News & Analysis as of

Medicare Reporting Requirements

Health Care Compliance Association (HCCA)

Privacy Briefs: September 2024

The HHS Centers for Medicare & Medicaid Services (CMS) and Wisconsin Physicians Service Insurance Corporation (WPS) are notifying 946,801 people whose protected health information or other personally identifiable information...more

Goldberg Segalla

[Webinar] Medicare Tune Up: Boosting Efficiency and Minimizing Costs - August 8th, 12:00 pm - 1:00 pm EDT

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As Medicare secondary payer penalties take effect this fall, find out what’s new, what’s on the horizon, and what to watch out for to avoid pitfalls. Join Goldberg Segalla partners Philip Unwin and Jennifer Santoro for a free...more

Epiq

The ‘Blind’ Medicare Reporting Conundrum: Clinical Trials Sponsor Compliance with MMSEA Section 111 Mandatory Insurer Reporting

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Organizations have an obligation to report claims for individuals who have coverage under group health plans (GHPs) and non-group health plans (NGHPs) when a settlement has been paid or when the plan pays for ongoing medical...more

Foley & Lardner LLP

Thorny Laws That ICHRA Vendors Should Consider

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Individual Coverage Health Reimbursement Arrangements (ICHRAs) have continued to grow in popularity since their inception in 2019 (see our article here summarizing the 2019 rule establishing ICHRAs). While initially it seemed...more

Arnall Golden Gregory LLP

CMS Issues Final Rule Mandating New Minimum Staffing Standards for Long-Term Care Facilities

On April 22, 2024, The Centers for Medicare & Medicaid Services (“CMS”) issued the “Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency...more

Gardner Law

From Discretion to Regulation: FDA's New Path for LDTs

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Earlier this year, we reported on the expected U.S. Food and Drug Administration (FDA) ruling concerning Laboratory Developed Tests (LDTs). The FDA has consistently shown a commitment to regulating LDTs. On May 6, 2024, the...more

King & Spalding

CMS Issues Hospice Proposed Payment Rule

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Last week, CMS issued a proposed rule (Proposed Rule) for fiscal year (FY) 2025 aiming to update Medicare hospice payments and aggregate cap amount in accordance with existing statutory and regulatory requirements. The...more

Mintz - Health Care Viewpoints

New York City's Health Care Price Transparency Law Takes Effect

In summer of 2023, New York City Mayor Eric Adams signed Intro. 844-A (Local Law 844-A) and amended the New York City Charter. Local Law 844-A directs Mayor Adams to establish an Office of Healthcare Accountability that will...more

Cornerstone Research

5 Questions with Sayeh Nikpay: The 340B Drug Pricing Program

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A periodic feature by Cornerstone Research, in which our affiliated experts, senior advisors, and professionals, talk about their research and findings. We interview Professor Sayeh Nikpay of the School of Public Health,...more

Rivkin Radler LLP

New HHS Rule for Nursing Home Ownership and Manager Disclosure

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A new rule will require nursing homes enrolled in Medicare or Medicaid to make disclosures about certain facility ownership, management and other operational information. The U.S. Department of Health and Human Services (HHS)...more

Venable LLP

Looming CTA Disclosure Requirements and Healthcare Providers

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The Federal Corporate Transparency Act (the CTA), 31 U.S.C. §5336, will soon require certain entities to disclose to the U.S. Treasury's Financial Crimes Enforcement Network (FinCEN) certain pieces of identifying information...more

Akin Gump Strauss Hauer & Feld LLP

Akin Intelligence - November 2023

Welcome to the November edition of Akin Intelligence. Looking back, October 2023 may be remembered as the month when the U.S. government tried to assume the mantle of global leadership on responsible artificial intelligence...more

Troutman Pepper

CMS Publishes Final Rule on Civil Monetary Penalties for Section 111 Reporting

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The Centers for Medicare and Medicaid Services (CMS) published the final rule outlining how civil monetary penalties will be calculated and imposed when Responsible Reporting Entities (RRE) fail to meet their Medicare...more

Pullman & Comley - Labor, Employment and...

Group Health Plans and Medicare Secondary Payer Rules: Do the Mandatory Reporting Obligations Apply to You?

The Medicare Secondary Payer provisions (MSP) apply to group health plans sponsored by employers with 20 or more employees, in both the private and public sectors. MSP’s mandatory reporting requirements are designed to...more

Holland & Knight LLP

Holland & Knight Health Dose: October 3, 2023

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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. ...more

Goodwin

Government Continues to Explore Role of 340B Contract Pharmacies

Goodwin on

The 340B Drug Pricing Program (the “Program”) allows certain healthcare providers (“covered entities”) to purchase pharmaceuticals from drug manufacturers at discounted rates. Some covered entities do not have an internal...more

McDermott+

Policy Update - CMS Releases FY 2024 IPPS Final Rule

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On August 1, 2023, the Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) final rule. The rule updates Medicare payment policies and quality reporting...more

Health Care Compliance Association (HCCA)

Adding some spice to your compliance program

Every quarter, each acute care hospital that is paid under the Inpatient Prospective Payment System has access to an Excel workbook that contains valuable information about your hospital’s compliance with myriad Medicare...more

Arnall Golden Gregory LLP

Proposed Rule Highlights Continued Push by CMS for Skilled Nursing Facility Ownership Transparency

In recent years, the Biden administration and Congress have pushed for greater transparency in skilled nursing facility ownership. In an effort focused on increased ownership disclosures specifically related to private equity...more

King & Spalding

CMS Issues Proposed Rules to Update Medicare Payment Rates and Policies for Skilled Nursing Facilities and Inpatient Psychiatric...

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On April 4, 2023, CMS issued proposed rules for Fiscal Year (FY) 2024 to update Medicare payment policies for skilled nursing facilities (SNFs) and inpatient psychiatric facilities (IPFs). CMS notes these rules are intended...more

McDermott Will & Emery

Biden Administration and CMS Propose New Rule to Provide Greater Transparency for Nursing Home Ownership

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Following the Biden administration’s efforts to promote nursing home safety, transparency, accountability and quality, the US Centers for Medicare & Medicaid Services (CMS) announced a proposed rule governing nursing home...more

Husch Blackwell LLP

COVID-19 Hospice How-To Series | The Results Are In: More Wins for Hospices in HIS Appeals

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COVID-19 remained a substantial obstacle to hospices’ efforts to comply with quality data reporting obligations in 2021. Those challenges resulted in a number of hospices receiving notices of a 2% Medicare payment reduction...more

King & Spalding

CMS Eyes State Medicaid Programs as Part of the Biden Administration’s Plan to Improve Nursing Home Care

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For the Biden administration, the over 200,000 COVID-related deaths of nursing home residents and staff have served as a powerful signal for the need for nursing home reform. As part of the administration’s reform efforts,...more

Husch Blackwell LLP

Hospice Audit Series | It's That Time of Year Again: Quality Data Reporting Determinations Raise New and Recurring Issues

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Each July, the Medicare Administrative Contractors issue notices of a 2% Medicare payment reduction to those providers who did not meet quality data reporting requirements. Those notices have been sent. In this episode, Husch...more

Mintz - Health Care Viewpoints

HRSA Demands Repayment from Providers that Failed to Comply with Provider Relief Fund Reporting Requirements

Under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (HHS) is authorized to distribute funds from its...more

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