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
On August 13, 2024, the Centers for Medicare and Medicaid Services (CMS) and its Center for Clinical Standards and Quality / Quality, Safety & Oversight Group issued its memorandum QSO-24-17-EMTALA (the “Memorandum”),...more
The Centers for Medicare and Medicaid Services (CMS) recently announced the release of updated model signage for use by Medicare-participating hospitals to inform patients of their rights under the Emergency Medical Treatment...more
As a general rule, healthcare employers are required to pay employed physicians and other contracted providers fair market value (FMV) for their services, but many employers do not understand relevant regulatory standards. ...more
On June 27, 2024, the U.S. Supreme Court dismissed Idaho v. United States on procedural grounds and sent the case back to the Ninth Circuit. By doing so, the Supreme Court reinstated the preliminary injunction issued by the...more
Almost 40 years after its passing, the Emergency Medical Treatment and Active Labor Act (EMTALA) remains not only a key consideration for hospitals with emergency departments, but also a significant federal enforcement...more
On May 21, the Centers for Medicare and Medicaid Services (CMS) announced a new option on CMS.gov to allow individuals to more easily file an Emergency Medical Treatment and Labor Act (EMTALA) complaint. Before launching the...more
CMS’s New Actions Related to EMTALA - On January 22, 2024, the Department of Health and Human Services (HHS) announced that, through the Centers for Medicare & Medicaid Services (CMS), it will launch a comprehensive plan...more
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have started a new effort to educate the public about the Emergency Medical Treatment and Labor Act (EMTALA)....more
Last week, McDermott+Consulting launched an election 2024 resource page, where you can find a 2024 health policy outlook and other insights into the November election. While regulations aren’t necessarily top-of-mind when...more
The Centers for Medicare and Medicaid Services (CMS) has increasingly focused its efforts on investigating hospital emergency departments for potential violations of the Emergency Medical Treatment and Labor Act (EMTALA),...more
The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more
On May 1st, the Centers for Medicare and Medicaid Services (CMS) announced investigations into two hospitals that did not provide necessary stabilizing treatment to a pregnant individual experiencing an emergency medical...more
In Idaho, persons under the age of 18 (“minors”) may consent to their own healthcare in only limited circumstances. General Rule: Obtain Consent from Parent or Surrogate Decision Maker. Idaho Code § 39‑4503 sets forth...more
On May 1, 2023, the Centers for Medicare and Medicaid Services (“CMS”) announced two investigations of hospitals that failed to offer necessary stabilizing care to a pregnant individual experiencing an emergency medical...more
The impending end of the COVID-19 national and public health emergency will present a complicated landscape to navigate for hospital systems, which look to minimize the impact of the transition to post-pandemic normality....more
The Biden Administration has announced that the federal Public Health Emergency (PHE) for COVID-19 will expire at the end of the day on May 11, 2023. During the COVID-19 PHE, the Centers for Medicare & Medicaid Services (CMS)...more
The terms clinically stable and stable for transfer are frequently used by and familiar to emergency department and hospital staff. When it comes to compliance with the Emergency Medical Treatment and Labor Act (EMTALA) in...more
On January 30, 2023, President Biden announced that both the COVID-19 national emergency and the public health emergency (PHE) will end May 11, 2023. This announcement has left many healthcare providers considering how the...more
The Centers for Medicare & Medicaid Services (CMS) released to the public on Dec. 5, 2022, new training materials (Training Materials) on the Emergency Medical Treatment and Labor Act (EMTALA) consisting of a new, high-level...more
Since the US Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization (Dobbs) in June 2022, the impact of the Court’s decision continues to ripple across the health care delivery system. In this multi-part series,...more
In recent months, decisions and laws limiting abortion rights in the United States have forced health care providers that serve pregnant women to keep abreast of quickly changing legal restrictions affecting their...more
The Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals with emergency departments and participating in Centers for Medicare and Medicaid Services (CMS) programs to provide medical screening, treatment and...more
In a newly filed lawsuit against the State of Idaho, the federal government argues that Idaho’s “near-total ban on abortion,” scheduled to take effect on August 25, 2022, overreaches by prohibiting abortion even where federal...more
According to guidance published by the Centers for Medicare and Medicaid Services (CMS) on July 11, 2022, EMTALA, the Emergency Medical Treatment and Labor Act of 1986, requires hospitals to provide abortion services when...more
In response to the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, the U.S. Department of Health and Human Services (“HHS”) Secretary Xavier Becerra directed HHS agencies to act within their power to...more