News & Analysis as of

Eligibility Medicare

Manatt, Phelps & Phillips, LLP

[Webinar] Access to Coverage and Care: Policy Trends in Medicaid, Medicare and the Commercial Market - October 6th, 1:00 pm - 2:00...

Join Manatt for the First of Our Imperatives Deep-Dive Sessions on the Topics You Voted Most Important to You. To benefit fully from America’s health care system, people need both timely access to health care services and...more

King & Spalding

CMS Proposes Updated Distance Rules and Continued Eligibility Reviews for Critical Access Hospitals and Conditions of...

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On July 1, 2022, CMS issued a proposed rule in which the agency proposes to update and potentially liberalize the distance rules applicable to Critical Access Hospitals (CAHs) as well as procedures for monitoring the...more

King & Spalding

OIG Issues Favorable Advisory Opinion Regarding Non-Profit Efforts to Provide Financial Assistance and Free Items to Individuals...

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On May 2, 2022, OIG posted Advisory Opinion 22-10, regarding a proposal to provide financial assistance and free items to individuals with a particular disease. The Requestor, a non-profit organization dedicated to providing...more

McDermott Will & Emery

[Webinar] 340B… Or Not 340B: Oversight, Compliance and Enforcement - July 15th, 9:00 am - 10:00 am PT

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The 340B Program has gained national attention over the last decade, in part due to the opportunities it provides to generate revenue for participating entities without risk of significant enforcement penalties for...more

Chambliss, Bahner & Stophel, P.C.

Provider Relief Fund Phase 2 Eligibility: Clarifications and Further Questions

As explained in our prior alert, the Department of Health and Human Services (HHS) is offering certain Medicare providers an additional opportunity to apply—by August 28, 2020—for Provider Relief Fund (PRF) distributions from...more

Seyfarth Shaw LLP

NPDB Waives Query Fees from March through May 2020

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To assist hospitals in credentialing physicians during the COVID-19 pandemic, the National Practitioner Data Bank (“NDPB”)—the federal clearinghouse for adverse action reports against physicians—has announced it is waiving...more

Foley & Lardner LLP

COVID-19: Resources for Oncology Providers (Medicaid, Grants, & Stark Law Waivers)

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The Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (HHS), the Office for Civil Rights (OCR), the Office of the Inspector General (OIG), and other Federal and State agencies and...more

Seyfarth Shaw LLP

HHS Issues Advisory Opinion on PREP Act: Immunity May Extend Beyond Actual Covered Persons and Approved Countermeasures

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With crisis comes uncertainty, and even the best-intentioned regulations can leave those combating the current COVID-19 public-health emergency out in the cold.  Many have asked whether the recent Declaration under the...more

Baker Donelson

HHS Pays $30 Billion in CARES Act Emergency Relief Payments to Health Care Providers

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Health care providers are beginning to receive payments from the Department of Health and Human Services (HHS) to address expenses and revenue losses related to coronavirus (COVID-19). On April 10, 2020, HHS announced the...more

Seyfarth Shaw LLP

Health CARES – How the CARES Act Impacts Health Care Providers

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Congress passed and the President signed the CARES Act on March 27, 2020. The Act impacts hospitals, post-acute providers and long term care facilities in numerous ways. The following is an outline of key provisions and their...more

King & Spalding

CMS Releases Tools to Support States’ Medicaid and CHIP Programs During the COVID-19 Outbreak

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On March 22, 2020, CMS announced a suite of four new tools intended to help states combat the coronavirus by allowing states to streamline enrollment into long-term care and home-based services and by expediting application...more

Seyfarth Shaw LLP

CMS Announces New Priorities for Facility Surveys and Inspections

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In light of findings from the COVID-19 outbreak at a nursing home in Kirkland, Washington, the Centers for Medicare and Medicaid Services (CMS) has announced that it will suspend all routine facility inspections and surveys...more

ArentFox Schiff

CMS Moves to Expand Medicare Advantage Program Access to Individuals with End-Stage Renal Disease

ArentFox Schiff on

On February 5, 2020, the Centers for Medicare and Medicaid Services (CMS) proposed removing long-standing prohibitions and eligibility restrictions that had barred many individuals with End-Stage Renal Disease (ESRD) from...more

Foley Hoag LLP - Medicaid and the Law

Latest HHS Financial Report Highlights Medicaid Eligibility Errors – and Foreshadows Future Actions

On November 19, 2019, CMS announced key results from the 2019 HHS Agency Financial Report, which generally provides fiscal and high-level performance data for HHS for the reporting period of October 1, 2018 through September...more

Polsinelli

Six Things to Know on CMS's Guidance Addressing the Low Volume Medicare Appeal Settlement

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The Centers for Medicare and Medicaid Services (“CMS”) recently issued guidance that starting Feb. 5, 2018, CMS will begin the process for the Low Volume Appeal (“LVA”) settlement option that CMS had announced on Nov. 3....more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - April 2017 #3

The focus is on the Marketplaces this week as CMS publishes a new Marketplace stabilization rule, even as President Trump threatens to withhold cost-sharing reduction payments to insurers. In the states, Florida announces...more

King & Spalding

Also In The News - Health Headlines - August 2016 #3

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CMS Releases Medicare Outpatient Observation Notice For Public Comment – CMS announced that the public has the opportunity to comment on the Medicare Outpatient Observation Notice (MOON). The MOON is a standardized form...more

King & Spalding

Also In The News - Health Headlines - June 2016 #4

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House Republicans Reveal Plan for Alternative to ACA – On June 22, 2016, House Republicans released a health plan in the form of a 37-page white paper outlining a series of proposals that would replace a repealed Affordable...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - September 2015

CMS permits states to use income information from other means-tested benefit programs for Medicaid eligibility determinations; Alaska’s Medicaid expansion is given the green light to launch today; and Washington State submits...more

King & Spalding

Outpatient Observation Status Bill Sent to President Obama

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On July 27, 2015, the Senate approved by unanimous consent the Notice of Observation, Treatment and Implication for Care Eligibility (NOTICE) Act, H.R. 876. The NOTICE Act, if signed by President Obama, would amend title...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - July 2015 #3

In quick succession, governors in Alaska and Utah announce Medicaid expansions this week; Iowa is transitioning its expansion away from the Marketplace to Medicaid managed care, for now; and, HHS extends its exception to...more

Foley & Lardner LLP

MSSP Final Rule ACO Eligibility Requirements, Application and Renewal Process

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This is the second post in Health Care Law Today’s series on the final rule. This post addresses Eligibility Requirements, and the Application and the Renewal Process. ACO Eligibility Requirements - Under the...more

Cozen O'Connor

Health Care Reform Implementation Update - February 26, 2014

Cozen O'Connor on

Though Congress was in recess this past week, congressional staff was hard at work continuing to consider ways to prevent a cut to Medicare providers’ payment rates that will be triggered by the sustainable growth rate...more

King & Spalding

Congressional Budget Office’s estimate on budgetary effects of raising Medicare eligibility age to 67

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On October 24, 2013, the Congressional Budget Office (CBO) released an updated estimate on the potential impact of raising Medicare’s eligibility age. Medicare costs are expected to rapidly increase in coming years due to...more

McDermott Will & Emery

What Have We Learned from Audits under the Medicare EHR Incentive Program?

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Through the first half of this year, the Centers for Medicare & Medicaid Services auditor has conducted numerous pre- and post-payment audits of meaningful use attestations submitted by eligible providers to the Medicare...more

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