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OIG Issues Four Advisory Opinions

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

Medicare Announces Geographic-Based Approach to Value-Based Care

On December 3, 2020, CMS unveiled a new payment and care delivery model, the Geographic Direct Contracting Model (Model). The Model is a geographic-based approach to value-based care aimed at improving the quality of care...more

Transparency in Coverage Final Rule Requires Insurance Disclosure to Consumers

On October 29, 2020, HHS, the Department of Labor, and the Department of Treasury (the Departments) jointly issued a final rule requiring health plans to disclose price and cost-sharing information to participants,...more

Medicare Payment Advisory Commission Estimates Hospital Industry Losses During Pandemic

On September 3, 2020, the Medicare Payment Advisory Commission (MedPAC) released analysis that estimates hospital losses for April to be between $20 billion and $30 billion due to federal CARES Act grants and facility cost...more

CMS Announces Reimbursement for Patient Counseling on Self-Isolation at Time of COVID-19 Testing

On July 30, 2020, CMS and the CDC announced that health care providers can be reimbursed for counseling patients regarding the importance of self-isolation prior to the onset of symptoms at the time of COVID-19 testing. As...more

HHS Revises Regulations Protecting the Confidentiality of Substance Use Disorder Patient Records

On July 15, 2020, HHS revised the Confidentiality of Alcohol and Drug Abuse Patient Records regulations, 42 C.F.R. Part 2, to further facilitate better coordination of care in response to the opioid epidemic while maintaining...more

House Passes COVID-19 Relief Bill, H.R. 6201 “Families First Coronavirus Response Act”

On March 14, 2020, the House of Representatives passed H.R. 6201, an emergency relief package intended to mitigate the economic damage stemming from COVID-19. The legislation provides for short-term paid leave benefits...more

Coalition of States Petitions for Supreme Court Review of Affordable Care Act Ruling

On January 3, 2020, a coalition of 20 states and the District of Columbia, led by California Attorney General Xavier Becerra, petitioned the U.S. Supreme Court for a writ of certiorari to review the recent Affordable Care Act...more

CMS Announces Enhanced Oversight of Nursing Home Inspections by Strengthening the State Performance Standards System

On October 17, 2019, CMS published the fiscal year (FY) 2020 State Performance Standards System (SPSS) Guidance with a focus on monitoring and improving each of the State Survey Agencies’ (SSAs) performance in nursing home...more

CMS Announces Proposed CY 2020 Physician Fee Schedule with a Focus on Updating Payment Policies and Rates as Well as...

On July 29, 2019, CMS released the Calendar Year (CY) 2020 Physician Fee Schedule (PFS) proposed rule (the Proposed Rule). The Proposed Rule updates payment policies, payment rates, and quality provisions for services...more

District Court Order Paves Way for HHS to Appeal Decision Finding 340B Rate Cut Unlawful Without First Providing a Proposed Remedy...

On July 10, 2019, Judge Rudolph Contreras of the U.S. District Court for the District of Columbia granted HHS’ request for a final judgment, clearing the way for the government to immediately appeal his earlier decision that...more

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