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OIG Reports Highlight State Challenges and Call for Increased Oversight to Improve the Provision of Medicaid Behavioral Health...

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently issued two data briefs addressing challenges with the provision of behavioral health services to Medicaid enrollees, and calling for...more

Telehealth, Split or (Shared) Visit, Critical Care, and Teaching Physician Billing Proposals in the CY 2022 Medicare Physician Fee...

On July 13, 2021, CMS released the Calendar Year (CY) 2022 Medicare Physician Fee Schedule (PFS) proposed rule, which includes several noteworthy proposals related to telehealth, billing for split (or shared) visits, critical...more

CMS Extends GME Affiliation Agreement Deadline

Under section 1135(b)(5) waiver authority, CMS once again extended the submission deadline for both new Medicare graduate medical education (GME) affiliation agreements and amendments to existing Medicare GME affiliation...more

Fiscal Year 2022 IPPS Proposals Related to GME Payments

The FY 2022 Inpatient Prospective Payment System (IPPS) Proposed Rule implements the three noteworthy Graduate Medical Education (GME) provisions included in the Consolidated Appropriations Act, 2021 (CAA). As explained in...more

The FCC's COVID-19 Telehealth Program Round 2 Application Window is About to Open for a Narrow One-Week Timeframe

The Federal Communications Commission (FCC) announced that it will accept applications for Round 2 of the COVID-19 Telehealth Program (the Program) from 12:00 p.m. ET Thursday, April 29 to 12:00 p.m. ET Thursday, May 6, 2021....more

A Deeper Dive into Telehealth, Graduate Medical Education and Rural Health Care Provisions in the Stimulus Legislation

In addition to the key health care provisions included in the Consolidated Appropriations Act of 2021 (Stimulus Legislation) summarized in Baker Donelson's recent publication, the new legislation includes a few additional...more

Regulatory Sprint: Understanding the Impact on the Stark Law, Anti-kickback Statute, and Value-based Arrangements

The Department of Health and Human Services has released extensive and significant revised final rules governing the Physician Self-Referral Law (the Stark law) and the Medicare Anti-Kickback Statute (AKS) in furtherance of...more

CMS Continues to Support Telehealth and Virtual Care Policies in the CY 2021 Medicare Physician Fee Schedule Final Rule

On December 1, 2020, CMS released the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS) Final Rule (Final Rule), which includes several policies to extend or make permanent certain policies to support expanded...more

CY 2021 ESRD PPS Final Rule Includes Policy Changes to Promote In-Home Dialysis

The Calendar Year (CY) 2021 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Final Rule, CMS-1732-F (Final Rule) was published in the Federal Register on November 9, 2020. The Final Rule includes payment...more

CMS Announces Further Telehealth Expansions

On October 14, CMS announced several changes designed to expand access to telehealth. CMS made further additions to the list of services that Medicare will pay for practitioners to furnish through telehealth for the duration...more

CMS Revises Definition of Displaced Residents Counted for Temporary Transfers of GME Cap Slots

In the fiscal year (FY) 2021 inpatient prospective payment systems (IPPS) final rule, CMS finalized policies to define more accurately "displaced residents" from closing hospitals and programs. By revising this definition,...more

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