As part of the CY 2023 Physician Fee Schedule proposed rule (the Proposed Rule) released on July 7, 2022, CMS has proposed significant changes to the Medicare Shared Savings Program (MSSP). The agency’s press release...more
On November 4, 2021, the Biden administration published two new rules governing employers with 100 or more employees and healthcare workers at hospitals, nursing homes and other facilities that participate in Medicare and...more
CMS and OIG released highly anticipated final changes to the rules implementing the Stark Law, the safe harbors issued under the Anti-Kickback Statute (AKS) and the beneficiary inducements provision in the civil monetary...more
12/1/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Cybersecurity ,
Digital Health ,
DMEPOS ,
Electronic Health Record Incentives ,
Fair Market Value ,
Final Rules ,
OIG ,
Proposed Rules ,
Remuneration ,
Risk Assessment ,
Safe Harbors ,
Stark Law ,
Value-Based Care
HHS has published additional Terms and Conditions associated with the acceptance of payments made from the $100 Billion Provider Relief Fund established pursuant to the Coronavirus Aid, Relief, and Economics Security Act...more
A recent report issued by OIG finding an Indiana community hospital owed over $22 million in extrapolated overpayments carries some important lessons for hospitals audited under OIG’s hospital compliance program. As described...more
2/21/2019
/ Administrative Appeals ,
Administrative Procedure Act ,
Audits ,
Billing ,
Department of Justice (DOJ) ,
Extrapolation ,
Hospitals ,
Inpatient Billing ,
Inpatient Rehab Facilities ,
Medicare ,
OIG ,
Overpayment ,
Physicians
CMS issued final rules on December 21, 2018, that were published in the December 31, 2018 Federal Register (ACO Final Rules), adopting major changes to the Medicare Shared Savings Program (MSSP) which impact currently...more