Counsel That Cares Podcast - Value-Based Care and Shifting Away from the Healthcare Fee-for-Service Model
Compliance Perspectives: Changes to the Physician Self-Referral and Anti-Kickback Rules
Value-based health care: compliance infrastructure
The Biggest Obstacle to Value-Based Care
Polsinelli Podcast - Health Care Payment Changes: From Service to Value
Editor’s Note: PYA and Foley & Lardner hosted the 6th Annual “Let’s Talk Compliance” two-day Virtual Conference on January 18 and 19, 2024. Panelists included Foley & Lardner attorneys and PYA experts. The event was hosted by...more
On April 20, 2023, the United States Department of Health and Human Services Office of the Inspector General (HHS OIG) released a new toolkit designed to help analyze telehealth claims to assess federal healthcare program...more
On February 14, 2023, and in response to Executive Order 14087 (“Lowering Prescription Drug Costs for Americans”), the Secretary of Health and Human Services (HHS) issued a report announcing the selection of three models that...more
On January 30, the Centers for Medicare & Medicaid Services (CMS) released a long-awaited final rule addressing how it will calculate and collect overpayments from Medicare Advantage (MA) plans arising from risk adjustment...more
Recently, the Office of Inspector General (“OIG”) for the Department of Health and Human Services published its Report on Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks...more
A pair of reports recently issued by the US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) highlight the important role telehealth services have played in ensuring access to medical...more
On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH)...more
On Thursday, April 8, 2021, the Center for Medicare and Medicaid Innovation (the “Innovation Center”) announced its final list of 53 organizations set to participate in the Global and Professional Direct Contracting (“GPDC”)...more
Following on last October’s publication of two proposed rules, the Department of Health and Human Services (HHS) published on November 20 two final rules intended to “modernize and clarify” the physician self-referral (Stark)...more
Report on Medicare Compliance 29, no. 42 (November 23, 2020) - CMS said Nov. 16 that the Medicare fee-for-service improper payment rate dropped to 6.27% in FY 2020 from 7.25% last year, although CMS had to “modify”...more
On Friday of last week, HHS published two long-awaited final rules implementing significant changes to the regulations under the Stark Law and Anti-Kickback Statute (AKS). The two final rules are: (i) Revisions to the Safe...more
Last week, HHS announced that it will now accept additional applicants for the Provider Relief Fund Phase 2 General Distribution. All eligible providers will only receive funding of up to 2 percent of their reported total...more
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
Report on Medicare Compliance 29, no. 21 (June 8, 2020) - The HHS Office of Inspector General (OIG) has released its Semiannual Report to Congress, which covers Oct. 1, 2019, through March 31, 2020. During this period, OIG...more
In recent days, the federal government has taken two significant steps to increase healthcare funding to assist providers in responding to the medical and economic consequences of the novel coronavirus pandemic. $100 Billion...more
King & Spalding’s Healthcare Finance practice is working to keep clients informed of issues that may be of concern to lenders in the healthcare space. Providers are continuing to face financial difficulties due to spikes in...more
In 1969, noted economist Milton Friedman coined the term “helicopter money” to describe the monetary policy of injecting liquidity into the market, much like dropping money to people from helicopters, as an alternative to...more
The U.S. Department of Health and Human Services (HHS) has begun the release of $30 billion of the $100 billion Public Health and Social Services Emergency Fund that is part of the Coronavirus Aid, Relief, and Economic...more
Healthcare providers are among those financially adversely affected by the COVID-19 pandemic. A survey conducted by the Medical Group Managers Association ("MGMA") on April 7 and 8, 2020, found that 97% of medical...more
Earlier this month, Williams Mullen reported that the CARES Act would provide $100 billion in relief funds to skilled nursing facilities, hospitals and other health care providers on the front lines of the COVID-19 response....more
The Coronavirus Aid, Relief, and Economic Security Act, known as the “CARES Act,” which became law on March 27, 2020, appropriates $100 billion to the Public Health and Social Services Emergency Fund to reimburse providers...more
Health care providers began receiving direct deposits into their bank accounts on April 10, 2020 as part of the first disbursement of the $100 billion in provider relief funds allocated under the CARES Act. Providers are...more
On April 10, 2020, the U.S. Department of Health and Human Services (“HHS”) provided additional details regarding its plan to provide billions in relief to providers in an effort to off-set healthcare-related expenses...more
Last week, CMS Administrator Seema Verma announced that approximately $30 billion from the CARES Act’s $100 billion hospital relief fund would be distributed to providers directly, based on past Medicare revenues. On April...more
On Friday, April 10, 2020, the U.S. Department of Health and Human Services (HHS) announced it will begin disbursing $30 billion of the $100 billion of the Public Health and Social Services Emergency Fund recently allocated...more