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On March 21, 2018, a representative from the Hospital and Ambulatory Policy Group at the CMS, held a listening session regarding proposed updates to documentation guidelines ...

CMS has released the "2015 National Impact Assessment of Quality Measures Report," which examines the effectiveness of quality measures used in CMS hospital, ambulatory, and post-acute quality programs.

As we noted, Centers for Medicare & Medicaid Services (CMS) recently proposed its Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs rules (Proposed Rule).

On January 30, the Centers for Medicare & Medicaid Services' (CMS') Innovation Center announced that sickle cell disease (SCD) will be the first focus of the Cell and Gene Therapy (CGT)...

A coalition of organ procurement organizations challenges a controversial CMS performance framework in federal court, but first must overcome a critical jurisdictional hurdle that could determine whether they can seek relief before facing potential decertification.

On May 6, 2015, CMS issued interim final rules relating to Medicare Part D beneficiary access to Part D drugs.

The Centers for Medicare and Medicaid (CMS) posted its final decision regarding its reconsideration of the Clinical Trials NCD (National Coverage Determination).

The Inflation Reduction Act (the "IRA") requires drug manufacturers to pay rebates to Medicare when the prices of their Part B and Part D prescription drug increase faster than the rate...

Last week, the Centers for Medicare and Medicaid Services released its proposed rule for the Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System for 2017.

How close is close enough for physician supervision of outpatient procedures? In its 2012 Outpatient Prospective Payment System (OPPS) proposed rule, the Centers for Medicare and Medicaid Services (CMS) has set its sights once again on physician supervision standards, this time proposing that an independent panel make recommendations as to which level of supervision is required for a particular therapeutic service.

Last week, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released the results of a study entitled CMS Response to Breaches and Medical Identity Theft.

On October 27, 2004, the Centers for Medicare & Medicaid Services ("CMS") held an "open door forum" to review and obtain public input regarding the agency’s plans to revise the Healthcare Common Procedure Coding System ("HCPCS") coding process. Reed Smith covered this event because of the significant impact the changes to the coding process will have on drug and device manufacturers.

On December 15, 2021, the Fifth Circuit Court of Appeals stayed, in part, a nationwide preliminary injunction prohibiting the Centers for Medicare and Medicaid Services (CMS)...

The Centers for Medicare & Medicaid Services (CMS) finalized its Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payment rates for calendar year (CY) 2024.

The proposals strive to balance increased federal government oversight and administration with continued recognition of, and flexibility for, state managed care programs.

According to an April 13, 2020 Press Release issued by the National Association of ACOs ("NAACOS"), a recent NAACOS survey shows that 56% of the survey-participating at-risk accountable care organizations ("ACOs") – i.e., ACOs ...

Bracing for the inevitable end of the COVID-19 Public Health Emergency (PHE), CMS has begun issuing voluminous guidance to states on unwinding Medicaid's continuous enrollment requirement without precipitating a calamitous drop in coverage.