Medicare Medicaid

News & Analysis as of

Capitol Hill Healthcare Update

After months of debate and partisan wrangling, the House on Wednesday voted 392-26 to pass the “21st Century Cures” bill designed to accelerate the development of new drugs and medical devices as well as increase federal...more

Health Law Insights: November Newsletter

ALERT: "No Contract" Disclaimer in Employee Handbook Upheld by Illinois CourtAuthor: Employee handbooks have long been a trap for the unwary employer that desires merely to establish a set of rules and policies without...more

10 Things You Need to Know About Health Care Bankruptcies in 2017

The coming year will likely continue to be a tumultuous year for health care providers, suppliers, and payers, as they adapt to meet new challenges and market forces, particularly in light of the open questions as to the...more

Long-Term Care Facilities: Recent Developments on Use of Arbitration Agreements

Three cases making their way through the courts demonstrate that the question of arbitration clauses in long-term care (LTC) facility admission agreements is an active and developing area of the law....more

Be wary of counterfactual assertions about Obamacare, Medicare, Medicaid

As speculation explodes about what the GOP and the president-elect will or won’t do with the Affordable Health Care Act (aka Obamacare), Medicare, and Medicaid, skeptical citizens would be well-served to learn as much as they...more

OIG Releases 2017 Work Plan

On November 10, 2016, the Office of Inspector General (“the OIG”) of the U.S. Department of Health and Human Services (“DHHS”) is charged with ensuring the integrity of more than 100 programs administered by DHHS, including...more

Out with the Old Rules? Will Trump and Republicans Target Health Care Regulations for Reversal in the New Year under...

The Congressional Review Act (CRA) has been used to overturn only one final rule in 20 years, but that situation may be about to change. According to a new Congressional Research Service (CRS) analysis, a “specific set of...more

Replacing The Affordable Care Act: A Reality Infusion

During the course of his campaign, President-elect Donald Trump repeatedly promised to repeal and replace President Obama's signature legislation, the Affordable Care Act (ACA). Certainly the Republican Party's continuing...more

OIG Issues 2017 Work Plan

On November 10, 2016, the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) posted its work plan (the “Work Plan”) for fiscal year 2017. The OIG publishes its Work Plan on an annual basis. The...more

New OIG Investigations to Look at Wide Range of Medicare, Medicaid Services in FY 2017

The HHS Office of Inspector General (OIG) has issued its FY 2017 Work Plan, which lays out the OIG’s current audit, evaluation, and other legal and investigative priorities. The largest number of new initiatives by far target...more

Will Republicans Embrace CMMI’s Authority?

The Affordable Care Act (ACA) and the Medicare and CHIP Reauthorization Act (MACRA) provided the Centers for Medicare & Medicaid Services (CMS) and the newly created Center for Medicare and Medicaid Innovation (CMMI)...more

Federal Judge Blocks CMS Rule Banning Arbitration In Nursing Home Disputes

In September, CMS announced a final rule that bans pre-dispute binding arbitration agreements related to care received in long-term care facilities. Among other things, the rule preserves the right of patients and their...more

Mississippi District Court Halts Implementation of New CMS Rule Banning Use of Arbitration Agreements in Long-Term Care Facilities

Anyone familiar with long-term care litigation knows that the number of disputes regarding the use and enforcement of arbitration agreements in the context of assisted living/nursing home admissions has risen sharply over the...more

Typical Social Security Recipient Will Get $4 Benefit Increase in 2017

Social Security benefits will rise only slightly in 2017. This follows no increase in benefits in 2016 and small increases for many of the previous years. The small bump in 2017 will likely be eaten up by higher Medicare Part...more

Federal Court Blocks CMS Ban on Pre-Dispute Nursing Home Arbitration Agreements Pending Legal Challenge: What the Ruling Means for...

Earlier this week, a federal court enjoined the federal Centers for Medicare and Medicaid Services (“CMS”) from enforcing a rule, promulgated on September 28, 2016, which barred pre-dispute arbitration agreements between...more

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

Health-Related Facilities That Receive Federal Financial Assistance Now Required to Post Non-Discrimination Notices

Health-related facilities that receive Federal financial assistance (e.g., Medicare or Medicaid reimbursement) have been required to comply with Federal, as well as State, non-discrimination laws in the provision of services....more

Federal Court Enjoins U.S. Agency’s Nursing Home Arbitration Agreement Ban

The Centers for Medicare and Medicaid Services (CMS), an agency within the U.S. Health and Human Services Department, recently issued a final rule prohibiting nursing homes and other long-term care facilities from utilizing...more

North District of California Misconstrues Express False Certification Liability

This summer, the Northern District of California issued an opinion in an intervened case that expanded the theory of express false certification to a startling degree. Ruling on a motion to dismiss, the court in U.S. ex rel....more

CMS Final Rule Prohibiting Nursing Home Use of Arbitration Agreements Put On Hold

This morning, U.S. District Court Judge Michael P. Mills granted a preliminary injunction in the U.S. District Court for the Northern District of Mississippi, putting on hold the looming November 28, 2016 deadline that would...more

INJUNCTION GRANTED: AHCA Jumps the First Hurdle in Overturning CMS's Ban on Pre-Dispute Arbitration

Judge Michael P. Mills granted a preliminary injunction in favor of the American Healthcare Association (AHCA) earlier today in the case of AHCA v. Burwell. A copy of the court's injunction order can be accessed here. The...more

All Eyes on Mississippi: Federal Judge Hears Argument Over CMS's New Pre-Dispute Arbitration Regulation

A federal judge in Oxford, Mississippi, heard oral argument today in the case of AHCA v. Burwell. The case – filed by the American Healthcare Association (AHCA) three weeks ago – has been closely followed because of its...more

CMS Releases the First Comprehensive Overhaul of Nursing Home Conditions of Participation in Over 25 Years

On October 4, 2016, the Center for Medicare and Medicaid Services (CMS) published a final rule to revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. CMS...more

Supreme Court Implied False Certification Case Reargued to First Circuit

On Tuesday, October 25, 2016, a three-judge panel of the United States Court of Appeals for the First Circuit heard argument in United States ex rel. Escobar, et al. v. Universal Health Services, Inc. This case was sent back...more

Making Sense of the MACRA Final Rule, Part 2 of 3: Alternative payment Models

Many observers view the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a game changer for the delivery and payment of health care services. On Oct. 14, 2016 the Centers for Medicare & Medicaid Services...more

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