As the healthcare system continues to shift from a volume to value orientation, observers across the country are increasingly raising concerns over how the Stark Law and Anti-Kickback Statute (AKS) limits the ability of providers to participate in and be appropriately compensated for care coordination.
The first performance period for the CMS Bundled Payments for Care Improvement Advanced (BPCI-A) program began on October 1, 2018. Now with the program having started, if you are a BPCI-A participant, you may be wondering how you can operationalize your bundled payment initiatives to position your organization for success.
In a ruling called “Pathways to Success,” the Centers for Medicare & Medicaid Services has overhauled the Medicare Shared Savings Program (MSSP), accelerating the path to financial risk for MSSP ACOs.
As we look forward to 2019, the hospital/health system M&A market is increasingly becoming a bifurcated landscape of clear “haves” and “have-nots”.
On December 27, 2018, the United States District Court for the District of Columbia granted a permanent injunction on the 2018 Medicare reimbursement cuts related to 340B drugs. What does this mean for the hospitals affected by these changes?
The Centers for Medicare & Medicaid Services (CMS) finalized key updates to the Medicare Hospital Outpatient Prospective Payment System (OPPS), the Ambulatory Surgical Center Payment System (ASCPS), and the Physician Fee Schedule (PFS) that will be effective January 1, 2019, with additional changes to be implemented in 2021.
On October 25, President Trump announced his plan to lower prescription drug prices. Under the plan’s new proposed payment system, the Centers for Medicare & Medicaid Services (CMS) will launch a five-year pilot program—the International Pricing Index (IPI) model—that will allow Medicare to pay less for select Part B drugs when a lower international price is available.
CMS is expected to announce the final payment rules for ASCs in the next few weeks. Here are four key changes to look for when the final rules are published in November:
In the final rule for the fiscal year 2019 update to the inpatient prospective payment system, effective August 17, 2018, CMS announced a new round of applications due to the closure of Memorial Hospital of Rhode Island. This is only the 13th round of section 5506 cap space reallocation since passage of the PPACA.
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