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Relocation of Physician-Owned Hospitals: CMS Advisory Insights

The Centers for Medicare and Medicaid Services (CMS) issued CMS Advisory Opinion No. CMS-AO-2025-1 on February 26, 2025, blessing the relocation of a physician-owned hospital. The hospital planned to relocate eight miles from...more

CMS Proposes Significant Changes to the Medicare Shared Savings Program and 60-Day Rule

Under the CY 2025 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposes several modifications to the Medicare Shared Savings Program (MSSP) that would become effective in performance year 2025. CMS also proposed...more

CMS Proposes Extending COVID-Era Telehealth and Supervision Flexibilities through CY 2025

The Centers for Medicare & Medicaid Services (CMS) proposed to extend a number of COVID-era regulatory flexibilities related to telehealth, remote services, and supervision in the CY 2025 Medicare Physician Fee Schedule (PFS)...more

Recent $345 Million Settlement Underscores Critical Importance of Appropriate Physician Compensation

In a settlement larger than Halifax and Tuomey combined, an Indianapolis-based health system recently settled with the Department of Justice for $345 million to resolve Stark Law and False Claims Act allegations relating to...more

COVID-19 Public Health Emergency Set to End May 11, 2023, Along with Many Waivers and Flexibilities

After more than three years, the Public Health Emergency (PHE) related to COVID-19 is scheduled to end on Thursday, May 11, 2023. The PHE declaration under the Public Health Service Act has allowed the Secretary of the...more

CMS Approves New Group Information Form under Self-Referral Disclosure Protocol

Following the comment period that ended on August 8, 2022, the Centers for Medicare and Medicaid Services (CMS) recently finalized changes to the Self-Referral Disclosure Protocol (SRDP) for physician practices to disclose...more

CMS Guidance on Rural Emergency Hospitals

On January 1, 2023, Medicare began paying for services provided at Rural Emergency Hospitals (REHs), a newly created provider type established to preserve access to emergency health care in rural areas and avert closure of...more

Medicaid Enrollment Redeterminations Looming

The Consolidated Appropriations Act (CAA) enacted on December 29, 2022, decoupled the Medicaid continuous enrollment requirement from the end of the Public Health Emergency (PHE), effective March 31, 2023.1 While CMS guidance...more

Biden Administration Announces Planned End of Emergency Declarations

This past week, President Biden issued a Statement of Administration Policy announcing an intention to end both the Public Health Emergency (PHE) and the National Emergency declarations on May 11, 2023. While the...more

Public Health Emergency Declaration Again Extended; Key Flexibilities Decoupled

On January 11, 2023, Department of Health and Human Services (HHS) Secretary Xavier Becerra again renewed the declaration of a Public Health Emergency (PHE) under the Public Health Service Act, extending the declaration...more

OIG Issues Favorable Advisory Opinion for Hospital's Provision of Nurse Practitioner Services

In one of the final advisory opinions of 2022, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) took a broad view that a hospital's provisions of care by nurse practitioners to patients of...more

CMS Revises Medicare Shared Savings Program's Performance Benchmarking Methodology to Encourage Continued Participation by Current...

On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year 2023 Physician Fee Schedule (PFS) Final Rule, which includes changes to the Medicare Shared Savings Program (MSSP), the nation's...more

Proposed Updates to the Medicare Shared Savings Program's Performance Benchmarking Methodology

On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) proposed rule that includes changes to the Medicare Shared Savings Program (MSSP) to advance...more

CMS Requests Comments on Proposed Changes to Stark Law Self-Referral Disclosure Protocol Forms

On June 9, 2022, the Centers for Medicare and Medicaid Services (CMS) solicited comments to proposed changes to the Self-Referral Disclosure Protocol (SRDP) for physician practices disclosing group practice noncompliance....more

Public Health Emergency Declaration Extended Through Mid-October

On July 15, 2022, Department of Health and Human Services (HHS) Secretary Xavier Becerra again renewed the declaration of a Public Health Emergency (PHE) under the Public Health Service Act, averting a July 15, 2022,...more

Public Health Emergency Set for Extension: Lack of Notice Implies Renewal through Mid-October

The declared Public Health Emergency (PHE) under the Public Health Service Act will apparently be renewed at least one further time beyond its current July 15, 2022 expiration, as the Department of Health and Human Services...more

Bracing for Impact: Most Recent Public Health Emergency Declaration Extension Establishes New Dates to Monitor

On April 12, 2022, Department of Health and Human Services (HHS) Secretary Xavier Becerra again renewed the declaration of a Public Health Emergency (PHE) under the Public Health Service Act, averting an April 16, 2022...more

The Post-Emergency Declarations Horizon

After two years, a multitude of factors are pointing toward the end of the formal public health emergency declaration, related emergency declarations, and associated waivers in connection with COVID-19, including declining...more

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