News & Analysis as of

HHS Ups The Ante: Announces Percentages And Time Frames On Goals For Medicare Pay-For-Value Efforts

On January 26, 2015, the Secretary of the United States Department of Health and Human Services (“HHS”), Sylvia Mathews Burwell, announced two important goals for the Department...more

Healthcare Compliance Programs: Stepping Up the Game

The Affordable Care Act was enacted in 2010 – can anyone remember back that far? The ACA required Medicare and Medicaid providers to have an ethics and compliance program....more

Manatt on Health Reform: Weekly Highlights #4

This week, the IRS announces relief for some taxpayers who received excess advanced premium tax credits; Indiana and Arkansas make major announcements on Medicaid expansion and Iowa’s Governor announces a shift towards...more

Medicare chief Tavenner stepping down; oversaw rocky health care rollout

News Alert: Medicare Chief Tavenner stepping down!!!! WASHINGTON — Medicare chief Marilyn Tavenner — who oversaw the rocky rollout of the president’s health care law — says she’s stepping down at the end of February....more

Effects of the New Federal Spending Package on the Health Sector

In mid-December, President Obama signed into law a $1.1 trillion spending bill known as the “Consolidated and Further Continuing Appropriations Act, 2015” or “Cromnibus.”[1] This post explores provisions that relate to the...more

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

In This Issue: - Top News ..Congress Passes Omnibus Spending Package ..HRSA Cancels Plan for 340B ‘Mega Reg’; Congress Weighs Options ..Supreme Court to Hear Challenge to ACA...more

With a New Year Rolls in a New OIG Work Plan

Recently, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) released its Work Plan for Fiscal Year 2015 (“Work Plan”). The OIG protects the integrity of HHS programs by identifying...more

Health Care Update - December 2014 #2

In This Issue: - SGR Replacement Odds Not Likely to Increase Ahead of Upcoming Deadline - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

CMS Issues Final Rule Designed to Enhance Agency Oversight of Medicare Providers and Strengthen Protections for Medicare...

On December 3, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (CMS-6045-F) that updates various requirements for providers and suppliers wishing to enroll in the Medicare program. CMS issued...more

New CMS Enrollment Rules Strengthen Oversight of Medicare Providers

On December 5, 2014, CMS published a final rule to strengthen its oversight of Medicare providers. The rule includes safeguards designed to prevent providers with unpaid debt from re-entering Medicare and to remove providers...more

Impact of Health Care Reform on Provider Liability

In this presentation: - The Changing Healthcare Landscape - Key Features of an ACO/CIN - ACO Standards and Quality Metrics - Examples of Quality Standards - Impact on Board and Corporate...more

OIG Identifies Top 10 Management Challenges for HHS in Fiscal Year 2014

On November 18, 2014, the HHS OIG released its annual list of the top 10 management and performance challenges faced by HHS and the OIG during the current fiscal year, and the new and emerging issues that the OIG anticipates...more

Health Care Update - November 2014 #3

In This Issue: - 21st Century Cures Remains Top Bi-Partisan Priority for 2015 - Senate Passes Critical Access Hospital Direct Supervision Bill - Implementation of the Affordable Care Act - Other...more

Government turns up the heat with the False Claims Act – 5 action steps for healthcare providers

Forbes magazine has dubbed 2014 “The Year of the Whistleblower.” For healthcare providers, this designation has translated into millions of dollars in fines and penalties and the initiation of criminal investigations. ...more

SRDP No Longer New Wine

More than four years after the Centers for Medicare & Medicaid Services' (CMS) issuance of the Stark Self-Referral Disclosure Protocol (SRDP), it's time to assess the results. The SRDP was designed by Congress to resolve...more

HHS OIG Announces Information Security Initiatives in 2015 Work Plan

The 2015 Work Plan of the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) posted on Friday, October 31, 2014, includes initiatives focused on testing information security controls related to...more

CMS Releases CY 2015 Outpatient PPS/Ambulatory Surgical Center Final Rule

On October 31, 2014, CMS issued its CY 2015 outpatient and ambulatory surgical center (ASC) PPS final rule. CMS finalized a net payment rate increase of 2.2 percent under the OPPS. This figure includes a 2.9 percent market...more

Health Care Update - November 2014

In This Issue: - CMS Releases Final Medicare Payment Rules - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional Initiatives - Other Health...more

Key Takeaways from OIG’s 2015 Work Plan

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Fiscal Year 2015 Work Plan on October 31. The Work Plan provides the OIG’s planned reviews and activities with respect to...more

Blog: HHS OIG Hands Out 2015 Work Plan For Halloween

On Friday October 31, 2014, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) released its annual “Work Plan” for fiscal year 2015. The Work Plan is a compilation of the OIG’s plans for...more

Getting the Best Medical Care: a Newsletter from Patrick Malone - November 2014

In This Issue: - Time Equals Money - What Are They Talking About? - Medicare Is Not Free - The Period of "Open Enrollment" Might Be Limited - Get Additional Help - Excerpt from...more

Health Law Alert: OIG Releases Proposed Revisions to Anti-Kickback Safe Harbors and Civil Monetary Penalty Rules

The Department of Health and Human Services Office of Inspector General (OIG) recently released a proposed rule that revises safe harbors under the Anti-Kickback Statute (AKS) and Civil Monetary Penalty (CMP) rules regarding...more

OIG Announces Proposed AKS and CMP Regulations

On October 3, 2014, the Office of the Inspector General (“OIG”) issued a proposed rule codifying into regulation several statutory changes to the Antikickback Statute (“AKS”) and the Civil Monetary Penalty (“CMP”) Law. Nearly...more

OIG Proposed Anti-Kickback Safe Harbors and CMP Regulations: The End of Frustration or Just the Beginning?

On October 3, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published an unexpected, yet long-awaited, set of proposed rules that would add new anti-kickback law safe harbors,...more

OIG Releases Proposed Rule Adding New Safe Harbors to the Anti-Kickback Statute

Last week, the HHS OIG released a proposed rule published in the October 3 Federal Register that would add new safe harbors to the Anti-Kickback Statute and expand the list of conduct exempt from civil monetary penalties...more

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