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
News Briefs - CMS Increases Acute Care Inpatient Hospital Payments by $2.9B - HHS has finalized the fiscal year 2025 Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System rule. The rule...more
In spring 2024, the Centers for Medicare and Medicaid Services (CMS) finalized the Medicaid access rule, which includes a provision that requires that 80% of Medicaid payments for most Medicaid-funded home health aide,...more
On April 22, 2024 the Centers for Medicare & Medicaid Services (CMS) published the Medicaid Program; Ensuring Access to Medicaid Services final rule. The rule has a particular focus on home- and community-based services...more
In May 2023, the Centers for Medicare and Medicaid Services (“CMS”) proposed a series of rule changes intended to help promote the availability of home and community-based services (“HCBS”) for Medicaid beneficiaries. Chief...more
News Briefs - House Subcommittee Considering 15 Bills to Expand Telehealth - A major House subcommittee is considering 15 bills to expand access to telehealth services as the clock ticks on a Dec. 31 deadline on pandemic-era...more
This program is part three of Manatt’s New Federal Rules on Medicaid Access and Managed Care webinar series. After releasing sweeping proposed rules on Medicaid access and managed care in spring 2023, the Centers for...more
News Briefs - More Nonprofit Hospitals Adding Concierge Physician Practices - Nonprofit hospitals created largely to serve the poor are adding concierge physician practices, charging patients annual membership fees of $2,000...more
Applicable Provider Types: Hospice; Home Health Agency - Is Your Entity in Compliance? The Centers for Medicare & Medicaid Services (CMS) finalized and expanded its so-called 36-month rule with certain changes...more
If you have had a loved one suffer from dementia, you know the emotional, physical, and financial toll of this terrible disease. With advancements in dementia treatment, however, there is renewed hope on addressing this...more
Since the Centers for Medicare & Medicaid Services (“CMS”) paused much of its audit activity during the COVID Public Health Emergency, the most recent rounds of Medicare audit activity may represent the first “look” at the...more
The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare enrollment regulations applicable to hospices and home health agencies (HHAs), including increasing the level of screening that...more
In this episode, Husch Blackwell’s Meg Pekarske is joined by friend and industry veteran Kim Skehan. In this wide-ranging conversation, they explore not only the recent survey reforms but the ways in which Kim’s decades of...more
Healthcare systems are facing significant challenges in recruiting and retaining talent within the burgeoning field of behavioral health services, primarily due to competition from telehealth providers and inconsistent...more
Health systems and hospitals have implemented “hospital at home” programs for several years, but the trend increased in popularity during the COVID-19 pandemic due to a Centers for Medicare & Medicaid Services (“CMS”) waiver....more
Centers for Medicare & Medicaid Services (CMS) devised a “Special Focus Program” to identify poor performing hospices and help them improve through more frequent surveys and technical assistance. CMS would also impose...more
On Wednesday, November 1, the Center for Medicare & Medicaid Services (CMS) released its Home Health Prospective Payment System Rate Update final rule for CY 2024 (the Final Rule). The Rule estimates that the aggregate...more
For a variety of unfortunate reasons, some hospices found themselves facing a 4% rate reduction for non-compliance with either Hospice Item Set (HIS) or Consumer Assessment of Healthcare Providers & Systems (CAHPS)...more
CMS has criticized hospices for underutilizing general inpatient care (GIP) but has also specifically targeted GIP claims for audit and medical review. In addition to CMS’s standard tools for reviewing GIP claims, such as...more
On June 6, 2023, the Center for Medicare and Medicaid Services (CMS) provided a Quality Safety & Oversight (QSO) memorandum outlining CMS-identified concerns with respect to the patient discharge process (Memo). As set forth...more
AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more
The U.S. Centers for Medicare & Medicaid Services (“CMS”), the agency that administers the Medicare hospice benefit, has announced increased scrutiny of hospice programs in the wake of growing concerns over hospice service...more
The US Centers for Medicare & Medicaid Services (CMS) recently announced a new, voluntary and nationwide test model designed to support two rapidly growing demographic groups: people living with dementia, and their unpaid...more
Hospices have been the target of increased government scrutiny in 2023, and the Centers for Medicare and Medicaid Services (CMS) is planning to take further aim in 2024 through surveys. Join Husch Blackwell’s Meg Pekarske,...more
Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more
On June 30, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule for the Home Health Prospective Payment System for the 2024 calendar year. The proposed rule aims to permanently update the payment...more