Danielle Moskos

Danielle Moskos

Ober|Kaler

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Stark Regulations: Proposed Physician Recruitment Provisions

Assistance to Employ a Non-Physician Practitioner (NPP) - Currently under the Stark law, the physician recruitment exception (42 C.F.R. § 411.357(e)) permits hospitals, Federally Qualified Health Centers (FQHCs) and...more

7/23/2015 - CMS FQHC Hospitals NPPs Physician Recruitment Agreement Physicians Recruitment Policies Remuneration Rural Health Care Providers Stark Law

OIG Approves Subsidies to Medicare Beneficiaries Provided by a Clinical Research Study

On May 28, 2015, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued an advisory opinion approving a medical device manufacturer’s proposed arrangement to provide subsidies to certain...more

6/23/2015 - Advisory Opinions Anti-Kickback Statute Civil Monetary Penalty Clinical Trials Device Manufacturers HHS Medical Devices Medicare OIG Subsidies

OIG Approves Free Diapers and Playpen in Connection with Medicaid Program Promoting Pre- and Post-Natal Care

On January 26, 2015, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued an advisory opinion approving an entity’s practice of advertising and providing free diapers and free portable...more

2/16/2015 - Advertising Advisory Opinions Anti-Kickback Statute Children's Products Civil Monetary Penalty HHS Medicaid OIG Post-Natal Care Pregnancy Preventive Health Care

Paperwork Burden Eased in CMS Voluntary Self-Referral Disclosure Protocol Filings

In late December 2014, CMS made a small change to its voluntary Self-Referral Disclosure Protocol (SRDP) to help reduce some of the paperwork burden associated with filing under the SRDP. Section 6409 of the Affordable...more

1/20/2015 - Affordable Care Act CMS Healthcare HHS Self-Referral Disclosure Protocol Stark Law

CMS Proposes Changes to the Medicare Shared Savings Program MSSP

On December 1, 2014, CMS published its proposed changes and updates to the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs). Comments are due by February 6, 2015. Below is a summary of the...more

1/9/2015 - ACOs CMS Healthcare Medicare Medicare Shared Savings Program Proposed Amendments

Recent Changes to Stark Law's Whole Hospital Exception

The federal physician self-referral law, or Stark Law, provides a number of exceptions to the law's prohibition of physician referrals of designated health services to an entity in which the physician has an ownership or...more

12/19/2014 - Affordable Care Act CMS Healthcare Hospitals Patient Referrals Physician Ownership Physicians Stark Law

OIG's 2015 Work Plan Highlights Departmental Priorities

Each year the Department of Health and Human Services, Office of the Inspector General (OIG) issues its Work Plan to identify for the provider community the key fraud and abuse issues on which it will focus on in the coming...more

11/24/2014 - Ambulance Providers Ambulatory Surgery Centers CMS Health Care Providers HHS Home Health Agencies Hospice Hospitals Medical Devices Nursing Homes OIG Prescription Drugs Work Plans

Medigap Policy Contract with Preferred Hospital Networks Approved by OIG

On August 18, 2014, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued another advisory opinion approving a licensed insurance broker’s proposal to establish a preferred hospital network...more

9/17/2014 - Healthcare Hospitals Medicare Medigap OIG

OMHA Announces Two New Programs to Process Administrative Law Judge (ALJ) Hearings More Efficiently

Earlier this year, the Office of Medicare Hearings and Appeals (OMHA) announced that for most hearing requests received after April 1, 2013, it will be deferring assignment of ALJs. OMHA’s announcement is available on its...more

8/21/2014 - Administrative Hearings ALJ Mediation OMHA Statistical Sampling

CMS Publishes FY 2015 Final IPPS Rule

On August 4, 2014, CMS posted its final changes and updates to the Medicare Inpatient Prospective Payment System (IPPS) that apply for fiscal year (FY) 2015, effective October 1, 2014. Below are some of the highlights of the...more

8/12/2014 - CMS Final Rules Hospitals IPPS Long Term Care Facilities Medicaid Medicare Physician Medicare Reimbursements

OIG Determines $4.3 Million Improperly Paid to LTCHs for Interrupted Stays in 2010 and 2011

The OIG issued a report on June 3, 2014 summarizing its findings concerning the vulnerabilities and enforcement of Medicare’s interrupted-stay policy for long-term care hospitals (LTCHs). Beneficiaries in LTCHs tend to have...more

7/28/2014 - Healthcare Hospitals Long Term Care Facilities Long-Term Care OIG

Changes Proposed to PRRB Dissatisfaction Requirement

On May 15, 2014, CMS published in the Federal Register its FY 2015 IPPS Proposed Rule [PDF], which included changes and updates to its Medicare IPPS policies. 79 Fed. Reg. 27978-28384. One change that CMS proposes is to amend...more

6/5/2014 - Affordable Care Act CMS Hospitals IPPS Jurisdiction Long Term Care Facilities Medicare Proposed Regulation

Comments Due for New Expedited Review Process for CMS's Voluntary Self-Referral Disclosure Protocol (SRDP)

The creation of the SRDP through the Affordable Care Act as a mechanism to resolve potential Stark violations was welcomed by the industry. However, since enactment of the regulations implementing the SRDP in 2010, the volume...more

5/29/2014 - Affordable Care Act CMS Healthcare Self-Reporting Stark Law Voluntary Disclosure

CMS Publishes Inpatient Prospective Payment System (IPPS) FY 2015 Proposed Rule

On April 30, 2014, CMS posted its proposed changes and updates to the Medicare IPPS [PDF] that would apply beginning in fiscal year (FY) 2015. Comments are due by June 30, 2014. Below is a summary of the major changes to the...more

5/19/2014 - CMS Healthcare Hospitals IPPS Long Term Care Facilities Medicare Proposed Regulation Provider Payments Public Comment

CMS's New System of Records for the Hospice Quality Reporting Program

On April 8, 2014, CMS published in the Federal Register a “Notice of a New System of Records (SOR).” CMS is establishing a new SOR titled, “Hospice Item Set System” (or HIS). ...more

4/28/2014 - CMS Healthcare Hospice

CMS to Test New Models of Care for Hospice: Summary of the Medicare Care Choices Model

On March 18, 2014, CMS launched an initiative to “develop innovate payment systems to improve care options for beneficiaries by allowing greater beneficiary access to comfort and rehabilitative care in Medicare and Medicaid.”...more

4/3/2014 - CMS Healthcare Hospice Medicare

Highlights from OMHA's Medicare Appellant Forum

The Office of Medicare Hearings and Appeals (OMHA) recently announced that for most hearing requests received after April 1, 2013, it will be deferring assigning to Administrative Law Judges (ALJs). OMHA will continue to...more

3/11/2014 - CMS Healthcare HHS Medicaid Medicare OMHA

OIG's 2014 Work Plan: A Roadmap to Key OIG Fraud and Abuse Priorities

The Department of Health and Human Services, Office of the Inspector General (OIG) released its Fiscal Year (FY) 2014 Work Plan on January 31, 2014. While the OIG usually releases its work plan in October of each year, in...more

2/13/2014 - CMS Compliance Fraud and Abuse Healthcare Medicaid Medicare OIG

CMS Creates New G-Code for Chronic Care Management

In the final Physician Fee Schedule for 2014, CMS recognized the critical component proper care management plays in improved outcomes and reduced costs through the creation of a new G-code. (G-codes were initially created for...more

2/12/2014 - CMS Healthcare

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