Last week, President Biden signed legislation formally ending the COVID-19 national emergency that was originally declared under the Trump administration in March 2020. The bill to end the national emergency, H. J. Res. 7,...more
Last week, President Biden presented an outline of a $1.75 trillion Build Back Better (BBB) social spending reconciliation framework resulting from months of negotiations with House and Senate Democrats. Congressional...more
11/3/2021
/ Affordable Care Act ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Veterans Affairs ,
Federal Poverty Line ,
FMAP ,
Healthcare ,
Healthcare Reform ,
Home and Community Based Services (HCBS) ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Mental Health ,
Nursing Homes
On Friday of last week, HHS published two long-awaited final rules implementing significant changes to the regulations under the Stark Law and Anti-Kickback Statute (AKS). The two final rules are: (i) Revisions to the Safe...more
11/30/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
DMEPOS ,
Electronic Health Record Incentives ,
Fee-for-Service ,
Final Rules ,
Medical Devices ,
OIG ,
Popular ,
Safe Harbors ,
Self-Referral ,
Stark Law ,
Value-Based Care
Last week, HHS and DOJ issued the Health Care Fraud and Abuse Control (HCFAC) Program FY 2019 Annual Report detailing federal enforcement activities and results during the federal fiscal year (FY) 2019, which ran from October...more
In a letter dated June 11, 2020, Senate Finance Committee Chairman Charles Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) urged HHS Secretary Alex Azar to take measures to increase transparency around funds...more
n a motion filed last week in Alexander v. Azar, No. 3:11-cv-1703-MPS (D. Conn.), HHS argued that it cannot be sued by Medicare beneficiaries objecting to a hospital’s decision to admit them as inpatients instead of placing...more
On Wednesday, September 13, the House Ways and Means Committee gave unanimous approval to H.R. 3726, the Stark Administrative Simplification Act (the “Bill”). The Bill would amend the Stark law, codified at 42 U.S.C. §...more
Last week OIG released its semiannual report to Congress, which details the results of OIG’s operations for the first half of the 2017 federal fiscal year. Healthcare fraud recoveries by OIG totaled $2.04 billion during the...more
This month, the United States District Court for the District of Utah dismissed a relator’s allegations that a cardiac surgeon and two hospitals based in Utah violated the federal False Claims Act (FCA) by billing Medicare...more
The U.S. District Court for the District of Columbia issued an order on December 5, 2016 compelling HHS to meet certain annual targets to resolve its backlog of hundreds of thousands of pending Medicare claim appeals. HHS...more
On November 17, 2016, House Budget Committee Chairman Rep. Tom Price (R-GA) provided some insights on the major changes Republicans plan to make to the Affordable Care Act and Medicare in 2017. The remarks come on the heels...more
On August 17, 2016 the United States District Court for the District of Columbia granted summary judgment in favor of HHS in a dispute over whether Part C days can be treated as “days entitled to benefits under Part A” for...more
8/25/2016
/ Arbitrary and Capricious ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Disproportionate Share Adjustments ,
Hospitals ,
Managed Care Contracts ,
Medicare ,
Medicare Part A ,
Medicare Part C ,
Notice and Comment ,
Summary Judgment
On July 11, 2016, the HHS Office for Civil Rights (OCR) released new HIPAA guidance regarding ransomware. The Fact Sheet, issued by OCR on July 11, covers various issues relating to ransomware, including reporting...more