On 2 December 2020, the Centers for Medicare & Medicaid Services (CMS) published a Notice of Final Rulemaking in the Federal Register (Final Rule), modifying the regulations implementing the federal physician self-referral...more
12/17/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Donations ,
Health Care Providers ,
Health Technology ,
Payment Systems ,
Physicians ,
Safe Harbors ,
Stark Law ,
Value-Based Care
In this week’s episode, Carla DewBerry and Kelsey Jernigan discuss issues in mental health parity in the context of recent California legislation. In particular, the presenters discuss how a new California bill has sparked a...more
9/29/2020
/ Affordable Care Act ,
Denial of Insurance Coverage ,
Essential Health Benefits ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Medical Necessity ,
Mental Health ,
Mental Health Parity Rule ,
Pending Legislation ,
Substance Abuse
On October 17, 2019, the Centers for Medicare & Medicaid Services (“CMS”) published a Notice of Proposed Rulemaking in the Federal Register (“Proposed Rule”), modifying the regulations implementing the federal physician...more
Recently, the Centers for Medicare & Medicaid Services (“CMS”) published its annual proposed rule outlining potential changes to the Medicare Physician Fee Schedule (“PFS”) for upcoming Calendar Year (“CY”) 2020 (“Proposed...more
9/18/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Drug Treatment ,
Health Care Providers ,
Medicare ,
Medicare Beneficiaries ,
Opioid ,
Physician Fee Schedule ,
Physicians ,
Prescribing Authority ,
SAMHSA
On November 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released in pre-publication form the Medicare Physician Fee Schedule (PFS) Final Rule for Calendar Year (CY) 2019 (PFS Final Rule)....more
As mandated by the 21st Century Cures Act of 2016 (the “Cures Act”), in June 2018 the Office for Civil Rights (“OCR”) issued guidance clarifying how individual authorizations under the Privacy Rule of the Health Insurance...more
On July 31, 2018, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule for the Medicare Hospital Outpatient Prospective Payment System (“OPPS”) and the Medicare Ambulatory Surgical Center payment...more
In the midst of ongoing national debates regarding drug pricing [1] and access to innovative therapies, patient assistance programs (“PAPs”) are facing an evolving legal landscape, as well as increased enforcement scrutiny...more
On October 30, 2015, the Centers for Medicare and Medicaid Services (“CMS”) posted a final rule, which was published in the Federal Register on November 16, 2015 (“Final Rule”), modifying the regulations implementing the...more
On June 12, 2015, the U.S. Court of Appeals for the District of Columbia (the “Court”) issued an opinion questioning the Department of Health & Human Services’ (“HHS”) interpretation of congressional intent when it...more
On July 15, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published proposed regulations governing policies and payments made under the Physician Fee Schedule for calendar year 2016 (the “Proposed Rule”). In...more
7/27/2015
/ Centers for Medicare & Medicaid Services (CMS) ,
CLIA ,
Compliance ,
FQHC ,
Health Care Providers ,
Healthcare ,
Medicaid ,
Medicare ,
Physician Fee Schedule ,
Physicians ,
Rural Health Care Providers ,
Self-Referral Disclosure Protocol ,
Stark Law
On December 31, 2014, the Treasury Department and the Internal Revenue Service (“IRS”) published a final rule (the “Final Rule”) implementing the requirements in Internal Revenue Code Section 501(r) for tax-exempt hospitals...more
On October 3, 2014, the Office of Inspector General of the Department of Health and Human Services (“OIG”) published a proposed rule and request for comments (“Proposed Rule”), which would amend the Anti-Kickback Statute...more