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New Medicare Advantage Regulations Add Provider and Beneficiary Protections Against Plan Utilization Management Policies | King & Spalding

On April 5, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule (CMS-4201-F) regarding the Medicare Advantage (MA) and Part D programs. The Final Rule includes...
Human Services Office Of Inspector Department Of Health Centers For Medicare Medicaid Services National Coverage Determinations Ncds Pharmacy Therapeuticspt Committee King Spalding

ACA-linked readmission rate improvements misleading

Hospital readmission rates began to improve upon implementation of the Affordable Care Act's Hospital Readmissions Reduction Program, but a new JAMA Network Open analysis has found that the readmission gains due to the HRRP were smaller than originally reported. The HRRP gives the federal government the authority to levy fines against hospitals with higher-than-expected
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Increasing Choice and Site Neutrality: CMS Finalizes Elimination of Inpatient Only List and Modifications to ASC Covered Procedures List | Baker Ober Health Law

To embed, copy and paste the code into your website or blog: On December 2, 2020, CMS issued a Final Rule finalizing revisions to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for Calendar Year (CY) 2021. Among other policies addressed in the rulemaking, CMS finalized its proposals to eliminate the Inpatient Only (IPO) list over a three-year transitional period, phase out the list completely by CY 2024, add ne...
Baker Donelson Care Quality Improvement Organization Baker Ober Health Law Advisory Panel On Hospital Outpatient Payment Midnight Rule To Services Medicare Ambulatory Surgical Center

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