In my experience, most physician groups rely on the “in-office ancillary service” exception to the Stark Law when determining how to allocate revenues from designated health services among group members. The Stark Law is, of...more
CMS Mandate: At the beginning of December we informed you that a Federal Court in Louisiana issued a nationwide stay on enforcement of the Centers for Medicare and Medicaid Services (CMS) COVID-19 vaccination mandate. During...more
A couple of weeks ago we alerted you regarding the Centers for Medicare and Medicaid Services (CMS) COVID-19 vaccination mandates. Reports have emerged today that an injunction has been placed upon this CMS requirement...more
On November 4, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued Interim Final Rules requiring many of its regulated providers and suppliers to require staff and employees to meet COVID-19 vaccination...more
As we previously predicted, the Centers for Medicare and Medicaid Services (“CMS”) has continued to issue expansions of the Blanket Waivers applicable during the COVID-19 pandemic. CMS states the reason for issuing these...more
The Centers for Medicare & Medicaid Services (CMS) has issued another set of regulatory changes and waivers intended to deliver expanded care to the nation’s seniors, and provide flexibility to the healthcare system during...more
The Centers for Medicare & Medicaid Services (CMS) issued Blanket Waivers of certain requirements of the Physician Self-Referral Law (Stark Law). The purpose for the Blanket Waivers is to provide the flexibility providers...more
The Centers for Medicare & Medicaid Services (CMS) have issued new recommendations targeted at communities in Phase 1 of the Guidelines for President Trump’s “Opening Up America Again.” The Phase 1 category includes...more
The Blanket Waivers that the Center of Medicare and Medicaid services issued under the Stark Law apply only to financial relationships and referrals that are related to the national emergency that is the COVID-19 outbreak in...more
The following is a list of categories of the Stark Law Blanket Waivers permitting deviations from the provisions of the Stark Law where necessary for a COVID-19 purpose. See Background on CMS Stark Law Waiver. The definition...more
The Centers for Medicare & Medicaid Services published at the end of March new blanket waivers under the federal physician self-referral law (commonly known as the Stark Law) in response to the COVID-19 pandemic. The waivers...more
The Affordable Care Act requires any person who has received an overpayment from certain defined government health programs to report and return the overpayment within 60 days after the overpayment is identified. If an...more
Well, it’s a start. New Medicare rules kicked in starting January 1, 2019 that are aimed at focusing less provider time on paperwork and more on patient care in inpatient rehabilitation facilities. Any change that reduces...more
If you navigate to the American Hospital Association (AHA) Interactive Town Hall of January 17, 2018, you can view a video in which Seema Verma, the current Administrator of the Centers for Medicare and Medicaid Services,...more
The Affordable Care Act added the Physician Payment Sunshine Act (Sunshine Act) as section 1128G to the Social Security Act. The Sunshine Act requires applicable manufacturers of drugs, devices, biologicals, or medical...more
4/7/2017
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Corrections ,
Medical Devices ,
Pharmaceutical Industry ,
Physician Payments ,
Physicians ,
Prescription Drugs ,
Social Security Act ,
Sunshine Act ,
Teaching Hospitals
In February, we reported on revisions to the Conditions of Participation for Home Health Agencies (HHA) released by the Centers for Medicare & Medicaid Services (CMS). CMS has now proposed the effective date of new Conditions...more
I frequently hear attorneys claim the Stark law applies equally to hospitals and physicians. This position is sometimes taken in the process of negotiating a transaction between a hospital and a physician or physician group....more
Medicare permits a physician to bill for certain services furnished by a nurse practitioner or other auxiliary personnel under what is referred to as the "incident to" billing rules. The "incident to" rules permit services...more
Recent OIG Release Emphasizes Need for Compliance Policies Specific to Provider Risks The Office of Inspector General recently published results of its audit of Medicare claims for chiropractic services made by a chiropractic...more
On January 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued Recommendations to Providers Regarding Cyber Security. In general, the Recommendations are intended to remind providers and suppliers to keep...more
On February 17, 2017, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule aimed at reforming and stabilizing the individual and small group health insurance markets. When (or if) finalized, the...more
The Center for Medicare and Medicaid Services has issued a final rule that revises and modernizes the Conditions of Participation (COP) for Home Health Agencies. The Final Rule can be found in its entirety at: Final Home...more
The HHS Office of Inspector General recently released a report indicating deficiencies in hospice election statements and physician certification of patient eligibility for hospice care. Medicare hospice care provides help...more
On October 4, 2016, the Center for Medicare and Medicaid Services (CMS) published a final rule to revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. CMS...more
11/3/2016
/ Binding Arbitration ,
Centers for Medicare & Medicaid Services (CMS) ,
Elder Abuse ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Nursing Homes ,
Physicians ,
Prescription Drugs ,
Quality of Care Standards ,
Training Requirements ,
Video Recordings