With the explosion of Artificial Intelligence (AI) use and application, the Massachusetts Attorney General’s recent release of AI guidelines should serve as a reminder to healthcare providers and health IT developers of the...more
While the pandemic is not over, the COVID-19 public health emergency (PHE) is expected to expire soon, which means that a number of operational, safety, and billing standards that were waived at the beginning of the pandemic...more
11/10/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Fraud and Abuse ,
Health Care Providers ,
Hospitals ,
Long Term Care Facilities ,
Medicare ,
Mental Health ,
Public Health Emergency ,
Telehealth ,
Waivers
In a recent unanimous decision, the Supreme Court found that the Centers for Medicare and Medicaid Services (“CMS”), part of the federal Department of Health and Human Services (“HHS”), erred when it significantly reduced...more
6/24/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Health Care Providers ,
Hospitals ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Prescription Drugs ,
SCOTUS ,
Section 340B
With many hospitals well into their FY 2021 Medicare cost report preparation, here is a brief reminder of the process required for protesting items, as well as a summary of two new developments for Medicare Graduate Medical...more
1/31/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Financial Reporting ,
Fiscal Reports ,
Fiscal Year ,
Graduate Medical Education ,
Health Care Providers ,
Hospitals ,
MACs ,
Medicare ,
Organ Transplant Centers ,
Reimbursements
While you were celebrating the New Year, Governor Baker signed Chapter 260 of the Acts of 2020, an “Act promoting a resilient health care system that puts patients first,” the result of the Legislature’s months of work to...more
As a holiday gift to providers, the U.S. Department of Health and Human Services (HHS) General Counsel recently issued a strongly worded Advisory Opinion indicating that federal law requires drug manufacturers to deliver...more
1. 340B ADR Process Established -
At long last, more than ten years after Congress directed it to do so, HHS has finalized an alternative dispute resolution (“ADR”) process for both providers and pharmaceutical...more
12/15/2020
/ American Depository Receipts (ADRs) ,
Department of Health and Human Services (HHS) ,
Dispute Resolution ,
Drug Pricing ,
Health Care Providers ,
Manufacturers ,
Outpatient Prospective Payment System (OPPS) ,
Pharmaceutical Industry ,
Prescription Drugs ,
Relief Measures ,
Section 340B
As the calendar year draws to a close, hospitals with a 9/30 fiscal year end are working intensely on completing their FY 2019 Medicare cost reports. This seemed like a good time to remind everyone of some of CMS’s more...more
While most providers understand the need to bill Medicare correctly, many often fail to recognize the potentially disastrous results of not keeping Medicare informed of your correct and up-to-date practice information. A...more
The Massachusetts Board of Registration in Medicine (“BORIM”) recently finalized revisions to 243 CMR 2.00 (Licensure and the Practice of Medicine). These changes took effect on August 9, 2019. Because of the uncertainty...more
9/12/2019
/ Consent ,
Corporate Practice of Medicine ,
Health Care Providers ,
Healthcare Facilities ,
Hospitals ,
Informed Consent ,
Medical License ,
New Guidance ,
New Regulations ,
Physicians ,
Regulatory Requirements ,
Unlicensed Medical Providers
Your hospital may have some corrective work to do over the next few weeks if you want to avoid delays in receiving payment for your Medicare claims for services rendered at off-campus outpatient provider-based departments....more
The U.S. Department of Health and Human Services (“HHS”) recently published a final rule on the 340B Drug Pricing Program (“340B Program”), moving the effective date for changes to the program up to January 1, 2019. Making...more
12/18/2018
/ Civil Monetary Penalty ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Final Rules ,
Health Care Providers ,
Health Clinics ,
Hospitals ,
Manufacturers ,
Pharmaceutical Industry ,
Prescription Drugs ,
Section 340B