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Medicaid › Health Care Providers

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Holland & Knight LLP

Holland Knight Health Dose: September 17, 2024

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Holland & Knight Health Dose 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

Whiteford

California Department of Public Health's (CDPH) Limits On CRNA Scope of Practice Reminds Hospitals Nationwide to Revisit...

Whiteford on

The California Department of Public Health (CDPH) issued a letter on September 6, 2024, to all general acute care hospitals clarifying the scope of practice for Certified Registered Nurse Anesthetists (CRNAs) following...more

Maynard Nexsen

Resources and Practical Response Tips

Maynard Nexsen on

After a lengthy absence, the South Carolina Department of Health and Human Services (“SCDHHS”) announced on September 10, 2024, that its Medicaid Recovery Audit Contractor (“RAC”) program was resuming on October 1, 2024. ...more

Manatt, Phelps & Phillips, LLP

Community Reinvestment: Forging New Partnerships in Medicaid

Manatt, Phelps & Phillips, LLP on

At least 10 states have implemented, or are in the process of implementing, a community reinvestment requirement in which Medicaid managed care organizations (MCOs) are required to reinvest in the communities they serve to...more

Husch Blackwell LLP

Hospice Insights Podcast: What’s the Latest on UPICs? Highlights from Recent Audit Activity, Part I

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UPIC activity is picking up, and the UPICs are reviving some old tactics. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss these trends which include extrapolation, Medicaid nursing home room and...more

Proskauer - Health Care Law Brief

Post‑Chevron Spotlight: Disproportionate Share Hospital Payments Restored as Texas Hospitals Prevail in Challenge to HHS Exclusion...

Proskauer - Health Care Law Brief on

In a victory for Texas health care providers, in Baylor All Saints Medical Center dba Baylor Scott & White All Saints Medical Center‑Fort Worth et al. v. Xavier Becerra, case number 4:24‑cv‑00432, the United States District...more

Alston & Bird

Health Care Week in Review: CMS Releases Mandatory TEAM Hospital Participants and Issues RFI on Medicare Administrative Contractor...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Alston & Bird

Health Care Week in Review: Biden Administration Announces $100 Million for ACA Marketplace Navigators and $81.3 Million for...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Manatt, Phelps & Phillips, LLP

CMS Releases Guidance to Promote Continuity of Coverage for Individuals Receiving HCBS

Manatt, Phelps & Phillips, LLP on

On August 19, the Centers for Medicare & Medicaid Services (CMS) released a Center for Medicaid and CHIP Services (CMCS) Informational Bulletin (CIB) and an accompanying slide deck reminding states of their obligation to...more

McCarter & English, LLP

CMS Adopts New Age-Friendly Hospital Measure for Care of Older Adults for CY 2025 Reporting

McCarter & English, LLP on

The Centers for Medicare & Medicaid Services (CMS) has adopted an age-friendly quality hospital measure in its most recent final rule addressing prospective payment systems, policy changes, and quality program requirements...more

McGuireWoods Consulting

Washington Healthcare Update - August 2024 #2

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This Week in Washington: Congress remains in recess....more

Holland & Hart LLP

FMV for Provider Contracts: Regulatory Standards

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As a general rule, healthcare employers are required to pay employed physicians and other contracted providers fair market value (FMV) for their services, but many employers do not understand relevant regulatory standards. ...more

Jones Day

Eighth Circuit Holds Penalties in Non-Intervened FCA Case Violate Excessive Fines Clause

Jones Day on

The Situation: The False Claims Act ("FCA") imposes treble damages on defendants, as well as mandatory penalties per false claim. Because alleged false claims often involve much smaller amounts—for example, in cases with a...more

Epstein Becker & Green

CMS Issues Mandatory “TEAM Model” for Acute Care Hospitals to Improve Episode-Based Alternative Payments and Advance Accountable...

Epstein Becker & Green on

On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released a final rule updating the Medicare inpatient prospective payment system (IPPS) for acute care hospitals and the Medicare prospective payment...more

Alston & Bird

Health Care Week in Review: CMS Finalizes the TCET Pathway for Breakthrough Technologies; HRSA Awards Health Centers Funding for...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McGuireWoods Consulting

Washington Healthcare Update - August 2024

McGuireWoods Consulting on

This Week in Washington: Senate Appropriations Committee reports FY 2025 Labor-HHS-Education and Related Agencies appropriations bill out of committee....more

Alston & Bird

Health Care Week in Review: CMS Finalizes FY 2025 Payment Rules for Inpatient Hospitals, Inpatient Rehab Facilities, Inpatient...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

The Volkov Law Group

Gentiva Pays $19.4 Million for False Claims Act Violations Involving Hospice Care

The Volkov Law Group on

Gentiva, the renamed former Kindred at Home, agreed to pay $19.4 million to resolve claims that its predecessor company, Kindred at Home and related companies, violated the False Claims Act by retaining overpayments for...more

Manatt, Phelps & Phillips, LLP

New CMS Guidance on the Provision of Medicaid and CHIP Services to Incarcerated Children and Youth

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This is an excerpt from a recent Manatt article published on State Health & Value Strategies. Click here to download insight. On July 23, 2024, the Centers for Medicare & Medicaid Services (CMS) released a State Health...more

Manatt, Phelps & Phillips, LLP

How States Can Ensure Safety Net Hospitals Benefit from the New Medicaid Access Rule

Manatt, Phelps & Phillips, LLP on

Safety net hospitals play a vital role in serving marginalized communities, however, their efforts to advance health equity are undermined because in many states Medicaid payment rates do not cover costs. Though many states...more

Manatt, Phelps & Phillips, LLP

CMS Approves Seven Reentry Section 1115 Demonstrations in July

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In July, the Centers for Medicare and Medicaid Services (CMS) approved seven new Reentry Section 1115 Demonstrations in Illinois, Kentucky, New Hampshire, New Mexico, Oregon, Utah, and Vermont. These states join California,...more

Manatt, Phelps & Phillips, LLP

CMS Releases Technical Guidance to States on Complying with Medicaid Access Final Rule

Manatt, Phelps & Phillips, LLP on

On July 12, CMS released a companion guide to the Ensuring Access to Medicaid Services final rule (the “Access Final Rule”). This technical guidance—which focuses on the provisions regarding fee-for-service (FFS) payment...more

Nelson Mullins Riley & Scarborough LLP

Medicaid Overpayment Audits: What Medical Providers Need to Know

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The Audit Process - While Medicaid audits are meant to ensure integrity and efficiency of the Medicaid Program, they can often be incredibly cumbersome and challenging for medical providers to navigate. During an audit,...more

King & Spalding

Physician Fee Schedule Proposed Rule Proposes New Quality-Driven Payment Policies

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Within its proposed CY 2025 Physician Fee Schedule (PFS) rule (the Proposed Rule), CMS is proposing to implement new payment policies intended to advance health equity and support whole-person care. CMS expects these new...more

Alston & Bird

Health Care Week in Review: CMS Releases Final Medicare Prescription Payment Plan Part 2 Guidance

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

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