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CMS Revises Immediate Jeopardy Citation Guidance

On March 5, 2019, CMS issued new guidance for surveyors to identify immediate jeopardy cases. CMS revised the previous version of Appendix Q to clarify and increase consistency for identifying immediate jeopardy and...more

OCR Recovers $28.7 Million from 2018 HIPAA Enforcement Actions

According to a summary released by the HHS Office for Civil Rights (OCR), in 2018, OCR settled 10 cases and was granted summary judgment in one case totaling $28.7 million in recoveries for alleged violations of the Health...more

IRS Provides Guidance Regarding 21% Excise Tax on Tax-Exempt Organizations for Excessive Executive Compensation

The Tax Cuts and Jobs Act imposes a 21 percent excise tax on charitable hospitals and other tax-exempt organizations that pay excess remuneration or excess parachute payments to certain highly-compensated employees. On...more

CMS Issues Proposal to Amend Medicare Parts C and D

On November 26, 2018, CMS published a proposed rule (the Proposed Rule) to amend the Medicare Advantage (MA) program and Medicare Part D with the goal of allowing health and drug plans to negotiate for lower drug prices and...more

OIG Approves Trust Donations to Research Institute Despite Business Relationships Between Long-Term Care Facilities owned by...

On November 6, 2018, the Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion No. 18-13, which concluded that proposed donations from a trust to a medical research institute would...more

New York Court of Appeals Strikes Down State Executive Compensation Cap from Non-State Funds

On October 18, 2018, the New York Court of Appeals refused to enforce New York Department of Health regulations which precluded healthcare providers from paying executive salaries over $199,000 regardless of the funding...more

D.C. Circuit Affirms District Court’s Dismissal of Legal Challenge to Medicare Rate Cut for 340B Discounted Drugs

On July 17, 2018, the United States Court of Appeals for the D.C. Circuit affirmed the D.C. district court’s dismissal of a pre-implementation challenge to CMS’s policy to cut the Medicare reimbursement rate for...more

CMS Announces Clinicians Exceeded Year 1 MIPS Participation Goal

On May 31, 2018, CMS Administrator Seema Verma announced that 91% of all Merit-based Incentive Payment System (MIPS) eligible clinicians participated in year one of the Quality Payment Program (QPP), surpassing CMS’s goal to...more

Massachusetts Federal Judge Approves Settlement to Expand Dialysis Company’s Compliance Department

On April 10, 2018, U.S. District Judge Allison D. Burroughs preliminarily approved a settlement requiring American Renal Associates Holdings, Inc. (ARAH) to expand its compliance department in response to a shareholder...more

Bipartisan Health Care Stabilization Act Dies

On March 19, Senators Lamar Alexander (R-TN) and Susan Collins (R-ME), along with Representatives Greg Walden (R-OR) and Ryan Costello (R-PA) proposed the Bipartisan Health Care Stabilization Act of 2018 in an effort to...more

CMS Proposes to Increase Payments to Medicare Managed Care Plans for 2019

CMS has released its proposal for 2019 Medicare Part C rates. CMS indicated it expects an average change in revenue of 1.84 percent for Medicare managed care plans for 2019 as a result of the proposed policy changes....more

OIG Requests Public Input on Anti-Kickback Statute Safe Harbors

In a notification published last week, OIG began soliciting proposals and recommendations for modifying existing and developing new safe harbor provisions under the Federal Anti-Kickback Statute (AKS). Public comments must...more

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