Category Archives: Final Rule

Medicare Physician Fee Schedule Expands Telehealth Coverage in 2014

The Centers for Medicare & Medicaid Services (“CMS”) recently released the final rule for Medicare’s Physician Fee Schedule for 2014 Calendar Year (“CY).  While physicians are expected to see a 20.1% reduction to their Medicare payments, the Fee Schedule also includes expanded coverage for telehealth services and increased reimbursement payments for such services. Continue reading

New Regulation Imposes Requirements on Agreements between Nursing Homes and Hospice Partners

Nursing facilities and skilled nursing facilities (collectively, “Nursing Homes”) will need to enter into written agreements, or revise existing agreements, with hospice providers, as well as implement new policies and procedures to meet the requirements of a final rule promulgated by the Centers for Medicare & Medicaid Services (“CMS”). The final rule, which can be found in the Federal Regulations at 42 CFR § 483.75(t), requires agreements between Nursing Home facilities and hospice providers to specifically address the roles and responsibilities of each entity and designate individuals responsible for oversight of related policies and procedures. Continue reading

HRSA Announces Merger of NPDB and HIPDB

The Health Resources and Services Administration (HRSA) has announced that the Healthcare Integrity and Protection Data Bank (HIPDB) and the National Practitioner Data Bank (NPDB) will merge on May 6, 2013.  On that date, the HIPDB will close down, and all future reporting must be done through the NPDB.

While the databases are merging, there has been no change in the reporting requirements.  Any user who was previously required to report information to the HIPDB must now do so through the NPDB. All information currently in the HIPDB will now be available through the NPDB. Continue reading

CMS Releases Guidance For 2% Sequester Reduction In Medicare Payment

On March 8, 2013, the Centers for Medicare and Medicaid Services (CMS) issued a message to health care providers and suppliers which clarifies the application of the 2% sequester reduction in Medicare payment.  Specifically, President Obama issued a sequestration order on March 1, 2013, carrying out the requirement under the Budget Control Act of 2011 for mandatory, across-the-board reductions in federal spending, which had been postponed for two months by the American Taxpayer Relief Act of 2012. Continue reading

CMS Releases Final Rule to Implement Physician Payment Sunshine Act

On February 1, 2013, the Centers for Medicare & Medicaid Services (“CMS”) released the long-awaited final version of the Physician Payment Sunshine Act Final Rule (the “Sunshine Act”). The Sunshine Act will make information publicly available concerning payments or other transfers of value from applicable manufacturers to physicians. The Sunshine Act will also make information publicly available concerning physician ownership or investment interests in applicable manufacturers and group purchasing organizations (“GPOs”), including physician-owned distributors (“PODs”). Continue reading

HHS and Other Federal Departments Issue New Rule on Health Plans

The U.S. Departments of Health and Human Services, Labor and Treasury issued a final rule on February 9, 2012 requiring health insurers and group health plans to provide consumers with an easy-to-understand summary of benefits and coverage and a uniform glossary of commonly used health insurance terms. These disclosure requirements are intended to help those shopping for insurance, as well as those already enrolled in a plan, to make comparisons to better evaluate their health insurance coverage options. The Final Rule is slated for publication in the February 14, 2012 Federal Register. Continue reading

Final Rule on Expansion of Physician-Owned Hospitals under the Stark Physicians Self Referral Rule

On November 1, 2010, the Centers for Medicare and Medicaid Services (“CMS”) released the final rule governing the procedures and requirements by which a physician-owned hospital may apply for an exception to the Stark Physician Self Referral Law’s prohibition against expanding a physician-owned hospital’s capacity. The rule, effective on January 1, 2012, will be published in the Federal Register on November 30, 2011. Continue reading