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Proposed Legislation Focuses on Private Equity and REITs in Healthcare

Efforts to draw attention to and, in some instances, dissuade private equity investment in healthcare have been on the rise. For example, in late 2023, the Centers for Medicare & Medicaid Services finalized a rule increasing...more

CMS Announces the Innovation in Behavioral Health Model

Overview - The Centers for Medicare & Medicaid Services (“CMS”) is launching a new model aimed at improving the quality of care and health outcomes for individuals with behavioral health (“BH”) problems. The model, announced...more

UPDATE: CMS Finalizes Rule Requiring Greater SNF Ownership Transparency, Including Private Equity and REIT Disclosures, and...

The Centers for Medicare & Medicaid Services (“CMS”) released a final rule on November 15, 2023 (published on November 17, 2023) (the “Rule”), requiring greater skilled nursing facility (“SNF”) ownership transparency. The...more

UPDATE: CMS Finalizes Hospice 36-Month Rule

The Centers for Medicare & Medicaid Services (“CMS”) has finalized 2024 home health rules to include application of the home health “36-month rule” to hospice providers. The revised rule will forbid any change in majority...more

Nursing Home Ownership Affiliations Published on Nursing Home Care Compare

In another step in the years-long process of increasing transparency in the nursing home industry, the Centers for Medicare & Medicaid Services (“CMS”) has begun posting nursing home affiliations on Nursing Home Care Compare....more

Home Health & Hospice Quarterly - Q2

AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more

Home Health & Hospice Quarterly - Q1

AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more

Owners of Home Health Agencies and Hospices Released for First Time

On April 20, 2023, the Centers for Medicare & Medicaid Services (“CMS”) publicly released data on home health and hospice agency ownership for the first time. The data is derived from self-reported information (primarily...more

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

CMS Announces Its First Home- and Community-Based Service Quality Measure Set

On July 21, 2022, the Centers for Medicare & Medicaid Services (“CMS”) released its first-ever nationally standardized Home- and Community-Based Services (“HCBS”) quality measure set to encourage consistent quality...more

HHS Extends ARP Spending Deadline to March 31, 2025 for HCBS Medicaid Recipients

States now have through March 31, 2025 to use the federal medical assistance percentage (FMAP) funding made available by the American Rescue Plan Act (ARPA). The announcement was made by the U.S. Department of Health and...more

CMS Releases Skilled Nursing CHOW (and Ownership) Data

For the first time, the Centers for Medicare & Medicaid Services (CMS) has released data publicly on skilled nursing facility changes of ownership (CHOWs)). The data, which was released on April 20, 2022, includes information...more

HHS Offers Medicare Providers Second Chance at Second Tranche Funding ($20 Billion Allocation)

As previously reported, the Department of Health & Human Services (HHS) issued Provider Relief Funds in multiple tranches. One of the largest tranches—$20 billion of the initial $50 billion general distribution—will be...more

Applying For or Updating a CLIA Waiver During The Pandemic

While much of the COVID-19 testing has been done by government and private dedicated laboratories, many providers in the acute and long-term care space are moving towards providing their own CLIA-waived tests.  ...more

COVID-19 Update: Ambulatory Surgery Centers and CMS’ Hospitals Without Walls Policy

On March 30, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued new rules and waivers targeted at ensuring hospitals and health systems have sufficient capacity to handle the potential surges of COVID-19...more

Medicare Relief Funds Hit Your Account: Can You Keep Them?

Many Medicare providers awoke the morning of Friday April 10, 2020 to an influx of Medicare funds.  The funds are a $30 billion portion of the $100 billion stimulus fund intended to provide relief to healthcare providers...more

COVID-19 and Compliance, Part II: What Assisted Living Facilities Need to Know Today About Acute Care Discharges

Every healthcare and public health tool available is engaged in the fight against COVID-19. Few tools are more precious than beds, and perhaps no bed is more precious during this time than hospital beds, where the most sick...more

CMS Grants Medicare Provider Enrollment Relief

As the single largest payor for health care in the United States, the Centers for Medicare & Medicaid Services (CMS) has recognized and acted on the need to move quickly in the fight against COVID-19....more

COVID-19 and Changes of Ownership

The President’s national emergency declaration on March 13, 2020, issued in response to COVID-19, enabled the Centers for Medicare and Medicaid Services (CMS) to grant state Medicaid agencies added flexibility through a...more

CMS Proposes Regulations that Would Have Significant Financial Impact on CCRCs

In November 2019, the Centers for Medicare & Medicaid Services proposed the Medicaid Fiscal Accountability Regulation (MFAR), a set of regulations targeted at promoting financial integrity in state Medicaid programs. ...more

UPDATE: New CMS Program Integrity Rule Now in Effect

The Centers for Medicare & Medicaid Services’ (CMS) final rule addressing program integrity and vulnerability issues, which was issued on September 5, 2019, went into effect on November 4, 2019. ...more

Program Efficiency, Transparency, and Burden Reduction, Oh My!: CMS Issues Fact Sheet on Updates to CoPs and CfCs

The Centers for Medicare & Medicaid Services (CMS) issued a fact sheet related to proposed regulations addressing conditions of participation (CoPs) and conditions for coverage (CfCs). ...more

CMS Seeks Input on Direct Provider Contracting

The Centers for Medicare & Medicaid Services (CMS) announced that it is seeking input on direct provider contracting (DPC) between “payers and primary care or multi-specialty groups to inform potential testing of a DPC model”...more

CMS Files Objection in Skilled Nursing Bankruptcy Case

An increasing number of Medicare providers have found themselves in financial distress and are contemplating bankruptcy filings. While provider bankruptcies include a host of issues outside the government reimbursement...more

New CMS Medicare Advantage Policy Could Have Significant Impact on Senior Living and In-Home Care Providers

A Centers for Medicare & Medicaid Services (CMS) call letter (the “Call Letter”) released on April 2, 2018, could mean a dramatic and positive shift in CMS policy related to Medicare Advantage (MA) plans and senior living and...more

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