Insights

Washington, D.C. – January 17, 2013: Crowell & Moring LLP is pleased to announce it has elected seven attorneys to the firm's partnership effective January 1, 2013. The firm has also promoted three attorneys to the position of senior counsel, and nine associates to the position of counsel. The new partners, senior counsel, and counsel have been promoted from within the ranks of the firm's Washington, D.C., San Francisco, Brussels, and London offices.

On Friday, October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released the pre-publication version of the final rule with comment period (Final Rule) that, beginning January 1, 2017, will implement the provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) relating to the new Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). MIPS and APMs are collectively referred to as the “Quality Payment Program” or “QPP”. Physicians, physician assistants, nurse practitioners, clinical nurse specialists and certified registered nurse anesthetists (collectively, “MIPS-eligible clinicians”) are part of the QPP if they bill Medicare more than $30,000 a year or provide care for more than 100 Medicare patients a year (both higher thresholds than initially proposed by CMS in the notice of proposed rulemaking).

The Office of the National Coordinator for Health IT (ONC) at HHS released guidance today – EHR Contracts Untangled – to help health care providers select and negotiate contract terms with technology vendors.

This summary of key lawsuits affecting managed care is provided by the Health Care Group of Crowell & Moring. If you have questions or need assistance on managed care law matters, please contact Chris Flynn, Peter Roan, or any member of the Health Care Group.

Troy Barsky, a Washington, D.C.-based partner in the firm's Health Care Group, explains recent legislation designed to repeal the sustainable growth rate (SGR) formula for physician reimbursement, as well as provisions echoing the fraud and abuse mandates in the Affordable Care Act. "This is a strong message from Congress that the focus on fraud and abuse is here today," Barsky said. "The bill was supposed to focus on physician payments, but…having a strong compliance program is vitally important if you continue to operate in this space."

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.