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Courts Diverge in Challenges to CMS's Minimum Staffing Requirements for LTC Facilities

On May 10, 2024, the Centers for Medicare and Medicaid Services (CMS) published its Final Rule to implement minimum staffing standards for long-term care (LTC) facilities in the United States. However, as discussed in our...more

HHS Rescinds Policy Extending Notice and Comment Rulemaking Procedures to Rules for Grants, Public Benefits, and Contracts

Effective March 3, 2025, the US Department of Health and Human Services (HHS) rescinded its long-standing policy that had waived a statutory exemption under the Administrative Procedure Act (APA) from notice and comment...more

DEA Proposed Telemedicine Prescribing Rule Could Burden Hospice Physicians and Hospice Operations

Signaling a possible future approach to regulating Schedule II-V prescribing via telemedicine in lieu of in-person examinations, on January 17 the DEA issued a notice of proposed rulemaking regarding its next iteration of...more

Healthcare and Life Sciences: Key Insights and Considerations for Stakeholders in 2025

This report compiles several important developments that shaped the healthcare and life sciences industries in 2024 and spotlights key areas to watch in 2025. Each section addresses either an industry sector within healthcare...more

Congress Temporarily Extends Hospice Telehealth Face-to-Face Flexibility

US Congress on December 20, 2024 passed a last-minute temporary government funding bill that keeps the government open for three months. As part of this package, a number of existing telehealth flexibilities were also...more

Tick-Tock: CMS Overpayment Refund Final Rule and Practical Implications

The Centers for Medicare & Medicaid Services issued its long-anticipated final rule clarifying the 60-day overpayment refund obligation (the 60-Day Rule) first established in a 2016 regulation for Medicare Part A and B...more

How the US Election May Affect Drug Pricing, Medicare, and Medicaid Programs – Key Areas to Watch

Heading into the new year, a Trump-Vance administration will control the White House and the Republicans will hold a narrow majority in both the House and Senate. This control trifecta is likely to impact both legislative and...more

CMS Proposes Additional Revisions to the 60-Day Rule

The Centers for Medicare & Medicaid Services has issued its Calendar Year 2025 Medicare Physician Fee Schedule Proposed Rule, scheduled for publication in the Federal Register on July 31, 2024. In response to industry...more

Hospice Update: March Goes Out Like a Lion

The old adage—March comes in like a lion and goes out like a lamb—didn’t quite hold true for the hospice sector, which experienced a late-month flurry of activity. The government gave the hospice sector a lot to consider,...more

My Health My Data Act Rollout Begins March 31: What You Need to Know

Washington’s My Health My Data Act (MHMDA), signed into law last year, is here and goes into effect on March 31, 2024, with small businesses having until June 30, 2024 to comply. ...more

Medicare’s New Dementia GUIDE Model: How Can Physicians, Hospices, and Home Health Agencies Participate?

If you have had a loved one suffer from dementia, you know the emotional, physical, and financial toll of this terrible disease. With advancements in dementia treatment, however, there is renewed hope on addressing this...more

Florida Healthcare Director Charged in Fraud Case Against CMS

Continuing its recent slate of high-profile indictments, convictions, and plea agreements involving healthcare executives who have violated federal healthcare laws, the US Department of Justice (DOJ) recently announced...more

Illinois Supreme Court Holds Healthcare Employee Fingerprint Data Exempt from BIPA

In the first win for defendants facing Illinois Biometric Information Privacy Act (BIPA) litigation before the Illinois Supreme Court, the Court in Mosby v. Ingalls Memorial Hospital held that BIPA excludes from its...more

OIG Advisory Opinion: Free Hearing Aids from Cochlear Implant Maker Could Violate Fraud and Abuse Laws

The US Department of Health and Human Services Office of Inspector General (OIG) posted on October 25, 2023 Advisory Opinion No. 23-08, in which OIG rejected a proposed arrangement from a cochlear implant device manufacturer...more

OIG Releases New ‘One-Stop Shop’ General Compliance Program Guidance

The US Department of Health and Human Services Office of Inspector General (OIG) released on November 6 its General Compliance Program Guidance (GCPG), a helpful new resource for the healthcare industry that consolidates...more

OIG Unveils New General Compliance Program Guidance, First Major Update Since 2008

The US Department of Health and Human Services Office of Inspector General (OIG) released its new General Compliance Program Guidance (GCPG) on November 6, 2023. The GCPG is designed to serve as a reference guide for the...more

CMS Increases Hospice Scrutiny through Provider Enrollment and Oversight Tools

The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, effective November 13, 2023, designed to enhance the oversight of hospice providers throughout the United States and increase regulatory...more

Texas Attorney Convicted of Conspiracy with Clients to Commit Healthcare Fraud

n the second blog post of our series on healthcare chief compliance officers and lawyers accused of “going bad,” we discuss Texas attorney Peter J. Bennett (licensed since 2007) who was charged in the Eastern District of...more

OIG Approves Per-Click Marketing Arrangement Involving Online Healthcare Directory

The US Department of Health and Human Services Office of Inspector General (OIG) recently released Advisory Opinion No. 23-04, which found that fraud and abuse risks were sufficiently low in light of certain safeguards to...more

Hospice in the Crosshairs: Medicare’s Enhanced Oversight and Newly Announced Audit Pilot

For over a year, the hospice industry, legislators, and state and federal regulators have expressed concerns about the fast growth and potentially unscrupulous activities of new hospices in several states in particular. Those...more

Chief Compliance Officer Convicted in Healthcare Fraud Case

The US Department of Justice (DOJ) announced on June 8, 2023 that Steven King, a compliance executive of pharmacy holding company A1C Holdings LLC, was convicted of defrauding Medicare out of more than $50 million in a scheme...more

Hospice General Inpatient Services (GIP): New OIG Audit Alert

The HHS Office of Inspector General (OIG) announced on June 15, 2023 that it plans to initiate a new audit of Medicare payments for hospice general inpatient (GIP) services, focused on hospice GIP services furnished to...more

How the End of the PHE Will Impact the Healthcare Industry

The Biden administration announced on January 30, 2023 that the COVID-19 Public Health Emergency (PHE) would officially end on May 11, 2023. The PHE declaration, which first was issued by the Secretary of the US Department of...more

OIG Overhauls Compliance Program Guidance Process

The US Department of Health and Human Services Office of Inspector General (OIG) announced on April 25 that it would be updating its Compliance Program Guidances (CPGs)....more

HHAs and Hospices: What to Expect When the COVID-19 PHE Ends

COVID-19 significantly affected home-based care providers, such as home health agencies (HHAs) and hospices, whose staff had to overcome both physical and mental burdens of going into patients’ homes to deliver care,...more

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