5 million for the remainder of 2019 (not scheduled to receive any new funding after this year)MedicareOutreach and Assistance for Low-Income ProgramsMIPPA §11942 U.S.C. §1395b-3 note$37.5 million annually (SHIPs, $13 million; AAAs, $7.5 million; ADRCs, $5 million; contractwith the National Center for Benefits and Outreach Enrollment, $12 million)MedicareTemporary Extension of LTCH Site Neutral Payment Policy Transition PeriodSSA §1886(m)(6)(B)(i)42 U.S.C.§1395ww(m)(6)(B)(i)No cost estimateMedicareTemporary Exception for Certain Spinal Cord Conditions from Application of the Medicare LTCH Site Neutral Payment for Certain LTCHsSSA §1886(m)(6)(F) 42 U.S.C. §1395ww(m)(6)(F)No cost estimateMedicareFunding for Implementation of Section 101 of MACRAMACRA § 101(c)(3))No cost estimateMedicarePriorities and Funding for Measure DevelopmentSSA §1848(s) 42 U.S.C. §1395w-4(s)Funds appropriated prior to FY2020 are available for obligation through the end of FY2022 ($15 million/year from FY2015 through FY2019)MedicareContract with a Consensus-Based Entity Regarding Performance MeasurementSSA §1890(d) 42 U.S.C. §1395aaaFunds appropriated prior to FY2020 are available for obligation until expended ($7.5 million/year from FY2018 and FY2019)MedicareQuality Measure SelectionSSA §1890A 42 U.S.C. §1395aaa-1Funds appropriated prior to FY2020 are available for obligation until expended ($7.5 million/year from FY2018 and FY2019)MedicarePatient-Centered Outcomes Research Trust FundIRC §9511 and §§4375- 4377, SSA §1183); 26 U.S.C. §9511; 26 U.S.C. §§4375-4377; 42 U.S.C. §1320e-2$150 million/year if programs are funded through FY2026OtherFamily-to-Family Health Information CentersSSA §501(c) 42 U.S.C. §701(c)(1)(A)(iii)$6 million/year if programs are funded through FY2024OtherSexual Risk Avoidance Education ProgramSSA §501 42 U.S.C. §710No cost estimateOtherPersonal Resp

s to allow inflated damage recoveries to stand without reduction.24This article was originally published in theTrial Advocate,Volume 42, No 1, a publication of theFlorida Defense Lawyers Associationand is republished here with permission.176 So. 3d 1247 (Fla. 2015).2 Id. at 1257.868 So. 2d 547 (Fla. 4th DCA 2003).4 872 So. 2d 956 (Fla. 2d DCA 2004).Thyssenkrupp, 868 So. 2d at 549.Id. at 550 (citing Cooperative Leasing Inc. v. Johnson, 872 So. 2d 956(Fla. 2d DCA 2004)).452 So. 2d 514 (Fla. 1984.)B 392 N.E.2d 1 (III. 1979).9 Thyssenkrupp, 868 So. 2d at 550 (citing Stanley, 452 So. 2d at 515).1° 337 So. 3d 1229 (Fla. 2022).11 Id. at 1230.12 Dial v. Calusa Palms Master Ass’n, 308 So. 3d 690, 692 (Fla. 2d DCA 2020).13 337 So. 3d at 1231.14 42 U.S.C. §§ 1395-1395i-4 (citing Stewart v. Sullivan, 816 F. Supp. 283, 284 (D.N.J. 1992).15 42 U.S.C. §§ 1395j-1395w-4 (citing Stewart v. Sullivan, 816 F. Supp. 283, 284 (D.N.J. 1992).16 42 U.S.C. §§ 1395u(b)(4).17 Stewart, 816 F. Supp. At 284.18 Id.19 42 U.S.C. §§ 1395w-4(g)(4)(A).20 42 U.S.C. §§ 1395(b)(2)(a)(i).21 42 U.S.C. §§ 1395(b)(3)(B).22 42 CFR § 405.430(b).23 United Senators Ass’n v. Shalala, 182 F.3d 965, 969 (D.C. Cir. 1999).24 Thyssenkrupp, 868 So. 2d at 550

Section 106(b)(2)(A) reads: "(2) PREVENTING BLOCKING THE SHARING OF INFORMATION.—(A) FOR MEANINGFUL USE EHR PROFESSIONALS.—Section 1848(o)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395w–4(o)(2)(A)(ii)) is amended by inserting before the period at the end the following: ', and the professional demonstrates (through a process specified by the Secretary, such as the use of an attestation) that the professional has not knowingly and willfully taken action (such as to disable functionality) to limit or restrict the compatibility or interoperability of the certified EHR technology.'"2 Note that the Medicare EHR Incentive program, as applied to eligible professionals, was folded into MIPS and expired as a separate program at the end of 2016.

Definition of “Applicable Laboratory” PAMA requires an “applicable laboratory” to collect and report to CMS “applicable information” (as defined below). PAMA defines an “applicable laboratory,” in part, as a lab entity that derives a majority of its Medicare revenue under the CLFS (42 U.S.C. 1395l and 42 U.S.C. 1395m-1) and the Physician Fee Schedule (42 U.S.C. 1395w–4). CMS makes significant changes to the criteria defining an “applicable laboratory”:NPI Level Entity.

Unfortunately, PAMPA’s language did not clearly delineate the scope of CMS’ discretionary authority to grant hardship exceptions. The new guidance and application help solidify the following changes to the 2015 hardship exception application process:• Revised Hardship Exception Deadlines: PAMPA, by revising existing law found at 42 U.S.C. 1395w-4(a)(7)(B), revised the Meaningful Use Hardship Exception application deadlines for avoiding 2017 payment adjustments. Now, CMS may accept applications from EPs until March 15, 2016 and from qualifying hospitals until April 1, 2016.

an “applicable laboratory” The impact of using the Clinical Laboratory Improvement Amendments of 1988 (“CLIA”) certificate to designate a “single laboratory” related to the definition of an ADLT, and the definition of a “successor owner” for retaining ADLT status Whether CMS should reduce the number of Medicare Administrative Contractors (“MACs”) to four or fewer with the responsibility of both writing local coverage determinations (“LCDs”) for lab tests and processing all claims and any alternatives to such a reduction in compliance with PAMADefinition of “Applicable Laboratory” Section 216 of PAMA requires an “applicable laboratory” to collect and report to CMS private payor rates for each clinical diagnostic laboratory test (“CDLT”) and the corresponding volumes of such tests by payment rate. PAMA defines an “applicable laboratory” as an entity that derives a majority of its Medicare revenue under the CLFS (42 U.S.C. 1395l and 42 U.S.C. 1395m-1) and the Physician Fee Schedule (42 U.S.C. 1395w–4). CMS proposes to use the CLIA definition of “laboratory” and identify the lab entity by Taxpayer Identification Number rather than by National Provider Identifier (“NPI”), which is broad enough to encompass every independent lab and any entity that includes a lab component, such as a physician office or hospital.

Specifically, it states:STUDY ON REMOTE PATIENT MONITORING SERVICES. The Comptroller General of the United States shall conduct a study: of the dissemination of remote patient monitoring technology in the private health insurance market; of the financial incentives in the private health insurance market relating to adoption of such technology; of the barriers to adoption of such services under the Medicare program under title XVIII of the Social Security Act; that evaluates the patients, conditions, and clinical circumstances that could most benefit from remote patient monitoring services; and that evaluates the challenges related to establishing appropriate valuation for remote patient monitoring services under the Medicare physician fee schedule under section 1848 of the Social Security Act (42 U.S.C. 1395w–4) in order to accurately reflect the resources involved in furnishing such services. REMOTE PATIENT MONITORING SERVICES.

ould not be based on agent or broker behavior. Recovery would be required for compensation associated with the months after the beneficiary disenrolled. CMS proposes regulatory changes that codify the agency's current policy.Finally, CMS proposes to codify its existing sub-regulatory guidance regarding referral or finder's fees. Specifically, CMS proposes to limit the amount that can be paid as a referral fee to independent, captive, and employed agents and brokers, regardless of who completes the enrollment, to a reasonable amount specified by CMS. For contract year 2014, that amount is $100. Furthermore, note that, under § 422.2274(a) and § 423.2274(a), CMS requires that referral fees paid to independent agents and brokers must be part of total compensation not to exceed the FMV for that calendar year.14. Drug Categories or Classes of Clinical Concern and Exceptions (§423.120(b)(2)(v) and (vi)) [79 Fed. Reg. 1936 – 47]The Proposed Rule would implement ACA's requirements set forth at 42 U.S.C. § 1395w-4(b)(3)(G) by revising § 423.120(b)(2)(v) and (vi) as follows: (1) establishing the criteria the Secretary will use to identify drug categories or classes of clinical concern; and (2) defining the exceptions that permit Part D sponsors to exclude certain Part D drugs from within an identified drug category or class from their formularies (or otherwise limit access to such drugs, including through utilization management or prior authorization restrictions). It also would specify the drug categories or classes that would meet the proposed criteria.Specifically, the Proposed Rule would modify § 423.120(b)(2)(v) to require that (unless an exception applies) all Part D drugs within a drug category or class be included on the formulary if the drug category or class of drugs for a "typical beneficiary"2 with a disease or condition treated by the drugs in the category or class meets both of the following criteria (as determined by CMS): a. Categories or Classes of Clinical Concern [79 Fed. Reg. 1937 – 4