News & Insights


Change is in the Air: How the Recently Passed SGR Legislation and Medicare's FY 2016 IPPS/LTCH Proposed Rule May Affect YOU

After years of simply patching Medicare’s Sustainable Growth Rate (SGR) while the impending cuts to physician payments grew each year, Congress recently passed far-reaching legislation that permanently repeals and replaces the SGR. In addition, CMS has once again proposed significant revisions and updates to Medicare's 2016 Inpatient Prospective Payment System (IPPS) and has afforded providers an opportunity to comment that expires June 16, 2015. Understanding these two significant developments is essential both for planning and budgetary purposes and to proactively participate in the implementation of these new polices.

On Friday, May 1, 2015, King & Spalding is hosting a Roundtable that will analyze the winners and losers under the recently passed legislation repealing the SGR as well as the essential items contained in CMS’s 2016 IPPS proposed rulemaking.

We are also offering a Webinar option for the Roundtable.

This seventy-five minute Roundtable will include the following topics:

  • The SGR Fix – The winners and losers under the legislative “doc fix” and the implications of its passage for future legislative efforts before Congress;

  • The 2016 IPPS Numbers – What is the net inpatient rate update, and what increases and reductions did CMS apply to get to that number?

  • The Latest on DSH/UCC Payments – Including why CMS proposes to reduce UCC payments by $1.3 billion and what can be done about it, as well as CMS’s proposal to limit a provider’s Medicaid days, for purposes of calculating its Factor 3, to less than a 12-month cost reporting period in some instances;

  • Pay-for-Performance – CMS’s continued expansion of the Value-Based Purchasing, Hospital Acquired Conditions (HAC) and Readmissions Programs, including the expansion of the HAC infection measures beyond ICUs;

  • Two Midnight Rule – The latest on the two-midnight rule, including the potential significance of CMS’s teaser for the OPPS rulemaking;

  • The Medicare Electronic Health Records Incentive Program – Stage 3 Meaningful Use and other program changes; and

  • LTCHs – CMS’s implementation of lower “site neutral” payment rates for LTCH discharges that do not meet certain clinical criteria.

King & Spalding Presenters:

  • Mark Polston

  • Daniel Hettich

  • Christopher Kenny

  • Susan Banks

You do not have to be a client to attend, and there is no charge.

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If you have questions concerning this Roundtable Webinar, e-mail

Event Details

Date: May 1, 2015

Time: 8:00 pm