The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that reduces payments to hospitals with excess readmissions. This performance program penalizes hospitals up to three percent of...more
On May 28, 2021, OIG released its Semiannual Report to Congress (the Report). The Report describes OIG’s work during the 6-month semiannual reporting period of October 1, 2020, through March 31, 2021 (the Semiannual Reporting...more
6/3/2021
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Fraud ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
Medicare Part B ,
Medicare Part D ,
OIG ,
Opioid
From December 23, 2020 through December 31, 2020, the OIG issued several advisory opinions. The advisory opinions analyzed (1) a program for a pharmaceutical manufacturer to provide financial assistance to certain patients,...more
1/8/2021
/ Advisory Opinions ,
Anti-Kickback Statute ,
Financial Assistance Policies ,
Food and Drug Administration (FDA) ,
Home Health Agencies ,
Manufacturers ,
Medicare ,
OIG ,
Pharmaceutical Industry ,
Prescription Drugs ,
Preventive Health Care ,
REMS ,
Skilled Nursing Facility
On December 2, 2020, CMS issued the calendar year (CY) 2021 Medicare Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule. Through these policy changes, CMS seeks to...more
On September 2, 2020, CMS issued the fiscal year (FY) 2021 final rule for the hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (the Final Rule). This article...more
9/11/2020
/ Bad Debt ,
Centers for Medicare & Medicaid Services (CMS) ,
DSH ,
Dual Eligibility ,
EHR ,
Final Rules ,
Financial Assistance Policies ,
Graduate Medical Education ,
Inpatient Prospective Payment System (IPPS) ,
Long Term Care Facilities ,
Medicaid ,
Medical Reimbursement ,
Medicare ,
Medicare Advantage ,
Patient Prospective Payment System
On February 11, 2019, CMS issued a proposed rule, to improve access to electronic health information (the Proposed Rule). The Proposed Rule results from the 21st Century Cures Act (the Cures Act), in which CMS and the Office...more
2/28/2019
/ 21st Century Cures Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Comment Period ,
Data-Sharing ,
Electronic Medical Records ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Patient Privacy Rights ,
Proposed Rules