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
An April 2024 independent report (“Report”) analyzed the results of the first four years following implementation of the Maryland Total Cost of Care Model (the “TCOC Model”), finding that between 2019 and 2022 (the “TCOC...more
The New York State fiscal year 2024 – 2025 budget was signed on April 20, 2024, instituting, among many other provisions, a new tax on health plans, including insurers and managed care organizations. This tax has been...more
The long term care industry is currently in the midst of a labor crisis, with nursing homes in particular experiencing chronic and severe staffing shortages. Even before the COVID-19 pandemic, a rapidly aging population,...more
A key element of the Medicaid Redesign Team 1115 Waiver amendment is the Medicaid Hospital Global Budget Initiative (GBI), a reimbursement model tied very closely to the States Advancing All-Payer Health Equity Approaches and...more
On January 29, 2023, a Florida Magistrate Judge recommended denying the State of Florida’s Motion for Preliminary Injunction and granting CMS’s Motion to Dismiss in connection with the implementation and enforcement of its...more
During the COVID-19 pandemic, telehealth utilization exploded. Globally, the telehealth market is valued at $83.5 billion and is expected to grow by 24% between 2023 and 2030. As services delivered via telehealth became more...more
Welcome back! We hope everyone had a great start to 2023. A new year provides an opportunity to look back on previous successes and identify areas for growth (this said, we certainly don’t expect everyone to make—let alone...more
Telemedicine is being used in innovative ways in freestanding emergency centers (a.k.a. FECs or FSEDs) around the country. Still, providers must stay compliant with Texas law and federal telemedicine regulations. ...more
Effective January 1, 2023, the recently enacted California Assembly Bill 1278,requires a physician and surgeon (defined as a physician and surgeon licensed pursuant to the Medical Practice Act or an osteopathic physician and...more
Two recent pieces of legislation will amend the Pennsylvania Health Care Facilities Act: Senate Bill 818 concerning Ambulatory Surgery Centers (“ASCs”), which is on the Governor’s desk awaiting signature, and Act 30 of 2022...more
On April 29, 2022, the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs...more
Hello readers! Today’s post focuses on a topic we’ve touched on a few times in the past – Medicaid drug formularies. Back in December 2021, the state of Oregon released a draft Medicaid waiver proposal that caught the...more
Following the Supreme Court’s decision in Biden v. Missouri, CMS will require those states previously subject to federal district court injunctions to be compliant with the “Phase 1” requirements of its Interim Final Rule...more
On February 2, 2022, Steptoe & Johnson PLLC attorneys Bill Wahoff, Jeff Tour, and Ashley Faulkner held an interactive webcast and provided employers an opportunity to ask questions related to paying for testing, creating...more
On January 22, 2022, Georgia and the Georgia Department of Community Health filed suit against the Centers for Medicare & Medicaid Services (CMS) seeking to prevent the rescission of the central aspects of Georgia’s 1115...more
On January 25, 2022, the federal Occupational Safety and Health Administration (“OSHA”) announced its withdrawal of the COVID-19 Emergency Temporary Standard (“ETS”) requiring vaccination or weekly testing. This action came...more
The vaccine mandates President Biden announced on September 9 have not aged well. Two are enjoined nationwide and a skeptical Supreme Court so undermined one that the government withdrew it, at least for the immediate future....more
On Wednesday, January 26, 2022, the U.S. Occupational Safety and Health Administration (OSHA) published a notice that it had formally withdrawn the OSHA COVID-19 Vaccination and Testing Emergency Temporary Standard (ETS) that...more
Benesch reviews state, federal modifications to restrictive covenant laws - In a “Year-End Review,” Benesch points out there was considerable activity in trade secret and restrictive covenant law in 2021. Some of the...more
On December 28, 2021, the Centers for Medicare and Medicaid Services (CMS) Quality, Safety and Oversight Group released a memorandum (QSO-22-07-ALL) providing guidance and details on survey procedures for assessing and...more
The Centers for Medicare & Medicaid Services (CMS) announced it will enforce the COVID-19 Health Care Staff Vaccination Interim Final Rule in the 25 states, District of Columbia, and territories in which the healthcare...more
In the past few days, there have been multiple developments in the legal challenges to the various vaccine mandates, one in favor of a mandate, one against. In addition, the first vaccine mandate challenge has now reached the...more
Judge Terry A. Doughty of the United States District Court for the Western District of Louisiana has ordered that the U.S. Department of Health and Human Services and the Center for Medicare and Medicaid Services are enjoined...more
Last Thursday, Gov. Ron DeSantis (R) signed sweeping legislation designed to protect private and public sector employees from losing their jobs due to COVID-19 vaccination mandates, as well as to protect the rights of...more
During a special session to consider what Governor Ron DeSantis called his “Keep Florida Free” agenda, the Florida Legislature passed several vaccine measures, some of which conflict with recently implemented federal rules,...more