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 August 15, 2024, CMS announced the results of the first round of the negotiated prices between CMS and participating drug manufacturers for the 10 selected drugs under the Inflation Reduction Act’s (IRA) Medicare Drug...more
The IRA’s Medicare Drug Price Negotiation Program (the “Negotiation Program” or “Program”), which enables the federal government to negotiate prices for some of the costliest Medicare Part D drugs, has been subject to several...more
In 2024, Medicare will, for the first time, have authority under the Inflation Reduction Act passed in 2022 to negotiate drug prices with pharmaceutical manufacturers. On August 29, the Centers for Medicare and Medicaid...more
On Aug. 29, the Centers for Medicare & Medicaid Services (“CMS”) issued the inaugural list of drugs selected for price setting under the Inflation Reduction Act of 2022 (IRA). Those selected drugs are Eliquis, Jardiance,...more
On December 9, 2022, a federal judge in Montana permanently blocked enforcement in healthcare settings of a first-in-the-nation law that had prohibited discrimination in employment and the provision of services based on...more
There have been several significant rulings on various provisions of the False Claims Act (FCA) in the first quarter of this year, which we highlight in this post. Government Dismissal Authority - To start the year, in...more
OSHA’s Emergency Temporary Standard - On November 5, 2021, the Occupational Safety and Health Administration (OSHA) issued an Emergency Temporary Standard (ETS) requiring most employers with 100 or more employees to either...more
Our Blog has been monitoring the ETS that OSHA issued in November 2021 that mandated employers of 100 or more employees to require their employees to obtain COVID-19 vaccinations or undergo regular COVID-19 testing instead. ...more
On Jan. 13, 2022, the United States Supreme Court (SCOTUS) granted an emergency request for relief staying the Occupational Safety and Health Administration’s Emergency Temporary Standard (ETS), requiring all employers with...more
Recently, the U.S. Supreme Court blocked the OSHA Emergency Temporary Standard (“ETS”) that would have required all employers with 100+ employees to mandate vaccination or testing, while allowing the Department of Health and...more
The Biden Administration continues its march towards implementation and enforcement of permanent vaccination mandates. OSHA withdraws OSHA Emergency Temporary Standard (ETS) - On January 13, 2022, the Administration’s...more
The Occupational Safety and Health Administration (OSHA) announced today, Jan. 25, 2022, that it is withdrawing its November 5, 2021 Emergency Temporary Standard (ETS), which would have required many private employers with...more
On January 25, 2022, the US Occupational Safety and Health Administration (OSHA) announced that it would withdraw its controversial “vax-or-test” Emergency Temporary Standard (ETS), which required large employers to impose...more
The legal landscape around COVID-19 policies and vaccine mandates in the workplace continues to shift under the feet of US employers. With the January 13 US Supreme Court ruling on the OSHA and CMS vaccine rules, and...more
Following the United States Supreme Court’s recent decision to enforce the COVID-19 vaccine mandate over healthcare workers at facilities that participate in Medicare and Medicaid, the deadline to become fully vaccinated has...more
On January 13, 2022, the Supreme Court issued its first rulings related to the Biden Administration’s COVID-19 vaccine mandates. In the case of NFIB v. OSHA, by a vote of 6-3, the Court held that the COVID-19 vaccination and...more
On January 13, 2022, the U.S. Supreme Court blocked OSHA’s “vaccine or test” Emergency Temporary Standard (“ETS”) mandate in a split 6-3 decision. Without the ETS, employers are not required to mandate vaccinations, but...more
On January 14, 2022, after the decision by the U.S. Supreme Court in Biden v. Missouri, the Centers for Medicare & Medicaid Services (CMS) issued guidance in QSO-22-09-ALL (“January 14 Memo”) on application of the November 5,...more
On January 13, 2022, the U.S. Supreme Court (“Court”) issued split decisions regarding Federal vaccine mandates issued by the Centers for Medicare and Medicaid Services (CMS) and the Occupational Safety and Health...more
What’s Next for Employers After SCOTUS’ Decisions on the OSHA ETS Mandate and the CMS Rule? On January 13, 2022, the U.S. Supreme Court reinstituted the stay of the federal vaccine or testing mandate, effectively killing...more
On Thursday, January 13, 2022, the U.S. Supreme Court issued a stay pausing implementation of the Occupational Safety and Health Administration (OSHA) Emergency Temporary Standard (ETS), finding that the challengers to the...more
On the same day that the United States Supreme Court imposed a stay of enforcement on OSHA’s vaccine mandate for private employers with over 100 employees, the Court ruled that the Centers for Medicare & Medicaid Services...more
Caption: On January 13, 2022, after hearing emergency oral arguments, the Supreme Court handed down decisions staying OSHA’s ETS and upholding the CMS Rule requiring healthcare workers to be fully vaccinated against...more
As stated in our previous client alert, the Centers for Medicare and Medicaid Services (CMS) set compliance dates for the vaccine mandate in all of the states where the injunction had been lifted, which became official for...more
Ever since the Sixth Circuit dissolved the injunction to OSHA’s Emergency Temporary Standard (ETS), which mandates employers with 100 employees or more to require employees be vaccinated or submit to weekly testing and wear...more