It is axiomatic that New York State requires every Medicaid provider to have an “effective” compliance program. New York Social Services Law § 363-d. In July 2022, the New York State Office of the Medicaid Inspector General...more
On June 8, 2023, the New York City Council passed a bill focused on healthcare accountability, with the goal of increasing access to healthcare services for New Yorkers. Entitled the Healthcare Accountability & Consumer...more
7/6/2023
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
City of New York ,
Drug Pricing ,
Health Insurance ,
Healthcare ,
Internal Revenue Code (IRC) ,
IRS ,
Medicaid ,
Medicare ,
New Amendments ,
Reimbursements
On November 4, 2021, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (the “Rule”) requiring COVID-19 vaccination for staff at Medicare- and Medicaid-certified providers and suppliers. The...more
11/8/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Employer Liability Issues ,
Health Care Providers ,
Healthcare ,
Healthcare Workers ,
Hospitals ,
Human Resources Professionals ,
Medicaid ,
Medicare ,
Physicians ,
Vaccinations
The Biden administration announced on September 10, 2021, the criteria for release of a $25.5 billion fourth tranche of COVID-19 relief funds. As with the other rounds of funding, the money is being made available to a wide...more
On July 19, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposal that would significantly increase the fines that would be imposed on hospitals for price transparency violations. This proposal,...more
While the business and personal relief provisions of the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) are understandably receiving the greatest coverage in the immediate aftermath of the bill’s signing,...more
On March 13, 2020, when President Trump declared a national emergency under the Stafford Act, the Secretary of Health and Human Services utilized his authority to take particular actions, such as temporarily waiving or...more
4/2/2020
/ 1135 Waivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Emergency Management Plans ,
EMTALA ,
Executive Orders ,
Health Care Providers ,
Healthcare ,
Medicaid ,
Medicare ,
Waivers
In response to the growing concerns of the capacity of the health care workforce as a result of the COVID-19 pandemic, on March 24, 2020 the Secretary of Health and Human Services, Alex Azar, issued a letter and associated...more
3/30/2020
/ 1135 Waivers ,
Children's Health Insurance Program (CHIP) ,
Coronavirus/COVID-19 ,
Emergency Management Plans ,
Health Care Providers ,
Healthcare Workers ,
Medicaid ,
Medicare ,
Regulatory Requirements ,
Relief Measures ,
Secretary of HHS ,
Telehealth ,
Telemedicine
In the 1990s, as part of the Federal Sentencing Guidelines, the U.S. Sentencing Commission developed for the first time the criteria upon which it will view an organization’s compliance program to be “effective.” In October...more
On March 25, 2015, a bipartisan group of U.S. Senators reintroduced the Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (“PRIME Act” or “Act”) following the lead of the U.S. House of Representatives,...more
On March 10, 2015, the Centers for Medicare & Medicaid Services’ (“CMS’s”) Center for Medicare and Medicaid Innovation (“Innovation Center”) announced a demonstration project incorporating new risk models for reimbursement of...more