Debra McCurdy

Debra McCurdy

Reed Smith

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CDC Issues Final Quarantine Rule to Strengthen Control of Communicable Diseases

The Centers for Disease Control and Prevention (CDC) has issued a final rule to strengthen the federal government’s ability to prevent the introduction, transmission, and spread of communicable diseases into the United States...more

1/19/2017 - CDC Public Health

SAMHSA Releases Final and Supplemental Proposed Rules on Substance Abuse Records Privacy Protections

A new Substance Abuse and Mental Health Services Administration (SAMHSA) final rule is intended to modernize federal regulations governing the confidentiality of substance abuse records. SAMHSA explains in the preamble that...more

1/19/2017 - HHS SAMHSA Substance Abuse

Obama Administration Finalizes Changes to Home Health Conditions of Participation

CMS has finalized extensive changes to the conditions of participation (CoPs) that home health agencies (HHAs) must meet to participate in the Medicare and Medicaid programs. The rule is intended to provide HHAs with enhanced...more

1/19/2017 - CMS Health Care Providers Home Health Agencies Home Health Care

CMS Guidance on Off-Campus Provider-Based Department Policy Changes

CMS recently released guidance on how hospitals can request from their CMS Regional Office a relocation exception from site-neutral payment rates for an excepted off-campus department of a provider due to an extraordinary...more

1/19/2017 - 21st Century Cures Act CMS Health Care Providers Outpatient Prospective Payment System (OPPS)

CMS to Host Call on Transitioning Physician Quality Reporting to MIPS (Jan. 24)

On January 24, 2017, CMS is hosting a call to discuss how to complete the final reporting period for the “legacy” Medicare physician quality reporting programs (Physician Quality Reporting System, Medicare Electronic Health...more

1/12/2017 - CMS Electronic Health Record Incentives Health Care Providers Medicare MIPS

CMS Again Extends HHA/Ambulance Enrollment Moratoria in Selected States

The Centers for Medicare & Medicaid Services (CMS) is extending for six months its current moratoria on the Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollment of new nonemergency ground ambulance...more

1/12/2017 - CHIP CMS Health Care Providers Home Health Agencies Moratorium

OIG Issues Annual Solicitation of Suggestions for New Fraud Alerts, Anti-Kickback Safe Harbors

The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) is inviting public recommendations for new or modified safe harbor provisions under the federal anti-kickback statute. The OIG also...more

1/12/2017 - Anti-Kickback Statute Health Care Providers HHS OIG Safe Harbors

CMS Corrects Final 2017 OPPS/ASC Rule, Results in Slight Payment Increase

CMS has published a notice correcting technical errors in its November 14, 2016 final rule with comment period updating the Medicare hospital outpatient prospective payment system (OPPS) and ambulatory surgical center payment...more

1/12/2017 - CMS Health Care Providers Hospitals Medicare OPPS

GAO Highlights Barriers to Small & Rural Provider Participation in Medicare Value-Based Payment Models

CMS has developed a variety of Medicare value-based payment models that tie payments to quality and efficiency metrics, and the importance of such models to physicians will increase under the new Quality Payment Program. The...more

12/22/2016 - CMS GAO Health Care Providers Medicare Quality Payment Program (QPP)

OIG Semiannual Report Highlights FY 2016 Fraud Recoveries, Enforcement Actions

The HHS Office of Inspector General’s (OIG) latest its Semiannual Report to Congress highlights top audits, investigations, and enforcement activities for the period of April 1 to September 30, 2016 and summarizes overall...more

12/22/2016 - Audits False Claims Act (FCA) Health Care Providers HHS OIG Unjust Enrichment

CMS Issues Final Mandatory Episode Payment Models for Cardiac and Orthopedic Cases, Plus New Cardiac Rehabilitation Incentive...

In the waning days of the Obama Administration, the Centers for Medicare & Medicaid Services (CMS) has unveiled a lengthy and complex final rule to establish mandatory Medicare bundled payment programs for acute myocardial...more

12/22/2016 - CMMI CMS Episode Payment Models (EPM) Final Rules HHS Inpatient Prospective Payment System (IPPS) Medicare OIG

OIG Finalizes Expanded CMP Authorities under the ACA

The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) has published a final rule to codify the OIG’s expanded authority under the Affordable Care Act (ACA) to impose civil monetary...more

12/21/2016 - Affordable Care Act Civil Monetary Penalty EMTALA Final Rules HHS OIG

GAO Calls for Improvements to CMS Nursing Home Rating System

The Government Accountability Office (GAO) has reviewed the Medicare Five-Star Quality Rating System for nursing homes and identified several factors that may prevent consumers from using the website “as an easy way to...more

12/21/2016 - CMS GAO Health Care Providers HHS Nursing Homes

GAO Assesses Impact of Medicare DMEPOS Competitive Bidding Program on Beneficiary Access, OIG Documents Market Share for Diabetes...

The number of Medicare beneficiaries who received durable medical equipment (DME) items generally fell after Round 2 of competitive bidding program (CBP) and the national mail-order program for diabetes testing supplies were...more

12/21/2016 - Competitive Bidding DMEPOS Durable Medical Equipment GAO HHS Medicare OIG

CMS Announces New Medicare Prior Authorization Requirements for Two Types of Power Wheelchairs

Beginning in March 2017, CMS is phasing in new Medicare prior authorization (PA) requirements for two types of power wheelchairs under a policy adopted in a final rule issued late in 2015. As previously reported, CMS...more

12/21/2016 - CMS DMEPOS Durable Medical Equipment Medicare Prior Authorization

CMS Announces Three New Innovation Models, Focusing on Patient Engagement and Dual-Eligible Population

The CMS Center for Medicare & Medicaid Innovation (CMMI) continues to launch initiatives to test ways to improve the quality of health care while controlling cost, despite an uncertain fate under the future Trump...more

12/21/2016 - ACOs CMMI CMS Health Care Providers Medicaid Medicare

CMS Issues Final ACA Benefit and Payment Policies for 2018; Questions Loom Over Implementation

On December 16, 2016, CMS released its Affordable Care Act (ACA) Notice of Benefit and Payment Parameters final rule and the final Annual Letter to Issuers for the 2018 plan year. Notably, the final rule revises the risk...more

12/20/2016 - Affordable Care Act CMS Health Care Providers

President Signs “Expanding Capacity for Health Outcomes Act” into Law

President Obama has signed into law S. 2873, the Expanding Capacity for Health Outcomes Act (ECHO Act), which is intended to use “distance health education” to improve health care, particularly in medically-underserved areas....more

12/19/2016 - Barack Obama Health Care Providers Rural Areas Secretary of HHS

CMS Releases Standardized Hospital Medicare Outpatient Observation Notice Form

Hospitals are facing a March 8, 2017 deadline to begin using the new Medicare Outpatient Observation Notice (MOON) to inform Medicare beneficiaries when they are outpatients receiving observation services and not inpatients...more

12/19/2016 - Beneficiaries CMS Hospitals Medicare Medicare Outpatient Observation Notice (MOON) NOTICE Act

Conflict of Interest Concerns Prompt New CMS Restrictions on Dialysis Facility Payment of Beneficiary Health Plan Premiums; Allows...

Citing “differences between providers’ and suppliers’ financial interests and patients’ interests” that “may result in providers and suppliers taking actions that put patients’ lives and wellbeing at risk,” CMS is imposing...more

12/19/2016 - CMS Conflicts of Interest Dialysis ESRD Medicaid Medicare

Medicare, Medicaid Payment Policies, Fraud Authorities Enacted as Part of 21st Century Cures Act

On December 13, 2016, President Obama signed into law the 21st Century Cures Act (Cures Act). While much of the focus has been on policies intended to accelerate drug and device development and approval, the Cures Act also...more

12/16/2016 - 21st Century Cures Initiative Barack Obama CMS Durable Medical Equipment EHR Health Care Providers Health Information Technologies HHS Medicaid Medicare Pharmaceutical Industry

CMS Issues Additional ACA Medicaid and CHIP Eligibility, Appeals, Enrollment Regulations

CMS has published a final rule that implements various Medicaid and Children’s Health Insurance Program (CHIP) eligibility, appeals, and related administrative changes under the Affordable Care Act (ACA) that were proposed in...more

12/16/2016 - Affordable Care Act CHIP CMS Medicaid Trump Administration

OIG Spreads Holiday Cheer By Increasing “Nominal Value” Limits for Gifts to Medicare Beneficiaries

The Office of Inspector General (OIG) has increased the value of permissible gifts that may be made to Medicare beneficiaries without running afoul of the civil monetary penalty (CMP) provision prohibiting beneficiary...more

12/9/2016 - Beneficiaries Civil Monetary Penalty Inducements Medicaid Medicare OIG

CMS Releases 2017 Medicare DMEPOS and Clinical Lab Fee Schedules

CMS has announced 2017 Medicare fee schedule rates for durable medical equipment (DME) prosthetic orthotics and supplies (DMEPOS) furnished in non-competitive bidding areas. The calendar year 2017 DMEPOS update factor is 0.7...more

12/7/2016 - CMS Competitive Bidding DMEPOS Durable Medical Equipment Medicare

Out with the Old Rules? Will Trump and Republicans Target Health Care Regulations for Reversal in the New Year under...

The Congressional Review Act (CRA) has been used to overturn only one final rule in 20 years, but that situation may be about to change. According to a new Congressional Research Service (CRS) analysis, a “specific set of...more

11/23/2016 - Congressional Review Act Donald Trump HHS Long Term Care Facilities Medicaid Medicare Opioid

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