On September 1, 2020, HHS announced that assisted living facilities (ALFs) that do not bill Medicare or Medicaid may now apply for funding under the Provider Relief Fund Phase 2 General Distribution allocation. HHS has...more
On August 25, 2020, CMS announced two new changes pertaining to nursing homes during the COVID-19 public health emergency. First, CMS published an interim final rule with comment period (IFC), which requires nursing home...more
Last week, HHS announced that it will now accept additional applicants for the Provider Relief Fund Phase 2 General Distribution. All eligible providers will only receive funding of up to 2 percent of their reported total...more
On April 27, 2020, the Supreme Court ruled in Maine Community Health Options v. United States that the government must pay over $12 billion to individual and small group health insurers who had claimed losses under the Risk...more
On March 26, 2020, the Manhattan U.S. Attorney’s Office filed suit against Anthem, Inc. for violations of the False Claims Act. The complaint alleges that between 2014–2018, Anthem submitted inaccurate diagnosis codes to CMS...more
Following President Trump’s declaration of a national emergency related to COVID-19 on March 13, 2020, CMS has been swiftly approving states’ requests for flexibilities for their Medicaid programs as they continue to battle...more
On November 25, 2019, CMS released a Request for Application (RFA) describing how organizations can apply to participate in two of three Direct Contracting Model options. The Direct Contracting Model is a set of voluntary...more
On May 15, 2018, the Senate Committee on Health, Education, Labor and Pensions held a hearing entitled “Examining Oversight Report on the 340B Drug Pricing Program.” Led by Subcommittee Chairman Sen. Lamar Alexander (R-TN),...more