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New CMS Rule Requires Extrapolation of Medicare Advantage RADV Audit Findings

The Centers for Medicare and Medicaid Services (CMS) published its final rule regarding the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program in early February 2023. Among other matters, the final rule...more

HHS Announces Targeted CARES Act Provider Relief Fund Payments to Medicaid and CHIP Providers and Safety Net Hospitals

The U.S. Department of Health and Human Services (HHS) recently announced two new targeted distributions from the CARES Act Provider Relief Fund (the Provider Relief Fund) to assist in the response to the medical and economic...more

HHS to Distribute First Tranche of $100 Billion to Healthcare Providers for COVID-19 Losses

The Coronavirus Aid, Relief, and Economic Security Act, known as the “CARES Act,” which became law on March 27, 2020, appropriates $100 billion to the Public Health and Social Services Emergency Fund to reimburse providers...more

Guide to Federal Health Program Waivers Concerning the COVID-19 Crisis

The federal Department of Health and Human Services (HHS) on March 13, 2020, invoked its authority under section 1135 of the Social Security Act (the act) to waive certain requirements that providers normally must meet to...more

Theft Of Unencrypted Laptops Leads To Two HHS Settlements Totaling Nearly $2 Million

On April 22, the U.S. Department of Health and Human Services (HHS) announced settlements with both Concentra Health Services (Concentra) and QCA Health Plan, Inc. (QCA). Through these latest settlements, HHS is reiterating...more

HHS OIG Takes Aim At CMS’ Oversight Of Electronic Health Records Incentive Program

On November 29, 2012, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a report raising concerns about the Centers for Medicare and Medicaid Services’ (CMS) oversight of the...more

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