The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the Fiscal Year (FY) 2025 Hospice Payment Rate Update at the end of July. This rule brings several significant updates to Medicare hospice payment rates and policies, ensuring alignment with statutory and reg...
Under the physician fee schedule (PFS), average payment rates will reduce the conversion factor by 2.83% in 2025 compared to 2024 rates, resting at $32.35 in 2025 compared to $33.29 in 2024. The PFS final rule eliminates the temporary 2.93% increase in Medicare physician payments as...
Grounds for Penalty: The final rule removes any basis other than timeliness from the penalties considered in the proposed rule. All references to “contradictory reporting” and “exceeding error tolerance” have been removed; timeliness is the sole basis for CMP per the Final Rule. What is timel...
In the recently issued calendar year 2025 Physician Fee Schedulefinal rule(Final Rule), the Centers for Medicare & Medicaid Services (CMS) finalized a number of policies related to the Medicare Prescription Drug Inflation Rebate Program (the Program). CMS established...
Stepping back: in the 2025 Medicare Final Rule, CMS proposed a redefinition of brokers’ compensation. This rule, stayed by a Texas district court in July 2024, highlights the scrutiny on broker channels and aligns with recent governmental actions to crack down on bad actors. Historically, broker...
On April 4, 2024, the Centers for Medicare & Medicaid Services (CMS) issueda final rulethat revises the Medicare Advantage and Part D programs in significant ways (the Final Rule). The Final Rule stems from the CY 2025 Medicare Advantage and Part D proposed rules issued in N...
The Centers for Medicare & Medicaid Services (CMS ) will lower the planned price of Medicare provider data under a final rule issued today, after the regional groups that wanted the data to create quality reports complained that previously proposed prices would keep them from participating. The ...
CMS finalized the overpayment final rule as part of the CY 2025 Medicare Physician Fee Schedule final rule that was published in the Federal Register on December 9, 2024 (2025 Rule). In Depth THE OVERPAYMENT STATUTE Under the Affordable Care Act, “persons” such as providers, suppliers, Med...
As a result of the Centers for Medicare & Medicaid Services’ (CMS) 2025 Medicare Advantage & Part D Final Rule, the industry expects to see standardized commissions and a cap on agent/broker non-salary compensation in 2025. Since a federal judge in Texas granted a stay in the lawsuits fil...
McDermott Will & Emeryon2/3/2025 On December 28, 2024, a long-awaited Centers for Medicare & Medicaid Services (CMS) final rule became effective, significantly updating laboratory personnel requirements under Subpart M of the Clinical Laboratory Improvement...more ...