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Deadlines Near for MSSP Application Cycle for Program Year 2017

As we near the end of May, critical deadlines for participation in the Medicare Shared Savings Program (“MSSP”) for program year 2017 are approaching.  Under the MSSP ACO Final Rule, CMS finalized new regulations that established a process for and the timing of initial applications for participation in the MSSP and renewals of existing participation … Continue Reading

Hospital Medicare Reimbursement: CMS Delays Publication of Notice Justifying .2% IPPS Payment Reduction for “Two Midnight” Policy

In August 2014 IPPS, CMS implemented a .2% reduction in IPPS rates for federal fiscal year (“FY”) 2014, and has carried that .2% reduction forward in FYs 2015 and 2016.  CMS claimed that this .2% reduction was necessary to offset a projected net increase in IPPS cases occasioned by CMS’s “Two Midnight” rule, also adopted … Continue Reading

Capital Thinking: Health Care Legislative Update

Two Health Bills Scheduled for House Floor House Majority Leader Kevin McCarthy (R-CA) has stated that the chamber may consider two health bills this coming week. On Tuesday, March 1, the House is expected to consider H.R. 2814, to Name the Department of Veterans Affairs Community-Base Outpatient Clinic in Sevierville, Tennessee, the Dannie A. Carr … Continue Reading

Capital Thinking: Health Care Legislative Update

Senate Cloture Vote Scheduled for FDA Nominee, Chamber May Consider Opioid Legislation On Monday, February 22, Senate Majority Leader Mitch McConnell (R-KY) has scheduled a cloture vote on the nomination of Dr. Robert Califf for Food and Drug Administration (FDA) Commissioner.   Three Senators – Joe Manchin (D-WV), Ed Markey (D-MA), and Bernie Sanders (I-VT) – … Continue Reading

Capital Thinking: Health Care Legislative Update

Congress Awaits Health Provisions in President’s Budget On Tuesday, February 9, President Barack Obama will submit his FY 2017 Budget Request to Congress, which is expected to include several large-scale investments for the nation’s health. Last week, the White House released a “sneak preview” of the Budget, which includes: $755 million for cancer research as … Continue Reading

Capital Thinking: Health Care Legislative Update

House to Consider Overriding President’s Veto of Reconciliation Legislation Following a postponement due to weather last week, House Majority Leader Kevin McCarthy (R-CA) has announced that on Tuesday, February 2, the House will consider the President’s veto message on H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015. The legislation seeks to repeal … Continue Reading

Capital Thinking: Health Care Legislative Update

Blizzard Postpones House Consideration of Veto Message on Reconciliation Legislation Due to the winter storm in Washington, the House will no longer be in session this week. Previously, House Majority Leader Kevin McCarthy (R-CA) had announced that on Tuesday, January 26, the House would consider the President’s veto message on H.R. 3762, the Restoring Americans’ … Continue Reading

HHS OIG Opines on Charity Financial Assistance and Kickbacks

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) posted two similar advisory opinions on January 4, 2016, regarding nonprofit, tax-exempt organizations and the financial assistance they give to the needy for their healthcare.  Specifically, the organizations asked OIG if (1) accepting donations for, and (2) disbursing financial assistance to federal … Continue Reading

Capital Thinking: Health Care Legislative Update

President May Highlight Obamacare Successes in State of the Union Address On Tuesday, January 12, President Barack Obama will give his final State of the Union address to Congress. While details of the speech have yet to be released, last week, the President vetoed Congress’s budget reconciliation bill, which aimed to dismantle the Affordable Care … Continue Reading

Capital Thinking: Health Care Legislative Update

House To Possibly Consider Amended Reconciliation Bill Last week, the Senate passed an amended H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015, on a vote of 52-47. House Majority Leader Kevin McCarthy (R-CA) has stated that the House of Representatives could possibly consider the Senate-passed bill on the House floor this week. … Continue Reading

CMS’s Top 7 Changes to the Stark Law

On November 16, 2015, the Department of Health and Human Services, Centers for Medicare and Medicaid Services, issued a final rule revising, clarifying, and adding exceptions to the Physician Self-referral Law (“Stark”) in order to (1) accommodate delivery and payment system reform; (2) reduce burdens; and (3) ensure and facilitate compliance. These changes include two new … Continue Reading

Capital Thinking: Health Care Legislative Update

Senate Republicans Eye Obamacare Repeal Measures In Reconciliation Bill Senate Majority Leader Mitch McConnell (R-KY) has scheduled a meeting on Monday, November 30, for Republican senators to discuss repealing parts of the Affordable Care Act (ACA). Senate Republican leaders are hoping to consider the Senate substitute amendment to the House-passed reconciliation bill, H.R. 3762, on … Continue Reading

Capital Thinking: Health Care Legislative Update

Health Bills Scheduled For House Floor Action House Majority Leader Kevin McCarthy (R-CA) has announced that on Monday, November 16, the House will consider two health bills under suspension of the rules: S. 599, the Improving Access to Emergency Psychiatric Care Act, which extends and expands the Medicaid emergency psychiatric demonstration project; and S. 799, … Continue Reading

Capital Thinking: Health Care Legislative Update

House Committee on Energy and Commerce Subcommittee on Health to Mark Up Seven Bills On Tuesday, November 3, and Wednesday, November 4, the House Committee on Energy and Commerce Subcommittee on Health will hold a markup to consider seven pieces of legislation: H.R. 2017, the Common Sense Nutrition Disclosure Act of 2015, and an amendment … Continue Reading

Capital Thinking: Health Care Legislative Update

House To Vote On ACA Repeal Provisions House Majority Leader Kevin McCarthy (R-CA) has included two health-related bills on this week’s floor schedule. On Wednesday, the House is expected to consider S. 1362, a bill to amend title XI of the Social Security Act to clarify waiver authority regarding programs of all-inclusive care for the … Continue Reading

Capital Thinking: Health Care Legislative Update

Health-Focused Reconciliation Recommendations Clear Three Committees Last week, three House committees considered and passed reconciliation recommendations that included health-related language. The House Committee on Ways and Means approved language that would repeal the individual and employer mandates, the excise taxes on medical devices and high cost employer-sponsored health coverage (also known as the Cadillac tax), … Continue Reading

Capital Thinking: Health Care Legislative Update

Health Legislation Hits House Floor House Majority Leader Kevin McCarthy (R-CA) has announced that the following health-related bills will be considered this week under suspension of the rules: H.R. 1624, the Protecting Affordable Coverage of Employees Act, as amended, which provides that employers with 51 to 100 employees are small employers for purposes of health … Continue Reading

Capital Thinking: Health Care Legislative Update

House Committee on Energy and Commerce to Mark Up Health Legislation The House Committee on Energy and Commerce has announced that it will hold a markup on Tuesday, July 28. Several health bills are on the agenda: H.R. 1344, the Early Hearing Detection and Intervention Act of 2015, which reauthorizes a program for early detection, … Continue Reading

Capital Thinking: Health Care Legislative Update

Republicans Postpone Reconciliation Actions Until After August Recess With the August District Work Period only weeks away, House Committee on the Budget Chairman Tom Price (R-GA) announced this past week that the House Committee on the Budget would not act on reconciliation until after the lawmakers reconvene in September. The three House committees and two … Continue Reading

Capital Thinking: Health Care Legislative Update

House to Consider 21st Century Cures Act Majority Leader Kevin McCarthy (R-CA) has announced that the House of Representatives will consider H.R. 6, the 21st Century Cures Act, this week. The House Committee on Rules will meet to consider the rules for the debate on Wednesday, July 8. Amendments to the legislation are to be … Continue Reading

Capital Thinking: Health Care Legislative Update

House to Continue Consideration of IPAB Repeal Majority Leader Kevin McCarthy (R-CA) has announced that the House of Representatives will complete consideration of H.R. 1190, the Protecting Seniors’ Access to Medicare Act of 2015, this week. This bill repeals the sections of the ACA that establish the Independent Payment Advisory Board (IPAB), an entity to … Continue Reading

OIG Puts Muscle Behind Its Alert

Only two days after releasing its latest fraud alert, a deputy director from HHS’s Office of Inspector General announced that the OIG will be hiring additional attorneys to look into taking more administrative actions against physicians in their individual capacity. This announcement emphasizes that the OIG means serious business – not only is the OIG … Continue Reading
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