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OIG Issues Favorable Advisory Opinion Regarding Use of Online Directory to Find Healthcare Providers

On July 11, 2023, OIG posted Advisory Opinion 23-04 regarding the use of an online healthcare directory for Federal healthcare program beneficiaries to find and book appointments with medical providers. Requestor sought OIG’s...more

HHS Announces the End of the COVID-19 Public Health Emergency

On May 9, 2023, HHS released a fact sheet announcing the expiration of the COVID-19 Public Health Emergency (PHE) on May 11, 2023. HHS also provided information on changes to the healthcare flexibilities issued during the...more

CMS Issues Proposed Rules to Update Medicare Payment Rates and Policies for Skilled Nursing Facilities and Inpatient Psychiatric...

On April 4, 2023, CMS issued proposed rules for Fiscal Year (FY) 2024 to update Medicare payment policies for skilled nursing facilities (SNFs) and inpatient psychiatric facilities (IPFs). CMS notes these rules are intended...more

DOJ Announces False Claims Act Recoveries for FY 2022

On February 7, 2023, the Department of Justice (DOJ) announced its annual False Claims Act (FCA) recoveries for fiscal year 2022. DOJ recovered $2.2 billion from a total of 351 settlements and judgments—the second-highest...more

CMS Announces Initiatives to Strengthen Nursing Home Safety and Transparency

On January 18, 2023, CMS issued a Quality, Safety & Oversight Group memorandum announcing its initiative to improve nursing home safety and transparency. Specifically, CMS will conduct audits to determine whether nursing...more

OIG Issues Advisory Opinion Regarding Pharmaceutical Companies’ Proposed Arrangement to Provide Cost-Sharing Subsidies

On October 5, 2022, OIG posted Advisory Opinion 22-19 in response to a nonprofit corporation’s (Requestor) request to analyze a proposal for certain pharmaceutical companies (each, the Funding Manufacturer) to subsidize: 1)...more

CMS Issues Proposed Rule to Streamline Medicaid and CHIP Enrollment and Renewal

On August 31, 2022, CMS issued a proposed rule to reduce coverage gaps by streamlining the application, enrollment, and renewal process for coverage in Medicaid and the Children’s Health Insurance Program (CHIP) (the Proposed...more

CMS Issues Guidance to Improve Care for Children with Medically Complex Conditions

On August 1, 2022, CMS issued guidance on the implementation of Section 1945A of the Social Security Act (the Act), which gives states the option to cover health home services for Medicaid-eligible children under age 21 with...more

HHS Says Hospitals Must Provide Abortions When an Emergency Medical Condition is Found to Exist; Texas Files Lawsuit in Response

HHS released guidance on July 11, 2022, stating that the Emergency Medical Treatment and Active Labor Act (EMTALA)—which requires hospitals and physicians to provide emergency medical treatment when an emergency medical...more

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