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Medicare Quality of Care Standards

WilmerHale

OIG Issues New Advisory Opinion on Federal Anti-Kickback Statute

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The Department of Health and Human Services Office of Inspector General (OIG) recently issued an advisory opinion that explored the limits of a relatively new safe harbor to the federal Anti-Kickback Statute (AKS) that aims...more

Holland & Knight LLP

OIG Releases New Compliance Program Guidance for All Healthcare Stakeholders

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The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) on Nov. 6, 2023, issued new General Compliance Program Guidance (GCPG) as a reference guide for the healthcare compliance community....more

Weintraub Tobin

Proposed Medicare and Medicaid Enrollment Rule for Skilled Nursing Facilities Implements Law Expanding Regulation of Private...

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On February 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) proposed a long-delayed regulation that would implement a provider enrollment provision of the Affordable Care Act that expands the information...more

ArentFox Schiff

Increased Federal Attention to Skilled Nursing Facility Compliance and Quality Improvement Results in Modified Program...

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The Biden Administration has embraced an aggressive and multi-part agenda designed to improve the safety and quality of care nationally in skilled nursing facilities (SNFs). The Biden Administration’s nursing home agenda...more

ArentFox Schiff

OIG Declines To Challenge Debt Cancellation and Restructured Financial Arrangements Between Health System and FQHC “Look-Alike”...

ArentFox Schiff on

In Advisory Opinion 22-17, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) concluded that a proposed restructuring of a loan and other contractual relationships between a health system...more

Holland & Knight LLP

Holland & Knight Health Dose: June 7, 2022

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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. This week's topics include . . ....more

Holland & Knight LLP

CMS Releases FY 2022 IPPS and LTCH Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) on April 27, 2021, released the Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) Prospective Payment...more

Holland & Knight LLP

CMS Issues FY 2021 Inpatient Prospective Payment System (IPPS) Final Rule

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The Centers for Medicaid & Medicaid Services (CMS) has released the Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final...more

Sheppard Mullin Richter & Hampton LLP

CMS’s Mandatory Radiation Oncology Payment Model: Negative Reactions in the Radiation Oncology Treatment Community

On July 10 2019, the Centers for Medicare & Medicaid Services (“CMS”) issued a Notice of Proposed Rulemaking (“NPR”) entitled, “Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures.” In...more

Foley & Lardner LLP

Radiation Oncology: What You Need to Know About the Long Awaited Bundled Payment Proposal

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On July 10, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Center for Medicare & Medicaid Innovation (Innovation Center) released a much awaited proposal for a new bundled payment model for radiation...more

Arnall Golden Gregory LLP

CMS Proposes a Host of Changes to Nursing Home Requirements for Participation - Part Two

The Centers for Medicare and Medicaid Services (CMS) proposes a host of changes to the revised Medicare Requirements for Participation (“Requirements for Participation”) that it promulgated in 2016 and an extension of the...more

Arnall Golden Gregory LLP

OIG Details Hospice Quality of Care Issues and Recommends Tougher Enforcement Measures

Earlier this month, the U.S. Department of Health and Human Services' Office of Inspector General (OIG) issued two companion reports that, together, called for increased regulatory scrutiny of hospices, greater transparency...more

Bass, Berry & Sims PLC

Tennessee Nursing Home Chain Reaches “Largest Worthless Services Resolution in Tennessee’s History”

Government Settles with Several Entities, Individuals - Last week, Vanguard Healthcare and related entities reached a settlement with the Department of Justice (DOJ) for the stated amount of more than $18 million to settle...more

Sheppard Mullin Richter & Hampton LLP

Blog Series Part 4: CMS Proposed Rule on Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug...

Quality Improvement Programs - The proposed rule issued November 1, 2018 (the “Proposed Rule”) by the Centers for Medicare and Medicaid Services (“CMS”) includes two technical changes to 42 C.F.R. Part 422. The first change...more

Epstein Becker & Green

OIG Portfolio Highlights Hospice Fraud and Quality-of-Care Concerns

Epstein Becker & Green on

On July 31, 2018, the Office of Inspector General (“OIG”) of the U.S. Department of Health and Human Services released a portfolio titled “Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program...more

Poyner Spruill LLP

Updated Hospice Quality Reporting Program Notices of Noncompliance and Reconsideration Requests

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The Centers for Medicare and Medicaid Services (CMS) has issued notification letters to hospice providers that are not in compliance with the Hospice Quality Reporting Program requirements. According to CMS, all noncompliance...more

Pullman & Comley - Connecticut Health Law

New Home Health Rules Effective in January 2018—Some Traps for the Unwary

The Centers for Medicare & Medicaid Services (CMS) have issued new Conditions of Participation (CoP) for home health agencies (HHA) that are effective January 13, 2018. The CoP were originally scheduled to take effect on...more

Pullman & Comley, LLC

ALERT: HHA's Should Make Use of Delay in New Medicare Rules

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Now that the Centers for Medicare & Medicaid Services (CMS) have published a Final Rule delaying the effective date of the revised Medicare Conditions of Participation (CoP) for home health agencies (HHAs) until January 13,...more

Mintz - Health Care Viewpoints

OIG Publishes Semiannual Report to Congress

Earlier this month, the Office of the Inspector General for the Department of Health and Human Services (“OIG”) published its Semiannual Report to Congress covering the period from October 1, 2016 to March 31, 2017. The...more

Stinson LLP

CMS Proposes Six-Month Delay for New Medicare and Medicaid Conditions of Participation for Home Health Agencies

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The Centers for Medicare & Medicaid Services (CMS) recently proposed a six-month delay for home health agencies (HHAs) to implement the revised conditions of participation (CoPs) that HHAs must satisfy to participate in the...more

Stinson LLP

CMS Issues Final Rule on New Medicare and Medicaid Conditions of Participation for Home Health Agencies

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The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule, 42 C.F.R. pt. 484, implementing significant changes to the conditions of participation (CoPs) that home health agencies (HHAs) must satisfy to...more

Ruder Ware

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

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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

Sheppard Mullin Richter & Hampton LLP

House Republicans Push Back on Medicare’s New Mandatory Bundled Payment Models

On July 25, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that promises to deliver coordinated, high-quality care for Medicare beneficiaries. The proposed rule (effective July 1, 2017)...more

King & Spalding

Also In The News - Health Headlines - August 2016 #4

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CMS Reports ACO Savings and Improved Quality of Care – CMS issued a press release on August 25, 2016 announcing the 2015 performance year results for the Medicare Shared Savings Program and the Pioneer Accountable Care...more

King & Spalding

Also In The News - Health Headlines - December 2015 #2

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CMS Releases HAC Data for FY 2016, Showing More Payment Reductions – On December 10, 2015, CMS published quality measure scores related to hospital-acquired conditions (HACs) for hospitals participating in the HAC Reduction...more

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