House Republicans have announced their intent to cut federal funding for training new pediatricians to hospitals that perform gender-affirming care on minors. The proposed bill, sponsored by Rep. Dan Crenshaw (R-Texas), would...more
On March 16, 2023, CMS issued Change Request 12669, which contains instructions for Medicare Administrative Contractors (MACs) to begin the process of retroactively reimbursing DSH hospitals for inpatient days attributable to...more
Hospitals that participate in the 340B program may be entitled to additional monies from Medicare Advantage plans in the wake of the Supreme Court’s decision in AHA v. Becerra.
In AHA v. Becerra, a unanimous Supreme Court...more
On February 24, 2023, CMS issued a proposed rule that would modify the Medicare Disproportionate Share Hospital (DSH) payment regulation to limit the universe of Section 1115 demonstration beneficiaries who can be “regarded...more
On January 18, 2023, CMS issued a Quality, Safety & Oversight Group memorandum announcing its initiative to improve nursing home safety and transparency. Specifically, CMS will conduct audits to determine whether nursing...more
On December 28, 2021, CMS announced that it would resume enforcement of its COVID-19 vaccine mandate for healthcare providers in areas not covered by injunctions issued by federal courts. As of December 15, 2021, federal...more
1/5/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Employer Mandates ,
Enforcement ,
Health Care Providers ,
Healthcare Workers ,
Injunctions ,
OSHA ,
Popular ,
Vaccinations ,
Virus Testing
Last Wednesday, the U.S. Supreme Court announced it would hear oral arguments on January 7, 2022, regarding the legality of two federal COVID-19 vaccine mandates issued under the Biden administration. The justices will be...more
On Wednesday, December 15, 2021, the Fifth Circuit Court of Appeals denied the federal government’s petition for a stay pending appeal of the preliminary injunction issued by a federal district court in Louisiana that...more
12/22/2021
/ Administrative Procedure Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Employer Mandates ,
En Banc Review ,
Enforcement ,
Interim Final Rules (IFR) ,
OSHA ,
Popular ,
Preliminary Injunctions ,
Vaccinations
On November 4, 2021, the Biden administration published two new rules governing employers with 100 or more employees and healthcare workers at hospitals, nursing homes and other facilities that participate in Medicare and...more
On January 19, 2021, CMS announced the results of its audit of off-campus outpatient departments claiming the “mid-build” exception following enactment of the 21st Century Cures Act (the Cures Act). Of the 334 providers that...more
On August 4, 2020, CMS proposed its annual rule adjusting the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System, as well as changes to quality reporting...more
The federal government has implemented a number of relief programs in response to the COVID-19 public health emergency. Many borrowers in the healthcare industry may be seeking funds under the recently-expanded Medicare...more
King & Spalding’s Healthcare Finance practice is working to keep clients informed of issues that may be of concern to lenders in the healthcare space. The CARES Act includes a number of provisions to offer financial relief to...more
On March 13, 2020, President Trump declared the coronavirus pandemic a national emergency, invoking powers under the National Emergency Act and the Stafford Act. The President’s declaration, coupled with Secretary Azar’s...more
CMS and its contractors have announced that beginning January 1, 2020, the agency will repay hospitals for underpaid evaluation and management (E/M) services provided in excepted off-campus provider-based departments during...more
In 2016, CMS issued a proposed rule to update the requirements that hospitals and critical access hospitals must meet to participate in Medicare and Medicaid programs....more
United States District Court Judge Reed O’Connor of the Northern District of Texas issued a ruling on Friday, December 14, 2018, declaring the Patient Protection and Affordable Care Act (ACA) unconstitutional in its entirety....more
The United States Court of Appeals for the District of Columbia Circuit recently held in Saint Francis Medical Center v. Azar that Medicare’s reopening regulation, which prohibits providers from seeking to revise payment...more
On July 13, 2017, CMS issued the Calendar Year (CY) 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System (ASCPS) proposed rule (Proposed Rule). CMS proposes to update OPPS...more
On March 8, 2017, the two House Committees responsible for healthcare policy related to the Affordable Care Act (ACA) held marathon-like deliberations to mark-up their respective portions of the Republicansponsored health...more
On November 1, 2016, the Centers for Medicare & Medicaid Services (CMS) issued its CY 2017 Outpatient Prospective Payment System (OPPS) Final Rule, which includes the agency’s final policies implementing legislative changes...more
On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) issued its CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule. The Proposed Rule includes several provisions regarding how CMS will...more