On Wednesday, December 15, 2021, the Fifth Circuit Court of Appeals denied the federal government’s petition for a stay pending appeal of the preliminary injunction issued by a federal district court in Louisiana that...more
12/22/2021
/ Administrative Procedure Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Employer Mandates ,
En Banc Review ,
Enforcement ,
Interim Final Rules (IFR) ,
OSHA ,
Popular ,
Preliminary Injunctions ,
Vaccinations
On November 12, 2021, CMS released “final guidance” for state survey agencies regarding shared space and co-location arrangements between hospitals and other hospitals or healthcare providers. This guidance is intended to...more
On August 24, 2021, CMS announced that it is again increasing the Medicare reimbursement rate for providers who administer at-home COVID-19 vaccines. This rate increase aims to boost the rate of COVID-19 vaccination,...more
On Thursday, March 11, 2021, the U.S. Supreme Court announced that it will no longer hear oral arguments that were set to occur on March 2, 2021, over D.C. Circuit Court of Appeals rulings striking down Medicaid work...more
3/18/2021
/ Appeals ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Dismissals ,
Executive Orders ,
Medicaid Act ,
Medicaid Work Requirements ,
Oral Argument ,
SCOTUS
On Thursday, January 28, 2021, the DOJ announced that electronic health record (EHR) vendor athenahealth, Inc. (Athenahealth) agreed to pay $18.25 million to resolve allegations that it violated the False Claims Act (FCA). ...more
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
On August 4, 2020, the California State Assembly referred SB-977 to the Committee on Appropriations, ahead of an August 31 deadline to send bills to Governor Gavin Newsom. SB-977, titled “Health care system consolidation:...more
On July 31, 2020, CMS issued Final Rule CMS-1737-F for fiscal year 2021, in its yearly update to Medicare payment policies for SNFs (the Final Rule). In addition to updating Medicare payment rates under the SNF prospective...more
On March 18, 2020, CMS issued Frequently Asked Questions (FAQs) to clarify that the diagnosis and treatment of Coronavirus Disease 2019 (COVID-19) is covered by catastrophic health plans. CMS also confirms that the agency...more
Despite a year-end push, Congress will not resolve the surprise billing issue until the first quarter of 2020, at the earliest. On Wednesday, December 11, 2019, House Ways and Means Committee Chairman Richard Neal (D-MA) and...more
Hospitals that attempt to discharge a patient to a post-acute level of care but are not able to because they cannot find an appropriate accepting facility must continue providing care if the patient cannot be safely...more
12/16/2019
/ Acute Facilities ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Health Insurance ,
Health Insurance Exchanges ,
Hospitals ,
Knox Keene ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Provider Agreements ,
Qualified Health Plans
In its June 2019 quarterly report to Congress, the Medicare Payment Advisory Commission (MedPAC) voted unanimously to recommend that Congress eliminate “incident-to” billing under Medicare and refine specialty designations...more
On Monday, June 24, 2019, President Trump issued an executive order requiring HHS and other agencies to propose regulations designed to promote transparency and upfront disclosure by hospitals to patients of the charge prices...more
On June 17, 2019, the U.S. District Court of the District of Massachusetts rejected Massachusetts General Hospital’s (MGH) request to dismiss a qui tam complaint alleging that the teaching hospital fraudulently overbilled...more
On Thursday, February 7, 2019, the U.S. District Court for the Middle District of Tennessee granted a request by the Department of Justice (DOJ) for a temporary restraining order (TRO) to close two pharmacies accused of...more
On January 15, 2019, the U.S. Court of Appeals for the Eighth Circuit issued an order affirming a lower court’s ruling that UnitedHealth’s interpretation of ERISA plan documents to authorize cross-plan offsetting was...more