Health Care is one of the most regulated industries in the country, and for many years, one of the key administrative agencies overseeing health care in the United States, the Department of Health and Human Services’ (“HHS”)...more
The President and his administration continue to tout their efforts to strengthen coverage for behavioral health care, including significantly increasing behavioral health spending and strengthening parity between physical...more
4/4/2022
/ Biden Administration ,
Denial of Insurance Coverage ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare ,
Healthcare Reform ,
Insurance Claims ,
Insurance Litigation ,
Mental Health ,
Plan Administrators ,
Scope of Coverage ,
Standard of Care
The end of 2021 brings positive indications of the continued acceptance of telehealth as an important clinical care approach post public health emergency (“PHE”). The Centers for Medicare and Medicaid Services (“CMS”), like...more
2/22/2022
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Inpatient Prospective Payment System (IPPS) ,
Medicaid ,
Medical Reimbursement ,
Medicare ,
Medicare Advantage ,
Outpatient Prospective Payment System (OPPS) ,
Payor Contracts ,
Physician Fee Schedule ,
Section 340B ,
Surprise Medical Bills ,
Telehealth
A new section of the 21st Century Cures Act provides much-needed relief for hospitals with an off-campus provider-based department (off-campus PBD) that was mid-build or under development as of November 2, 2015 (the Mid-Build...more
2/8/2017
/ 21st Century Cures Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Certification Requirements ,
Compliance Dates ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Medicare ,
Medicare Administrative Contractors (MAC) ,
Off-Campus Departments ,
Outpatient Prospective Payment System (OPPS) ,
Professional Development
For relocations that occurred between 11.2.15 and 12.31.16, providers must submit relocation requests by 1.31.2017.
The CY 2017 OPPS Final Rule brought significant changes to the way Medicare reimburses hospitals for...more
Without fanfare or any significant discussion, the Bipartisan Budget Act (Act) contains the first legislative action related to provider-based status—and it is a sweeping action with negative financial consequences to many...more
11/2/2015
/ Bipartisan Agreement ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Health Care Providers ,
Healthcare ,
Medicare ,
MedPAC ,
Obama Administration ,
OIG ,
OPPS ,
Pending Legislation ,
Pharmaceutical Industry ,
Physician Fee Schedule ,
Prescription Drugs ,
Section 340B
In a final rule released on July 31, the U.S. Department of Health and Human Services (HHS) confirmed October 1, 2015 as the compliance date for health care providers, health plans, and health care clearinghouses to...more