The Centers for Medicare and Medicaid Services (CMS) has proposed a new amendment that could significantly modify the standard governing identification of overpayments by providers....more
In an effort to ease achieving compliance with its newly instituted Hospital Price Transparency Rule, the Centers for Medicare & Medicaid Services (CMS) has recently published three sample formats on its website for hospitals...more
The Department of Justice recently reported that in fiscal year 2021, it received more than $5.6 billion in settlements and judgments. Of that total, over $5 billion relates to matters that involved the health care industry....more
The Centers for Medicare & Medicaid Services’ (“CMS”) message this year has been consistent – hospitals need to comply with CMS’ Hospital Transparency Rule. This rule requires hospitals and health systems to disclose a...more
The Office of Inspector General’s (“OIG”) new Anti-Kickback Statute (“AKS”) regulations modify the safe harbor for personal services and management contracts (42 CFR § 1001.952(d)) in a manner that allows providers...more
5/24/2021
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Hospitals ,
Management Contracts ,
New Rules ,
OIG ,
Personal Services ,
Physicians ,
Proposed Rules ,
Safe Harbors ,
Stark Law ,
Value-Based Care
The Centers for Medicare & Medicaid Services’ (“CMS”) new final rule amending the implementing regulations of the Physician Self-Referral Law (“Stark Law”), in part, defines fundamental terms, such as “fair market value” and...more
A recent $100 million verdict serves as a grim reminder for health care providers of the risk of paying independent contractors to market services. In United States v. Mallory, et al., the United States Court of Appeals for...more
On January 1, 2021, hospitals and health systems will be required to comply with Hospital Price Transparency requirements or face possible penalties from the Centers of Medicare and Medicaid Services (CMS). This rule requires...more
The U.S. Department of Health and Human Services (“HHS”) recently issued two corresponding final rules amending the implementing regulations of the Physician Self-Referral Law (“Stark Law”), the Anti-Kickback Statute (“AKS”),...more
On August 11, the Center for Medicare & Medicaid Services ("CMS") announced the creation of its new Community Health Access and Rural Transformation (“CHART”) Model. The CHART Model seeks to provide new seed funding and...more
On September 5, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a final rule expanding CMS’ authority to deny or revoke enrollment in the Medicare program as a result of “bad actor” affiliations. Providers...more
10/2/2019
/ Bad Actors ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Disclosure Requirements ,
Enrollment ,
Final Rules ,
Health Care Providers ,
Medicaid ,
Medicare ,
Revocation ,
Suppliers
On July 16, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a final rule that lifted the ban on the use of pre-dispute, binding arbitration agreements by long term care facilities. Under the Obama...more