centers for medicare and medicaid services

Dr. Michael Cohen, an operations officer in the Office of Investigations, is interviewed by Tyler Daniels, a public affairs specialist in Washington DC.

Ed Burley, Deputy Regional Inspector General in the Office of Evaluation and Inspections in Philadelphia, is interviewed by Sheila Davis, a public affairs specialist in Washington, DC.

A recap of OIG's work in 2017, including topics like reaching a $155 million civil settlement with an electronic health records vendor, releasing a data brief on opioids in Medicare Part D highlighting concerns about extreme use and questionable prescribing, and the largest healthcare fraud takedown in history.

Jarvis Rodgers, the HHS-OIG IT Audit Director, is interviewed by Sheila Davis, a public affairs specialist in Washington, DC.

John shares our take on what happened in health care at the end of July, including how the Centers for Medicare and Medicaid Services is proposing both a rule for site-neutral payments, as well as potentially more 340B cuts.

• The Centers for Medicare and Medicaid Services (CMS) has proposed a rule to move toward “site neutral” payments for clinic visits, under the 2019 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. Clinic visits are “essentially checkups with a clinician,” CMS said, and are the most common service billed under OPPS.
• CMS proposed to reduce 340B payments in 2019 to non-excepted off-campus departments of hospitals that are paid under the physician fee schedule. Earlier this year, CMS had already reduced $1.6 billion in Medicare outpatient drug payments to some 340B hospitals.

About Darwin Research Group
Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

OIG released a portfolio that found significant problems with quality of care, as well as improper billing in the Medicare hospice program.