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  • Article

    CMS Offers Additional COVID-19 Guidance For Medicare Advantage And Part D Plans

    The Centers for Medicare and Medicaid Services (CMS) continues to offer guidance related to the coronavirus (COVID-19) outbreak.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Holland & Knight
    Holland & Knight
  • Article

    CMS Proposes Major Changes To Medicare Parts C And D

    On January 10, the Centers for Medicare & Medicaid Services published proposed rules labeled as "policy and technical" changes to the Medicare Advantage (Part C) and Medicare Prescription Drug Benefit (Part D) Programs.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.
Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.
  • Article

    CMS Proposes New Home Health Agency Rule Including Potential Changes To Reimbursement, Coverage, Quality, And More: CMS Accepting Comments Until September 9, 2019

    On July 11, 2019, the Centers for Medicare and Medicaid Services ("CMS") announced a proposed rule for home health agency Medicare reimbursement that would increase payments by an aggregate 1.3% for 2020
    United StatesFood, Drugs, Healthcare, Life Sciences
    Sheppard
    Sheppard
  • Article

    CMS Revises 2021 Remote Patient Monitoring Rules, Issues Correction

    CMS just issued a correction to its guidance on 2021 Medicare rules for remote physiologic monitoring (RPM) services. The correction is effective January 1, 2021 and revises the preamble commentary...
    United StatesFood, Drugs, Healthcare, Life Sciences
    Foley & Lardner LLP
    Foley & Lardner LLP
  • Article

    CMS Revises Signature Requirements For Ambulance Transports In Final Physician Fee Schedule Rule

    On Thursday, November 1, 2007, the Centers for Medicare & Medicaid Services (CMS) released the Final 2008 Physician Fee Schedule Rule with Comment Period (Final Rule), which included a revised version of the ambulance beneficiary signature provision included in the proposed rule released in July of this year (Proposed Rule).
    United StatesFood, Drugs, Healthcare, Life Sciences
    Foley & Lardner LLP
    Foley & Lardner LLP
  • Article

    CMS Updates List Of DMEPOS Items Subject To Medicare Prior Authorization

    CMS is adding six types of lower limb prosthetics to the list of equipment subject to Medicare prior authorization (PA) requirements, and extending certain current PA requirements.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
  • Article

    Medicare Issues Final Rules For Hospital Outpatient And Ambulatory Surgery Center Payment Systems

    On November 15, 2012, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register final rules that would, among other things, update payment policies and rates under the Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment System for Calendar Year (CY) 2013.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Foley & Lardner LLP
    Foley & Lardner LLP
  • Article

    New CMS Final Rule Strengthens Enforcement Authorities To Bolster Fraud And Abuse Prevention

    The goal for CMS is to keep those providers and suppliers that have committed fraud out of the federal healthcare programs.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Duane Morris LLP
    Duane Morris LLP
  • Article

    Overview Of Recent Stark Law Developments

    There has been a flurry of judicial and administrative activity regarding the Stark Law in recent weeks...
    United StatesFood, Drugs, Healthcare, Life Sciences
    McDermott Will & Emery
    McDermott Will & Emery
  • Article

    The Finish Line Is Here: CMS And OIG Finalize Transformative Stark And Anti-Kickback Regulations

    Late this afternoon, the Centers for Medicare & Medicaid Services ("CMS") and Office of Inspector General ("OIG") released long-awaited and highly anticipated Stark and Anti-Kickback Statute...
    United StatesFood, Drugs, Healthcare, Life Sciences
    Hall, Render, Killian, Health & Lyman
    Hall, Render, Killian, Health & Lyman
  • Article

    Update: No Surprises Act Implementation & CMS Guidance On Vaccination Mandate For Health Care Staff

    As of January 1, 2022, the major provisions of the federal No Surprises Act (NSA) have gone into effect. The NSA, enacted in December 2020 as part of the Consolidated Appropriations Act, 2021...
    United StatesFood, Drugs, Healthcare, Life Sciences
    Manatt, Phelps & Phillips, LLP
    Manatt, Phelps & Phillips, LLP
  • Article

    CMS Finalizes Medicare Advantage And Part D Drug Pricing Rule

    Earlier this month, CMS issued a final rule aimed at lowering drug prices and reducing out-of-pocket expenses in Medicare Advantage and Medicare Part D.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.
    Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.
  • Article

    Oh, My Stars! A Federal Court (Again) Upends CMS’s Medicare Advantage Ratings

    A federal district court ruled that CMS exceeded its statutory authority in calculating Medicare Advantage Star Ratings measures, potentially affecting how quality bonus payments are determined across the industry. Following the decision, CMS voluntarily recalculated ratings for all Medicare Advantage Organizations using only authorized data sources, marking a significant shift in how plan performance is evaluated and compensated.
    United StatesFinance and Banking
    Groom Law Group, Chartered
    Groom Law Group, Chartered
  • Article

    CMS ‘Crackdown On Fraud’ Continues With Nationwide Six-Month Moratoria On New Medicare Enrollments For Hospices And Home Health Agencies

    On May 13, 2026, the Centers for Medicare & Medicaid Services (CMS) imposed two nationwide, six‑month moratoria on new Medicare enrollments of hospice and home health agencies (HHAs).
    United StatesFood, Drugs, Healthcare, Life Sciences
    Akin
    Akin
  • Article

    Major Policy Changes Proposed For Medicare Payment, Accreditation, And Prior Authorization For DME Suppliers

    Among other things, the Proposed Rule signals that a CMS announcement of the next round of the DMEPOS CBP is forthcoming, with significant overhauls of the policies that applied in prior rounds.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Sheppard
    Sheppard
  • Article

    Expansion Of Renewable Energy In Russia: CMS Advising On The Acquisition And Development Of 9 Photovoltaic Parks

    Russia has already made advances in the renewable energy sector over recent years and is on the offensive in the solar energy sector.
    RussiaEnergy and Natural Resources
    CMS Reich-Rohrwig Hainz
    CMS Reich-Rohrwig Hainz
  • Article

    Children’s Hospitals Obtain Temporary Injunction Against CMS

    Court Enjoins CMS’s Interpretation of Medicaid DSH Reimbursement Formula.
    United StatesFood, Drugs, Healthcare, Life Sciences
    BakerHostetler
    BakerHostetler
  • Article

    CMS Fines Insurer For Misleading Medicare Part D Beneficiaries

    According to CMS’s notice, Aetna misleading enrollees about which pharmacies would be part of the network resulted in a significant amount of complaints to CMS.
    United StatesFood, Drugs, Healthcare, Life Sciences
    BakerHostetler
    BakerHostetler
  • Article

    CMS Releases PY 2020 RADV Audit Methods And Instructions: Key Takeaways For Health Plans

    On March 20, 2026, the Centers for Medicare and Medicaid Services released new guidance outlining the agency’s audit methods and instructions for Medicare Advantage plans subject to upcoming risk adjustment data validation audits for payment year 2020.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Crowell & Moring LLP
    Crowell & Moring LLP
  • Article

    CMS To Implement Fingerprint-Based Background Checks For High-Risk Providers And Suppliers In 2014

    The Centers for Medicare & Medicaid Services has selected a Fingerprint-Based Background Check Contractor.
    United StatesFood, Drugs, Healthcare, Life Sciences
    Reed Smith
    Reed Smith
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