Affordable Care Act, Healthcare, OIG

Is Your Employee or Contractor Excluded?

Quarles & Brady LLP on 6/10/2024

Employers must check its employees, contractors and vendors to see if an individual or organization is excluded from participating in federal and/or state programs. While there are a variety of exclusion programs at the...more

DOJ Antitrust Division and HHS OIG Enter into Partnership to Increase Coordination and Enforcement in Health Care

Foley & Lardner LLP on 12/14/2022

On December 9, 2022, the U.S. Department of Justice Antitrust Division (DOJ) and Office of Inspector General of the U.S. Department of Health and Human Services (OIG) announced they had entered a Memorandum of Understanding...more

COVID-19: Resources for Oncology Providers (Medicaid, Grants, & Stark Law Waivers)

Foley & Lardner LLP on 4/16/2020

The Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (HHS), the Office for Civil Rights (OCR), the Office of the Inspector General (OIG), and other Federal and State agencies and...more

HHS Issues Advisory Opinion on PREP Act: Immunity May Extend Beyond Actual Covered Persons and Approved Countermeasures

Seyfarth Shaw LLP on 4/15/2020

With crisis comes uncertainty, and even the best-intentioned regulations can leave those combating the current COVID-19 public-health emergency out in the cold. Many have asked whether the recent Declaration under the...more

CMS Announces New Priorities for Facility Surveys and Inspections

Seyfarth Shaw LLP on 3/25/2020

In light of findings from the COVID-19 outbreak at a nursing home in Kirkland, Washington, the Centers for Medicare and Medicaid Services (CMS) has announced that it will suspend all routine facility inspections and surveys...more

HHS OIG Issues Final Regulation Addressing Exclusion Authority

King & Spalding on 1/19/2017

On January 12, 2017, the HHS OIG issued its final rule amending regulations relating to its authority under the Affordable Care Act (ACA) to exclude individuals and entities from participation in federal healthcare programs....more

HHS OIG Finalizes New Exclusion Rules as Administration Exits

Hogan Lovells on 1/13/2017

With just a week left before a new administration takes office, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) finalized changes to the regulations authorizing OIG to exclude...more

OIG Revises Safe Harbors under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements

McDermott Will & Emery on 12/14/2016

On December 7, 2016, the Office of Inspector General of the US Department of Health and Human Services published a final rule containing revisions to both the federal Anti-Kickback Statute safe harbors and the beneficiary...more

2016 Health Care Year in Review

Burr & Forman on 12/12/2016

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Manatt on Health Reform: Weekly Highlights - November 2016 #3

Manatt, Phelps & Phillips, LLP on 11/16/2016

In a special “Manatt on Health Reform” feature, we track Governors’ and state healthcare officials’ reactions to the Presidential election; HHS plans investigations into rising drug costs; and Colorado voters reject a...more

Proposed Rule to Strengthen State Medicaid Fraud Control Units

Polsinelli on 11/7/2016

A recently published proposed rule expands the functions and responsibilities of state Medicaid Fraud Control Units (MFCUs). The rule was issued by the Centers for Medicare and Medicaid Services (CMS) and the Office of...more

Manatt on Health Reform: Weekly Highlights - October 2016 #3

Manatt, Phelps & Phillips, LLP on 10/26/2016

HealthCare.gov consumers begin previewing 2017 coverage options as HHS projects a 9% enrollment increase over last year and an average 22% benchmark premium increase; Oregon study finds increased primary care spending in...more

Manatt on Health Reform: Weekly Highlights - October 2015 #3

Manatt, Phelps & Phillips, LLP on 10/21/2015

Arizona seeks Medicaid Waiver to implement new coverage restrictions for Medicaid expansion enrollees and delivery system reform; Tennessee’s uninsured rate continues to drop; and Louisiana gubernatorial candidates line up...more

Washington Healthcare Update

McGuireWoods LLP on 10/20/2015

Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...more

A&B Healthcare Week In Review, September 2015

Alston & Bird on 10/1/2015

On September 25, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled “Medicare Program: Medicare Clinical Diagnostic Laboratory Tests Payment System”. This proposed rule would...more

Manatt on Health Reform: Weekly Highlights - September 2015 #5

Manatt, Phelps & Phillips, LLP on 9/30/2015

New study shows Marketplace premiums parallel the employer market; Montana likely to select a private insurer to administer benefits to its Medicaid expansion population; and Washington’s Exchange customers will begin paying...more

Manatt on Health Reform: Weekly Highlights - September 2015 #4

Manatt, Phelps & Phillips, LLP on 9/23/2015

The Massachusetts Marketplace takes steps to ease consumer confusion by reducing choice among QHPs; North Carolina appears poised to pass Medicaid reform legislation; and bipartisan support is gaining for defining businesses...more

Hospital Compliance Program Overview

Poyner Spruill LLP on 8/27/2015

In the constantly evolving climate of health care enforcement, maintaining a comprehensive and effective internal compliance program has taken on added significance, especially in the past few years. While detailed coverage...more

Health Law Pulse - August 2015

Robinson & Cole LLP on 8/18/2015

The Office of the Inspector General (OIG) recently issued a favorable advisory opinion (Advisory Opinion) to a nonprofit health system (System) and a nonprofit psychiatric hospital (Center) regarding a proposal whereby the...more

Manatt on Health Reform: Weekly Highlights - August 2015 #2

Manatt, Phelps & Phillips, LLP on 8/12/2015

Reductions in uninsured rates are greatest in states with Medicaid expansions and State-based or State Partnership Marketplaces; Kentucky finds increased use of preventive healthcare following Medicaid expansion; and,...more

Washington Healthcare Update

McGuireWoods LLP on 7/21/2015

This Week: Senate Reauthorizes Older Americans Act; Bill Heads to the House... White House Holds 2015 Conference on Aging and Launches Several New Administration Healthy Aging Initiatives Enveloping Alzheimer’s, Dementia,...more

SGR Law Brings Changes to CMP Prohibition on Gainsharing

K&L Gates LLP on 4/20/2015

On April 16, President Barack Obama signed into law the “Medicare Access and CHIP Reauthorization Act of 2015,” ending a perennial struggle over the Medicare reimbursement formula for physicians. Although the law is most...more

OIG Report Outlines Five Recommendations for Hospice Care Reform

Obermayer Rebmann Maxwell & Hippel LLP on 2/20/2015

The Patient Protection and Affordable Care Act requires the Centers for Medicare and Medicaid Services (“CMS”) to reform the hospice payment system, collect data relevant to revising hospice payments and develop quality...more

Challenges Physicians Can Expect in 2015

McAfee & Taft on 1/12/2015

Reimbursement for medical services continues to decline. Continuing uncertainty about the Affordable Care Act persists. Government regulations create burdensome paperwork, busywork, and compliance headaches. Technology costs...more

2014 – The Health Law Year in Review

Bradley Arant Boult Cummings LLP on 12/31/2014

Each year brings significant changes and challenges in the laws governing the health care industry, and 2014 proved to be no exception. What the year may have lacked in the high drama that accompanies comprehensive health...more

Patient Protection and Affordable Care Act (PPACA) › Healthcare › Office of the Inspector General

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