The CMS Interoperability and Prior Authorization Rules
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Findings from Gibbins’ Annual Healthcare Bankruptcy Report
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Transparency and the Open Payments Program
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Behind the Curtain: Enhanced Provider Enrollment Oversight
Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences
Inflation Reduction Act’s Drug Price Negotiation Provisions – What Now? – Diagnosing Health Care Podcast
A Glimpse Into the Other Side: Understanding the Perspective of Government Enforcers
I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules
Podcast: Inflation Reduction Act’s Drug Price Negotiation Provisions – What’s Next? - Diagnosing Health Care
Quick Takeaways From the 2024 Proposed Hospice Wage Index Rule
On June 28, 2024, the Supreme Court made a sharp about-face from a doctrine that has governed administrative law for decades, overruling the “Chevron deference” doctrine with its decisions in Loper Bright Enterprises v....more
These days, efforts by the federal government to mandate COVID-19 vaccinations for various groups seem like ancient history. Nevertheless, federal courts continue hearing challenges to the mandates filed by state governments,...more
After hearing oral argument on January 7, 2022, on January 14, 2022, the Supreme Court issued a ruling staying the Biden administration’s vaccine or testing mandate for large employers. As many doubtless know, on...more
A pair of rulings issued by the United States Supreme Court on January 13, 2022 provided employers with some clarity on vaccine mandates pushed by the Biden Administration. One ruling blocked the Vaccination or Test Emergency...more
On September 9, 2021, President Biden announced a plan “to require more Americans to be vaccinated.” As part of that plan, President Biden instructed the Department of Labor to issue an emergency rule mandating that employers...more
The U.S. Supreme Court today reached split decisions on the so-called vaccination mandates issued, respectively, by the Occupational Safety and Health Administration (OSHA) and the Centers for Medicare & Medicaid Services...more
Today, the United States Supreme Court decided to block the OSHA Emergency Temporary Standard (“ETS”) requiring that employers with 100 or more employees ensure that their employees are vaccinated or tested weekly for...more
A divided Supreme Court delivered two highly-anticipated decisions on January 13, 2022, announcing whether the federal Occupational Safety and Health Administration (OSHA) and Centers for Medicare & Medicaid Services (CMS)...more
Key Takeaways of the Court’s Rulings: OSHA cannot enforce its vax-or-test ETS covering all employers with 100 or more employees, and employers have no obligations under it. However, the CMS mandate affecting certain health...more
On December 7, 2021, the Supreme Court of the United States heard oral argument on the cases challenging both the secretary of Health and Human Services’ interim final rule and the secretary of Labor’s emergency temporary...more
On Thursday, January 13, 2022, the Supreme Court of the United States stayed the Occupational Safety and Health Administration’s (OSHA) COVID-19 Vaccination and Testing Emergency Temporary Standard (ETS). The Court remanded...more
On January 13 in two highly anticipated decisions, the U.S. Supreme Court first reinstated an injunction blocking implementation of the Occupational Safety and Health Administration’s COVID-19 emergency temporary standard...more
In a 6-3 decision, the US Supreme Court voted to stay the vaccine-or-test regulation, ruling that the Biden administration’s vaccine-or-test requirements for large private companies exceeded their authority. Separately, the...more
The United States Supreme Court blocked the Biden administration from implementing and enforcing its OSHA vaccine-or-test requirements for large, private companies, see here. In a 6-3 majority opinion, the Court found that...more
Keeping track of a dizzying number of injunctions and stays by multiple federal district courts and courts of appeal involving three separate federal COVID-19 vaccination mandates with a couple exceptions is no small task....more
This is a big legal week for hospitals and health systems as the U.S. Supreme Court heard not one, but TWO different oral arguments related to federal government payments to hospitals and health systems. In both cases, the...more
A number of health care related cases have come before the United States Supreme Court this session, including two cases on topics we have previously reported on: Medicare’s site-neutral payment policy for off-campus...more
The United States Court of Appeals for the District of Columbia recently upheld CMS's authority to expand site-neutral payment reductions for evaluation and management (E&M) services provided at longstanding off-campus...more
On July 31, 2020, the D.C. Circuit Court of Appeals issued a decision reversing a lower court decision and upholding Medicare payment cuts to certain hospitals participating in the 340B drug pricing program that have been in...more
As forewarned, CMS's finalization of the Calendar Year (CY) 2020 Physician Fee Schedule, effective January 1, 2020, brings significant changes to its authority to deny or revoke a Medicare enrollment for physicians and other...more
In a September 17, 2019 decision, the United States District Court for the District of Columbia invalidated a CMS rule expanding site-neutral payment reductions to evaluation and management (E&M) services furnished in...more
The Final Rule Requires Manufacturers to Disclose List Prices of Prescription Drugs and Biological Products in Television Advertisements - On May 8, 2019, the U.S. Department of Health and Human Services (HHS or the...more
On October 4, 2016 CMS issued its Final Rule entitled “Reform of Requirements for Long Term Care Facilities” which updates the requirements for all SNFs and NFs participating in Medicare and Medicaid. Many of the changes...more
The Office of Inspector General of the Department of Health and Human Services (OIG) has issued updated guidance on the use of its so-called permissive exclusion authority under Section 1128(b)(7) of the Social Security Act...more
Proposed rules, touted as enhancing the provider enrollment process, would provide CMS with sanction authority that closely parallels the OIG’s exclusion authority. Under the proposed rules, CMS would have expanded bases to...more