Dept. of Health and Human Services Medicare

The United States Department of Health and Human Services is a federal executive department established in 1953, as part of the Department of Health, Education and Welfare. The Agency became independent in 1980... more +
The United States Department of Health and Human Services is a federal executive department established in 1953, as part of the Department of Health, Education and Welfare. The Agency became independent in 1980 and was renamed The Department of Health and Human Services at that time. HHS is charged with protecting and improving the health of the American population, as well as providing essential services.    less -
News & Analysis as of

CMS Releases Physician Medicare Billing Data

The U.S. Department of Health and Human Services (HHS) announced on April 9th a “historic” release of Medicare payment data to provide consumers with “unprecedented transparency on the medical services physicians provide and...more

Department of Health and Human Services to Release Medicare System Data

Last week, the Department of Health and Human Services (HHS) announced that they will begin to publicly release Medicare system data, including payment and utilization rates, for the 880,000 physicians currently participating...more

D.C. Circuit Requires Greater Disclosure of Changes in Medicare Regulations

The rulemaking process often accommodates a variety of interests, including the preference of regulatory agencies to maintain some flexibility and the rights of interested parties to participate in the regulatory process. On...more

HHS Extends Medicare Coverage to Same-Sex Couples

The U.S. Department of Health & Human Services (“HHS”) announced last week that same-sex married couples can now qualify for Medicare Part A and Part B special enrollment periods and reductions in late enrollment penalties....more

HHS DAB Upholds Revocation of Clinic’s Medicare Provider Number

On February 20, 2014, the US Department of Health and Human Services, Departmental Appeals Board upheld CMS’ revocation of the Medicare provider number of a clinic/group practice. In Advanced Care Medical Center v CMS...more

Program Integrity Priorities Revealed in FY 2015 HHS Budget

On March 14, 2014, President Obama unveiled his Administration’s proposed fiscal year 2015 budget for the Department of Health and Human Services (HHS). In total, the Administration is seeking $77.1 billion to fund HHS in FY...more

FY 2015 Budget Request Includes Reductions and Reforms to CMS Spending

President Obama has released the administration’s FY 2015 budget request, and it includes investments and proposals for HHS that are estimated to save $355.6 billion over 10 years. The FY 2015 budget estimate for CMS is...more

OIG 2014 Work Plan – Skilled Nursing Facilities

Recently, the Department of Health and Human Services Office of the Inspector General (the “OIG”) released its work plan for 2014. The work plan provides stakeholders in the health care industry with a broad overview of the...more

Highlights from OMHA's Medicare Appellant Forum

The Office of Medicare Hearings and Appeals (OMHA) recently announced that for most hearing requests received after April 1, 2013, it will be deferring assigning to Administrative Law Judges (ALJs). OMHA will continue to...more

OIG Targets Integrated Hospital Systems With Recommended Changes to Medicare’s 3-Day DRG Payment Window

On February 19, 2014, the Office of the Inspector General of the United States Department of Health and Human Services (“OIG”) released a report recommending two changes in the Medicare Diagnosis Related Group (“DRG”)...more

Health Care Reform Implementation Update - February 26, 2014

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

Third Circuit Holds Judicial Review of Extrapolated Overpayment Determinations is Precluded

On February 12, 2014, the U.S. Court of Appeals for the Third Circuit held that Federal courts do not have jurisdiction to review HHS’s determination of a “sustained or high level of payment error,” one of two possible...more

More Than 100 House Members Urge HHS to Reform RACs

A bipartisan group of 111 members of the United States House of Representatives sent a letter to HHS Secretary Kathleen Sebelius on February 10, 2014, urging the Secretary to reform the Medicare Recovery Audit Contractor...more

OIG 2014 Work Plan Focuses On Compounded Pharmaceuticals Reimbursed By Medicare

The Office of Inspector General for the U.S. Department of Health and Human Services (“OIG”) included two items in its recently-released 2014 Work Plan indicating a new focus on the quality and safety of compounded...more

Healthcare Enforcement Actions and Trends: 2013 Overview

The Department of Justice (DOJ) and the Office of Inspector General for the U.S. Department of Health and Human Services continued aggressive enforcement of the healthcare industry in 2013. Officials employed a variety of...more

Health Care Reform Implementation Update - February 10, 2014

Last week the Congressional Budget Office (CBO) released a report on the Affordable Care Act (ACA), in which it projected a decline in the number of full-time-equivalent hours worked; the Senate Finance, House Ways and Means,...more

New Privacy Rule Gives Patients Right To Access Lab Test Reports

On February 6, 2014, the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services Office for Civil Rights (HHS OCR) issued a final rule amending the Clinical Laboratory Improvement...more

OIG Releases Fiscal Year 2014 Work Plan

On January 31, 2014, the Department of Health and Human Services Office of Inspector General (OIG) released its work plan for fiscal year 2014. The work plan identifies the programs OIG will review in the upcoming year. The...more

CMS Issues New Policy on Disclosure of Physician Payment Information

On January 17, 2014, the Centers for Medicare & Medicaid Services (CMS) announced that it will release Medicare expenditure data on specific physicians under the Freedom of Information Act (FOIA). This new “transparency”...more

Health Reform + Related Health Policy News - January 2014, Issue 1

In This Issue: - Top News ..Congress Approves Budget Deal with Short-Term ‘Doc Fix' ..CMS “Two-Midnight” Rule delayed until March 31, 2014 ..Individuals with Canceled Insurance Policies May Apply for...more

Health Care Reform Implementation Update - December 19, 2013

The deadline to enroll in coverage for January 1 was officially extended by a week, but the new December 23 deadline is fast approaching, and premium payments are required to be paid by the last day of 2013 for January 2014...more

OIG Calls for Increased Scrutiny on Hospital Outlier Payments

In a recent report [PDF], the Department of Health and Human Services Office of the Inspector General (OIG) highlighted hospital outlier payment trends it found troubling: Of the nearly 3,200 hospitals reviewed, approximately...more

Health Care Reform Update -- November 25, 2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; and Hearings and Mark-Ups Scheduled. Excerpt from...more

OIG Report Concludes that Physician-owned Distributors Increase Utilization

In response to the U.S. Senate Committee on Finance’s continued questioning of physician-owned distributorships (PODs), the U.S. Department Health and Human Services Office of the Inspector General issued its long-awaited...more

DHHS Takes 35 Years to Become Federally Compliant With Medicare/Medicaid Crossover Issues

It is without question that the implementation of NCTracks has been a complete debacle. NCTracks is the new computer system that is processing Medicaid claims for all health care providers who accept Medicaid in North...more

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