On November 15, 2023, the US Department of Health and Human Services (HHS) released its updated Language Access Plan (Updated Plan) to further ensure that the limited English proficiency (LEP) community and individuals with...more
Starting in mid-2024, Illinois hospitals will be required to take a much more active role in limiting consumers’ medical debt by screening all consenting uninsured patients for both public health insurance program coverage...more
12/4/2023
/ Affordable Care Act ,
Debt ,
Debt Collection ,
Enforcement Actions ,
Financial Regulatory Reform ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
Illinois ,
Medical Debt ,
New Legislation ,
New Regulations ,
No Surprises Act (NSA) ,
Patients ,
Uninsured Patients
In September, the US Department of Health and Human Services Office of Inspector General (OIG) issued an unfavorable advisory opinion to a pathology laboratory concerning a proposed services arrangement with referring...more
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for September 2023. We discuss several criminal and civil enforcement actions that involve violations of the False Claims Act (FCA), the...more
10/23/2023
/ Advisory Opinions ,
Anti-Kickback Statute ,
Antitrust Violations ,
Enforcement Actions ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Reform ,
OIG ,
Regulatory Agenda ,
Regulatory Reform ,
Stark Law
Discrimination on the basis of disability has contributed to significant disparities in healthcare and child welfare. To address these disparities, the US Department of Health and Human Services (HHS) has proposed updated...more
In February 2022, US President Joseph Biden announced an overhaul of regulations affecting nursing homes. These reforms, aimed at enhancing the safety and quality of care for nursing-home residents, focus on improving...more
Since 2022, Illinois has enacted two laws that aim to meet federal requirements for promoting health equity and are pertinent to healthcare providers. Beginning in 2025, certain licensed healthcare providers in Illinois will...more
On April 20, 2023, the US Department of Health and Human Services (HHS) made ownership data of all Medicare-certified hospices and home health agencies publicly available for the first time. This move is consistent with the...more
Following the Biden administration’s efforts to promote nursing home safety, transparency, accountability and quality, the US Centers for Medicare & Medicaid Services (CMS) announced a proposed rule governing nursing home...more
3/31/2023
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Data Reporting ,
Disclosure Requirements ,
Medicare ,
New Rules ,
Nursing Homes ,
REIT ,
Reporting Requirements ,
Skilled Nursing Facility ,
Transparency
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity between November 21 and December 31, 2022, including recent enforcement activity and a summary of the Office of Inspector...more
2/8/2023
/ Anti-Kickback Statute ,
Audits ,
Clinical Laboratories ,
Coronavirus/COVID-19 ,
Enforcement Actions ,
Fraud ,
Health Care Violations ,
Medicaid ,
Medical Devices ,
OIG ,
Regulatory Agenda
In connection with the Biden-Harris administration’s stated goals of improving safety, transparency, accountability and quality in nursing homes, the US Centers for Medicare & Medicaid Services (CMS) have announced new...more
Starting July 1, 2023, The Joint Commission (TJC) will set health equity as a National Patient Safety Goal for certain TJC-accredited organizations and roll out a new Health Care Equity certification program to recognize and...more
2/1/2023
/ Affordable Care Act ,
Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Certifications ,
Critical Access Hospitals ,
Health Care Providers ,
Hospitals ,
Mental Health ,
Patients ,
Proposed Rules ,
The Joint Commission
Nursing homes and long-term care facilities were hit hard by COVID-19. However, as of September 11, 2022, 87.3% of residents and 86.9% of staff have completed primary vaccination. Such adherence may have been instrumental in...more
On August 4, 2022, the US Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking (NPRM or proposed rule) to reinterpret section 1557 of the Affordable Care Act (ACA), which prohibits...more
8/5/2022
/ ADEA ,
Affordable Care Act ,
Americans with Disabilities Act (ADA) ,
Bostock v Clayton County Georgia ,
Children's Health Insurance Program (CHIP) ,
Civil Rights Act ,
Department of Health and Human Services (HHS) ,
Dobbs v. Jackson Women’s Health Organization ,
Enforcement ,
Final Rules ,
Limited English Proficiency (LEP) ,
Medicare Part A ,
Medicare Part B ,
Non-Discrimination Rules ,
Notice of Proposed Rulemaking (NOPR) ,
PACE ,
Proposed Rules ,
Rehabilitation Act ,
Reproductive Healthcare Issues ,
Title VI
This special inaugural issue of McDermott’s Healthcare Regulatory Check-Up highlights noticeable enforcement activity, OIG regulatory developments, CMS regulatory developments and other key developments for healthcare...more
5/27/2022
/ Advisory Opinions ,
Anti-Kickback Statute ,
Co-payments ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Drug Pricing ,
False Claims Act (FCA) ,
Health Care Providers ,
Manufacturers ,
Medicaid Drug Rebate Program ,
OIG ,
Pharmaceutical Industry ,
Prescription Drugs ,
Stark Law
This special inaugural issue of McDermott’s Healthcare Regulatory Check-Up highlights noticeable enforcement activity, OIG regulatory developments, CMS regulatory developments and other key developments for healthcare...more
5/26/2022
/ Advisory Opinions ,
Anti-Kickback Statute ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Nursing Home Reform Act (FNHRA) ,
Global Code of Ethics ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
OIG ,
Regulatory Agenda
The Centers for Medicare & Medicaid Services (CMS) recently published detailed databases summarizing changes of ownership of Medicare-enrolled hospitals and skilled nursing facilities (SNFs). The databases currently include...more
4/28/2022
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Competition ,
Hospitals ,
Long Term Care Facilities ,
Nursing Homes ,
Payment Systems ,
Proposed Rules ,
Rate Parity Agreement ,
Skilled Nursing Facility ,
Transparency ,
Value-Based Purchasing
On February 28, 2022, the White House issued a fact sheet outlining several efforts aimed to increase safety, accountability, oversight and transparency in the senior services industry (Fact Sheet). Although the Fact Sheet’s...more
3/14/2022
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Health and Safety ,
Health Care Providers ,
Healthcare Reform ,
Long Term Care Facilities ,
Medicare ,
Nursing Homes ,
Regulatory Oversight ,
Skilled Nursing Facility
The Centers for Medicare and Medicaid Services (CMS) published an interim final rule with comment period (IFR) on November 5, 2021, that implements the Biden administration’s previously announced vaccine mandate for...more
As we continue our three-part webinar series, McDermott’s litigation and healthcare lawyers will focus on how payors can actively prepare for possible enforcement and litigation stemming from recent and potential changes to...more
4/29/2021
/ Affordable Care Act ,
Anti-Discrimination Policies ,
Commercial Litigation ,
Continuing Legal Education ,
Department of Health and Human Services (HHS) ,
Enforcement ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Payor Contracts ,
Reimbursements ,
Rulemaking Process ,
Section 1557 ,
Webinars
Stay current on the healthcare enforcement issues impacting your business’ compliance strategies. In this installment of the Healthcare Enforcement Roundup, we address:
• Key areas of enforcement scrutiny in 2021,...more
4/2/2021
/ 1135 Waivers ,
Biden Administration ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Enforcement Guidance ,
Executive Orders ,
False Claims Act (FCA) ,
Healthcare Fraud ,
OIG ,
Private Equity ,
Regulatory Oversight ,
Revocation ,
Telehealth ,
Telemedicine
The Centers for Medicare and Medicaid Services (CMS) notified state survey agency directors that it has lifted previously imposed hospital survey suspensions and resumed routine hospital reaccreditation and recertification...more
One day before an updated rule of the US Department of Health and Human Services regarding Section 1557 of the Patient Protection and Affordable Care Act took effect, the US District Court for the Eastern District of New York...more
In this installment of the Healthcare Enforcement Roundup we cover new and longstanding issues impacting the healthcare enforcement landscape. First, we explore the impact of the Coronavirus (COVID-19) on the healthcare...more
7/27/2020
/ 1135 Waivers ,
Compliance ,
Continuing Legal Education ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
e ,
False Claims Act (FCA) ,
Guidance Update ,
Health Care Providers ,
Hospitals ,
Objective Falsity ,
Physicians ,
Split of Authority ,
Stark Law ,
Whistleblowers
On June 12, 2020, the Office for Civil Rights (OCR) of the US Department of Health and Human Services (HHS) finalized a rule under Section 1557 of the Patient Protection and Affordable Care Act (the 2020 Final Rule) that...more
6/18/2020
/ Altitude Express Inc v Zarda ,
Bostock v Clayton County Georgia ,
Civil Rights Act ,
EEOC v RG & GR Harris Funeral Homes ,
Employer Liability Issues ,
Gender Identity ,
Hiring & Firing ,
LGBTQ ,
SCOTUS ,
Sex Discrimination ,
Sexual Orientation ,
Sexual Orientation Discrimination ,
Title VII ,
Transgender