicaid Services ("CMS") issued its Second Interim Final Rule in response to the COVID-19 pandemic, which includes additional regulatory waivers...

On July 1, 2009, CMS placed on display its proposed changes to its Hospital Outpatient Prospective Payment System rule. Included among those changes are proposals to alter CMS's physician supervision requirements pertaining to hospital outpatient services, requirements that have been in flux since last year.