HELPFUL HINTS -
The Federal No Surprises Act The Federal No Surprises Act (the “Act”) became fully effective on January 1, 2022. The Act protects enrollees in group and individual market plans (including ERISA plans) and...more
1/25/2022
/ Advisory Opinions ,
Anti-Kickback Statute ,
Biden v Missouri ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Employer Mandates ,
Healthcare ,
Healthcare Fraud ,
Healthcare Reform ,
Healthcare Workers ,
Infectious Diseases ,
Mental Health ,
National Federation of Independent Business v Department of Labor and OSHA ,
New Legislation ,
OIG ,
OSHA ,
Surprise Medical Bills ,
Vaccinations
Helpful hints -
OIG Updates Health Care Fraud Self-Disclosure Protocol (“SDP”) -
On November 8, 2021, the OIG issued an updated SDP to providers, which included clarifications of existing guidance and increased the minimum...more
11/16/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Disproportionate Share Adjustments ,
Employer Mandates ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
OIG ,
Outpatient Prospective Payment System (OPPS) ,
Physician Fee Schedule ,
Self-Disclosure Requirements ,
Vaccinations
On November 4, 2021, the Centers for Medicare & Medicaid Services (“CMS”) announced its interim final rule regarding vaccination requirements for eligible staff of certain health care providers. The rule, which becomes...more
11/5/2021
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Coronavirus/COVID-19 ,
Emergency Management Plans ,
Employer Liability Issues ,
Employer Mandates ,
Essential Workers ,
Health and Safety ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Infectious Diseases ,
Interim Final Rules (IFR) ,
Public Health Emergency ,
Vaccinations ,
Workplace Safety
Helpful Hints -
ADPH Says Vaccine Administration is Limited at this Time The Alabama Department of Public Health issued a press release on January 11, 2021, urging Alabamians to have patience in receiving the COVID-19...more
1/29/2021
/ 1135 Waivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Clinical Trials ,
Coronavirus/COVID-19 ,
Food and Drug Administration (FDA) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Privacy Rule ,
Infectious Diseases ,
OCR ,
Right of Access ,
Stark Law ,
Vaccinations
On December 2, 2020, the Centers for Medicare and Medicaid Services (“CMS”) finalized sweeping changes to the federal Physician Self-Referral Law, commonly known as the Stark Law. Many of the changes reflect CMS’ intent to...more
On October 9, 2019, the Centers for Medicare and Medicaid Services (“CMS”) proposed sweeping changes to the federal Physician Self-Referral Law, commonly referred to as the Stark Law. While many of the changes reflect CMS’...more
12/30/2019
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Physician Compensation Arrangements ,
Physicians ,
Regulatory Reform ,
Regulatory Requirements ,
Rulemaking Process ,
Stark Law
If the 2017 healthcare environment could be summed up in one word, it would be “uncertainty.” With the largely unexpected election of Donald Trump as President, the multiple, unsuccessful attempts by the Republican controlled...more
12/18/2017
/ Affordable Care Act ,
Bundled Payments ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Opioid ,
Pain Management Clinics ,
Physicians ,
Trump Administration
Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more
12/12/2016
/ 60-Day Rule ,
Affordable Care Act ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Data Breach ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Fraud ,
HIPAA Breach ,
Hospitals ,
Implied Certification ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
OIG ,
Overpayment Recovery Time Limits ,
PHI ,
Physicians ,
Popular ,
Premiums ,
Provider Payments ,
Quality Payment Program (QPP) ,
Trump Administration ,
Universal Health Services Inc v United States ex rel Escobar ,
Value-Based Payments