Latest Publications

Share:

CMS Issues Proposed PPS Rule for Inpatient Psychiatric Hospitals

On March 28, 2024, CMS issued its fiscal year (FY) 2025 prospective payment system (PPS) proposed payment rule for inpatient psychiatric hospitals (IPFs). The proposed rule is expected to be published in the Federal Register...more

CMS Issues Proposed PPS Rule for Inpatient Rehabilitation Facilities

On March 29, 2024, CMS published its fiscal year (FY) 2025 prospective payment system (PPS) proposed rule for inpatient rehabilitation facilities (IRFs). Comments are due by 5 pm ET on May 28, 2024. In the IRF PPS proposed...more

House Republicans Intend to Tie GME Training Funds to Ban Gender Affirming Care

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

CMS Announces Initiatives to Strengthen Nursing Home Safety and Transparency

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

Major Changes Finalized to Stark Rules, Anti-Kickback Statute Safe Harbors and the Beneficiary Inducements CMP

CMS and OIG released highly anticipated final changes to the rules implementing the Stark Law, the safe harbors issued under the Anti-Kickback Statute (AKS) and the beneficiary inducements provision in the civil monetary...more

CMS Extends Timeline to Finalize Updated Medicare Rules for Hospitals to June 2020

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

Major Changes to the Medicare Shared Savings Program Impact Current and Prospective ACOs

CMS issued final rules on December 21, 2018, that were published in the December 31, 2018 Federal Register (ACO Final Rules), adopting major changes to the Medicare Shared Savings Program (MSSP) which impact currently...more

California Enacts Sweeping Privacy Law

On June 28, California’s Governor Jerry Brown signed into law the California Consumer Privacy Act of 2018 (AB 375), a broad privacy law modeled after the new European General Data Protection Regulation. The new law, which is...more

OIG Report Alleges that Telehealth Claims Did Not Meet Medicare Requirements

OIG recently issued a report in April 2018 titled, “CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements,” in which it claims to have found that CMS improperly paid practitioners in 31 of 100...more

CMS Announces Plans to Expand Settlement Options to Decrease Medicare Appeals Backlog

On November 3, 2017, CMS announced that it plans to implement two appeals settlement initiatives designed to decrease the backlog of Medicare appeals pending at the Medicare Appeals Council (MAC) of the Department Appeals...more

Bipartisan Congressional Opposition Mounts Against Proposed CY 2019 Home Health Groupings Model in Home Health PPS Proposed Rule

On July 28, 2017, CMS published the calendar year (CY) 2018 Home Health Prospective Payment System (PPS) Proposed Rule (the Proposed Rule) in which it proposed a new CY 2019 Home Health Groupings Model (HHGM). The proposed...more

Court Instructs Federal Agencies to Re-Examine Their Response to Comments Regarding Out-of-Network Emergency Services...

On August 31, 2017, the U.S. District Court for the District of Columbia held that HHS, the Department of Labor and the Department of Treasury (the Departments) failed to adequately address commenters’ concerns and proposed...more

House Committee Issues Letter to HRSA Requesting Audit Documentation Regarding 340B Drug Pricing Program

The House Committee on Energy and Commerce (Committee) sent a letter dated June 1, 2017, to the Health Resources and Services Administration (HRSA) Administrator expressing concerns about the growth and oversight of the 340B...more

CMS Proposes Rule to Update the Hospice Wage Index and Payment Rates and Discusses Hospice Quality Reporting Requirements

On April 27, 2017, CMS released a proposed rule (the Proposed Rule) that would update the hospice wage index, payment rates and cap amount for fiscal year (FY) 2018. It also provides an update with respect to quality...more

Senate Finance Committee May Tackle Medicare Appeals Backlog

According to Kimberly Brandt, Chief Oversight Counsel for the Senate Finance Committee’s majority staff, the Senate Finance Committee could reintroduce the Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of...more

District Court Dismisses Antitrust Suit Against Palmetto Health

On March 2, 2017, the U.S. District for the District of South Carolina dismissed all of Providence’s antitrust and State law claims against Palmetto Health stemming from Palmetto Health’s employment of more than 330 employees...more

DOJ Settles with Nursing Home for Allegations of Worthless Services

On February 1, 2017, an Iowa nursing facility and residential care facility operator entered into a settlement agreement (the Agreement) with DOJ and the State of Iowa for alleged violations of the False Claims Act for the...more

CMS and OIG Issue Notice of Amended Waivers for Next Generation ACO Model

On December 29, 2016, CMS and OIG issued a Notice of Amended Waivers of Certain Fraud and Abuse Laws in Connection with the Next Generation ACO Model (the 2016 Notice). The 2016 Notice does not change or limit arrangements...more

Update on Recent Telehealth Legislation Activity

On November 29, 2016, the Senate passed the Expanding Capacity for Health Outcomes Act, S. 2873 (the ECHO Act) in a 97-0 vote, which would require HHS to study and report on the use of telehealth services that connect...more

CMS Releases OPPS and ASC Payment Final Rules, Finalizes Changes to Off-Campus Provider-Based Status

On November 1, 2016, CMS released the final payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) final rule (OPPS Final Rule) and Ambulatory Surgical Center Payment System Final Rule...more

OMB Is Reviewing MACRA Final Rule

On September 14, 2016, the White House Office of Management and Budget (OMB) received CMS’s final rule implementing the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models established in MACRA. CMS had...more

CMS Proposes New Bundled Payment Models for Cardiac and Orthopedic Care

On July 25, 2016, CMS posted a proposed rule that would create three new Medicare Parts A and B episode payment models for patients admitted for care for a heart attack, bypass surgery or surgical hip/femur fracture treatment...more

Senate Finance Committee Chairman Releases White Paper Examining Potential Reforms to the Stark Law

On June 30, 2016, Senate Finance Committee Chairman Orrin Hatch released a white paper examining potential reforms to the Federal Stark law. The white paper, entitled “Why Stark, Why Now? Suggestions to Improve the Stark...more

23 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide