Most Recent Advisories

Home Health PPS: The Final Rule for CY 2012
January 25, 2012 The Centers for Medicare & Medicaid Services in the November 4, 2011 Federal Register published the calendar year 2012 final rule for the home health prospective payment system.

Interim Final Rule: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status
December 19, 2011 On July 8, 2011, the Office of the Secretary of Health and Human Services (HHS) published an interim final rule (IFR) regarding the adoption of operating rules for two transaction standards under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Medicare Outpatient PPS and ASC Final Rule for CY 2012
December 13, 2011 On Nov. 1, the Centers for Medicare & Medicaid Services released the outpatient prospective payment system (OPPS) and ambulatory surgical center final rule for calendar year 2012.

Part A to Part B Rebilling Demonstration Project 
December 12, 2011 The Centers for Medicare & Medicaid Services on November 15 announced a new Part A to Part B Rebilling Demonstration Project, and the agency will begin accepting hospital applications today at 2 p.m. Eastern Time at the email addresses listed on page two of this advisory.

Medicare Physician Fee Schedule Final Rule for CY 2012
December 6, 2011 A summary of CMS's physician fee schedule final rule for CY 2012 with changes to the Medicare and other Medicare Part B payment policies.

Proposed Rule for Hospital and CAH Conditions of Participation 
December 5, 2011 Highlights of CMS's proposed rule to revise the existing Medicare and Medicaid Conditions of Participation (CoPs) for hospitals and critical access hospitals.

Inpatient Rehabilitation Facility PPS: Final Rule for Fiscal Year 2012 
November 21, 2011 In the August 5 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published its fiscal year (FY) 2012 final rule for the inpatient rehabilitation facility (IRF) prospective payment system (PPS). In addition to standard annual updates, this regulation initiates the implementation of pay-for-reporting for IRFs, as required by the Patient Protection and Affordable Care Act of 2010 (ACA).

Long-Term Care Hospital PPS: Final Rule for Fiscal Year 2012  
November 16, 2011 In the August 18 Federal Register, CMS published its fiscal year (FY) 2012 final rule for the inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS. This advisory covers the LTCH provisions in the final rule regulation.

The Medicare Shared Savings Program Accountable Care Organizations: The Final Rule 
November 8, 2011 On October 20, the Centers for Medicare & Medicaid Services (CMS) released the much-anticipated final regulation for the Medicare Shared Savings Program (MSSP), which encourages the voluntary formation of accountable care organizations (ACOs). The final regulation is available at http://www.ofr.gov/OFRUpload/OFRData/2011-27461_PI.pdf and was published in the November 2 Federal Register.

Accountable Care Organizations: Guidance to Address Antitrust, Fraud & Abuse and Tax Exemption Barriers 
November 8, 2011 CMS released a final regulation (ACO rule) governing the creation of accountable care organizations (ACOs) under the Medicare Shared Savings Program (ACO program). The Department of Justice in conjunction with the Federal Trade Commission issued a Final Statement; CMS and the Department of Health and Human Services’ Office of the Inspector General issued an Interim Final Rule; and the Internal Revenue Service (IRS) issued a Fact Sheet. This Legal Advisory addresses each of these three guidance documents related to ACO development.

Medicaid Recovery Audit Contractor Program: The Final Rule
October 17, 2011 On September 14, the Centers for Medicare & Medicaid Services released a final regulation for the new Medicaid Recovery Audit Contractor program. The final rule, available at http://www.gpo.gov/fdsys/pkg/FR-2011-09-16/pdf/2011-23695.pdf was published in the September 16 Federal Register.

The Physician Electronic Prescribing Incentive Program: Final Rule
October 12, 2011 On September 6, the Centers for Medicare & Medicaid Services published in the Federal Register a final rule with changes to the Physician Electronic Prescribing (eRx) Incentive Program.

CMS Bundled Payments for Care Improvement Initiative
September 14, 2011 On August 23, the Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation (CMMI) unveiled its Bundled Payments for Care Improvement Initiative.

Notification of Employee Rights Under the National Labor Relations Act
September 01, 2011 The National Labor Relations Board (NLRB or the Board) issued on August 30 a final rule to require that all employers subject to the National Labor Relations Act (NLRA or the Act), including most hospitals and health systems, post a notice informing employees of their rights under the Act.

Skilled Nursing Facility PPS: The Final Rule For FY 2012
September 01, 2011 The Centers for Medicare & Medicaid Services (CMS) in the August 8 Federal Register published the fiscal year (FY) 2012 final rule for the skilled nursing facility (SNF) prospective payment system (PPS).

National Preparedness Month Information for Hospitals about Terrorist Use of Toxins and Poisons
August 31, 2011 National Preparedness Month Information for Hospitals about Terrorist Use of Toxins and Poisons

Medicare Inpatient PPS: The Final Rule for Fiscal Year 2012
August 22, 2011 On August 1, the Centers for Medicare & Medicaid Services (CMS) released its fiscal year (FY) 2012 final rule for the hospital inpatient and long-term care prospective payment systems (PPS).

Medicare ESRD PPS Proposed Rule for CY 2012 
August 15, 2011 In the July 8 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule for the Medicare end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2012 and the ESRD PPS quality incentive program (QIP) for payment years (PYs) 2013 and 2014.

Updated Readmission and Mortality Rate Data on Hospital Compare
August 04, 2011 The Centers for Medicare & Medicaid Services (CMS) will update information on care provided in hospitals on the publicly available website Hospital Compare (www.hospitalcompare.hhs.gov).

Medicare Physician Fee Schedule Proposed Rule for CY 2012
July 29, 2011 The Centers for Medicare & Medicaid Services (CMS) published its physician fee schedule (PFS) proposed rule for calendar year (CY) 2012 in the July 19 Federal Register

Home Health PPS: The Proposed Rule For CY 2012
July 28, 2011 The Centers for Medicare & Medicaid Services (CMS) in the July 12 Federal Register published the calendar year (CY) 2012 proposed rule for the home health (HH) prospective payment system (PPS).

Proposed Insurance Reform Rules
July 25, 2011 On July 15, the Department of Health and Human Services (HHS) issued the first of several proposed rules to implement the state health insurance exchanges for individuals and small businesses established by the Patient Protection and Affordable Care Act (ACA).

AHA Endorses Patient Safety Policies Requiring Influenza Vaccination of Health Care Workers
July 22, 2011 To protect the lives and welfare of patients and hospital employees, the AHA's Board of Trustees recently approved a policy supporting mandatory patient safety policies that require either influenza vaccination or wearing a mask in the presence of patients across health care settings during flu season.

Medicare Outpatient PPS and ASCL Proposed Rule for CY 2012
July 21, 2011 On July 1, the Centers for Medicare & Medicaid Services (CMS) released the outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) proposed rule for calendar year (CY) 2012.

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