Category Archives: Centers for Medicare & Medicaid Services (“CMS”)

CMS Issues Proposed ACO Rule to Address Industry Concerns and Encourage Participation in Alternative Risk-Based ACO Models

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On Monday, December 1, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a Proposed Rule with several proposed changes to the regulations finalized in 2011 for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP).  According to CMS, the Proposed Rule is intended to reduce administrative burdens and improve program function and transparency for ACOs participating in the MSSP. There are currently 330 ACOs serving almost 5 million Medicare beneficiaries in 47 states. Continue reading →

The New Two-Midnight Rule – Scrutiny Delayed until March 31, 2014

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CMS indicated on its website in early November that it is extending the implementation period for another three months, until March 31, 2014. The website says that, “in general, CMS will not conduct post-payment patient status reviews for claims with dates of admission of October 1, 2013 thru March 31, 2014.” CMS also issued two new guidance documents on its website that describe selecting and reviewing hospital claims for patient status.

Written by: Emily Grey

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The New Two-Midnight Rule – Scrutiny Delayed for 90 Days

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The Center for Medicare and Medicaid Services (CMS) released what has become known as the “Two Midnight Rule” on August 2, 2013 in the Inpatient Prospective Payment System (IPPS). The Final Rule is available in the August 19, 2013 Federal Register.
Last week, in response to provider concerns and a letter from more than 100 members of Congress asking for postponement of the rule, CMS announced a 90 day implementation period beginning on October 1, 2013. Continue reading →