News & Analysis as of

Office of the Inspector General Medicaid Children's Health Insurance Program (CHIP)

Quarles & Brady LLP

Is Your Employee or Contractor Excluded?

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Employers must check its employees, contractors and vendors to see if an individual or organization is excluded from participating in federal and/or state programs. While there are a variety of exclusion programs at the...more

Husch Blackwell LLP

Increasing Hospital Reimbursement by Paying to the Upper Payment Limit

Husch Blackwell LLP on

This post is the first in a series dedicated to Colorado’s Medicaid finance and payment systems, challenges faced by those programs, and opportunities for expansion. The Colorado Healthcare Affordability and Sustainability...more

Burr & Forman

Hot Topics in Health Care May 2023

Burr & Forman on

Proposed Protections for Patient Data Related to Reproductive Care - On April 12, 2023, the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services (HHS) proposed a new rule to strengthen HIPAA...more

Alston & Bird

Health Care Week in Review: Biden Administration Released a Final Rule on Surprise Billing

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

Morgan Lewis - Health Law Scan

MA Audit: Hospices Unaware of Dual Eligibles Medicaid Filing Rule, Causing Potential Overpayments

The US Department of Health and Human Services, Office of Inspector General (OIG) recently transmitted a memorandum to the Center for Medicaid and CHIP Services detailing the findings of the Massachusetts state auditor's...more

Morgan Lewis

HHS Makes More Provider Relief Funds Available, Offers 60-Day Grace Period for First Reporting Deadline

Morgan Lewis on

The US Department of Health and Human Services (HHS) recently announced that it will make $25.5 billion available in new COVID-19 relief funds to providers through the Health Resources and Services Administration (HRSA). To...more

ArentFox Schiff

Searching for Safe Harbors? CMS-Sponsored Model Participants Receive Anti-Kickback Statute Protection

ArentFox Schiff on

Enrolling in such a CMS-sponsored innovation model now has an added benefit: a new Anti-Kickback Statute (AKS) safe harbor. ...In its mission to reward value over volume, the Centers for Medicare & Medicaid Services’ (CMS)...more

Fox Rothschild LLP

HHS Extends COVID-19 Related Public Health Emergency Through January 20, 2021

Fox Rothschild LLP on

On October 2, 2020, Health and Human Services (HHS) Secretary, Alex M. Azar II, announced the renewal of the public health emergency declaration due to the continued consequences of the COVID-19 pandemic. The 90-day renewal...more

Arnall Golden Gregory LLP

CMS Increases Scrutiny of Owners through Medicare Provider Enrollment Process

The Centers for Medicare & Medicaid Services (CMS) issued a final rule on September 5, 2019, intended to address program integrity and vulnerability issues....more

Alston & Bird

Alston & Bird Healthcare Week in Review

Alston & Bird on

Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health...more

Manatt, Phelps & Phillips, LLP

States Report Increases in Children’s Medicaid Dental Utilization

On May 4, 2018, Center for Medicaid and CHIP Services (CMCS) Acting Director Timothy Hill released an Informational Bulletin calling for states to review their Medicaid and CHIP payment policies to ensure alignment with...more

Clark Hill PLC

Texas OIG Turns Over New Leaf: MCOs Must Turn Attention to SIUs

Clark Hill PLC on

More active SIUs may mean more scrutiny of Medicaid providers - The Texas Office of Inspector General (OIG) has just completed its first full year of reforms under a new Inspector General. 2017 may reveal whether these...more

Mintz - Health Care Viewpoints

Forty-Five Days and Counting for Current HHS Leadership: Implications for Rulemaking

Before we all turn our full attention to the nominations of Representative Tom Price as Secretary of Health and Human Services, and policy consultant Seema Verma to lead CMS, we need to remember that there are still...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - November 2016 #5

The incoming Trump Administration selects HHS and CMS leadership; Alaska moves forward with its proposed 1332 waiver for its ACA reinsurance program; and a new Manatt Health report considers the role of Medicaid supplemental...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - August 2016 #3

CMS’s risk adjustment program data signals an improving risk pool while the agency announces plans to modify the program; California enrolls 134,000 undocumented immigrant children into Medicaid; and Oregon approves increases...more

McAfee & Taft

OIG rules hospital's offer of free transportation, lodging doesn't violate anti-kickback statute

McAfee & Taft on

The Office of Inspector General of the Department of Health and Human Services recently posted an Advisory Opinion describing a proposed arrangement by an academic medical center that offers free transportation and lodging to...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - March 2016

STATE STAFFING UPDATES: Nevada: New Insurance Commissioner Appointed - The Director of Nevada's Department and Industry announced Barbara Richardson as the Commissioner of the Division of Insurance. Richardson...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - October 2015 #3

Arizona seeks Medicaid Waiver to implement new coverage restrictions for Medicaid expansion enrollees and delivery system reform; Tennessee’s uninsured rate continues to drop; and Louisiana gubernatorial candidates line up...more

Alston & Bird

A&B Healthcare Week In Review, September 2015

Alston & Bird on

On September 25, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled “Medicare Program: Medicare Clinical Diagnostic Laboratory Tests Payment System”. This proposed rule would...more

Poyner Spruill LLP

Hospital Compliance Program Overview

Poyner Spruill LLP on

In the constantly evolving climate of health care enforcement, maintaining a comprehensive and effective internal compliance program has taken on added significance, especially in the past few years. While detailed coverage...more

McDermott Will & Emery

Medicaid Managed Care Update: A Middle Ground for Network Adequacy Standards

McDermott Will & Emery on

This article is part of a series that takes an in-depth look at several proposals that would affect managed care organizations, health care providers and other industry stakeholders participating in, and contracting with...more

Cooley LLP

Blog: CMS Announces that Data Analytics has Prevented $820M in Improper Medicare Payments

Cooley LLP on

The Office of Inspector General (OIG) recently certified the “positive return on investment” from the FPS and recommended its continued operation, although the OIG determined that it was not feasible at this time to expand...more

The Volkov Law Group

Who is Committing Healthcare Fraud?

The Volkov Law Group on

The financial recoveries for healthcare fraud are staggering. The Justice Department and Health and Human Services (Office of Inspector General (“OIG”) and Centers for Medicare and Medicaid Services (“CMS”)) regularly...more

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