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2023 Health Care Predictions

See below the Saul Ewing LLP Health Law Practice Group 2023 predictions from various members of our practice group! Our colleagues help interested parties in the health care delivery system with transactional, regulatory,...more

2022 Health Care Predictions

​COVID-19 – and its variants Delta and Omicron – continue to wreak havoc around the world. Thousands of individuals have died and continue to die, and millions more have been diagnosed as having COVID-19. Many sectors of the...more

HHS OIG Releases Updated Health Care Fraud Self-Disclosure Protocol

On November 8, 2021, the United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released an updated Self-Disclosure Protocol (SDP) (here). The revision of the SDP is an important...more

CMS Releases Interim Final Rule to End Surprise Medical Bills

On July 1, 2021, the U.S. Department of Health and Human Services (HHS), along with several other federal agencies, issued an interim final rule to implement the first of several requirements in the No Surprises Act, which...more

2021 Health Care Predictions

One year ago – in early 2020 – most of us did not know what COVID-19 meant (co-Corona; vi-Virus; d-disease; 19 – 2019); had no idea how to “zoom”; did not know what social distance meant; and, were largely unfamiliar with...more

Maryland and Virginia Hospitals Settle Religious Discrimination Complaints Related to Clergy Visitations During COVID-19 Pandemic

On October 20, 2020, the Office for Civil Rights (“OCR”) within the U.S. Department of Health and Human Services (“HHS”) announced the resolution of two (2) sets of religious discrimination complaints to ensure clergy had...more

CMS Proposes Medicare Coverage of Certain New Medical Devices, Clarification of “Reasonable and Necessary” Definition

On September 1, 2020, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a proposed rule that, if finalized, would establish a Medicare coverage pathway to provide Medicare beneficiaries with...more

Hospital and Physician Practice and Nursing Home Alert: CMS Expands Accelerated and Advance Payment Program

On March 28, 2020, in connection with the recently enacted Coronavirus Aid, Relief, and Economic Security (CARES) Act, the Centers for Medicare & Medicaid Services (CMS) announced it is expanding its accelerated and advance...more

CMS Expands Telehealth Benefits for Medicare Beneficiaries

On March 17, 2020, the Trump administration announced expanded Medicare telehealth coverage allowing Medicare beneficiaries greater access to health care services in the safety of their homes as a “temporary resource.”...more

HHS Publishes Proposed Changes to the Stark Law and Anti-Kickback Statute

On October 9, 2019, the Centers for Medicare and Medicaid Services (CMS) and Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS), each issued a proposed rule to amend respectively the...more

CMS Issues DRAFT Guidance for Hospital Co-Location Initiatives; Industry is Invited to Submit Comments

As the health care delivery system continues to evolve, on May 3, 2019, the Centers for Medicare & Medicaid Services (“CMS”) issued a draft guidance document to state survey agency directors entitled, “Guidance for Hospital...more

Health and Human Services Office of Insepctor General Semi-Annual Fraud Report Highlights Federal Government Enforcement...

There continues to be significant media attention on health care privacy and data breaches, the opioid crisis, Medicaid funding and expansion efforts, telemedicine, and mergers and acquisitions affecting the health care...more

OIG Issues 2017 Work Plan

On November 10, 2016, the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) posted its work plan (the “Work Plan”) for fiscal year 2017. The OIG publishes its Work Plan on an annual basis. The...more

Could There Be A “Stark” Law Change?

There appears to be momentum on Capitol Hill in Washington, DC to modify and/or repeal the Ethics in Patient Referrals Act of 1989, more commonly known as the Stark Law, which was enacted to curb overutilization of certain...more

Highly Anticipated Final Rule from CMS on Returning Overpayments Affords Providers a Roadmap for Avoiding FCA Claims

In the February 12, 2016 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) with respect to reporting and returning overpayments by Medicare Part A and Part B providers to...more

CMS Releases Highly Anticipated Final Rule on Returning Overpayments

In the February 12, 2016 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) with respect to reporting and returning overpayments by Medicare Part A and Part B providers to...more

CMS and OIG Issue Final ACO Waivers

On Thursday, October 29, 2015, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of Inspector General (“OIG”) jointly issued a rule (the “Final Rule”) to finalize five (5) waivers of certain fraud and abuse...more

HHS Announces Next Generation ACO Model of Payment

On Tuesday, March 10, 2015, the U.S. Department of Health and Human Services ("HHS") announced the introduction of the Next Generation Accountable Care Organization ("ACO") Model of payment and care delivery. ACOs...more

CMS Issues Additional Sunshine Act Guidance With Respect to Payments to Speakers at Continuing Medical Education Events

In a final rule published in the Federal Register on November 13, 2014, the Centers for Medicare and Medicaid Services (CMS) eliminated the federal Sunshine Act reporting exclusion for payments to physicians at continuing...more

Medicare Shared Saving Program Interim Final Rule Extended

On October 17, 2014, the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services, Office of Inspector General (OIG) published in the Federal Register (79 FR 62356 et seq) a notice...more

Sunshine Act Implementation Proceeds; CMS Re-opens the Open Payments System

On August 15, 2014, the Centers for Medicare and Medicaid Services (CMS) re-opened the Open Payments system for physicians and teaching hospitals to register, review, and, if needed, dispute information gathered to date. CMS...more

CMS Shuts Down Sunshine Act Online Verification Process

On August 7, 2014, the Centers for Medicare & Medicaid Services (CMS) announced that the Open Payments system is “temporarily” off-line. The CMS announcement did not state when the Open Payments system would be back on-line....more

CMS Proposes Elimination of CME Exception to Sunshine Act Reporting

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule that includes a plan to eliminate the continuing medical education (“CME”) exclusion to the reporting requirements under the federal Physician...more

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