Since the Centers for Medicare & Medicaid Services (“CMS”) paused much of its audit activity during the COVID Public Health Emergency, the most recent rounds of Medicare audit activity may represent the first “look” at the...more
Summer is in full swing, but the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) is doing anything but taking a vacation from HIPAA. In May and June, OCR issued five resolution agreements...more
A popular saying is that it takes 21 days to form a habit and about 66 days on average for a behavior to become automatic. If that is correct, the three-year period of unprecedented waivers and flexibilities in the provision...more
With 2023 underway, healthcare providers and other “covered entities,” as defined under the Health Insurance Portability and Accountability Act (“HIPAA”), should be mindful of the upcoming annual reporting deadline for small...more
Recently, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced three more resolution agreements settling alleged violations of the HIPAA right of access. These agreements bring...more
As the COVID-19 Public Health Emergency (“PHE”) approaches the three-year mark, what initially seemed like the “new” normal seems closer to just plain normal for many healthcare providers. As a result, while the Department of...more
More than 23 million American households — nearly 1 in 5 nationwide — adopted a pet during the COVID-19 pandemic, according to the American Society for the Prevention of Cruelty to Animals (ASPCA). The increasing rates of pet...more
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently updated its 2021 Work Plan in January to include audits of Medicare Part B and home health telehealth services by OIG’s Office...more
As the end of 2020 approaches, the melody to “Auld Lang Syne” inevitably comes to mind. The meaning of this song is particularly appropriate as we consider what will stay, and what will pass when it comes to telehealth in...more
CMS Announces Hospice Capitation Rates for Medicare Advantage -
The U.S. Centers for Medicare and Medicaid Services (CMS) recently released the capitation rates for hospice care through the value-based insurance design...more
Exactly one year after the Bipartisan Budget Act of 2018 redefined the statutory definition of “attending physician” to allow physician assistants (PAs) to serve as a hospice attending physician, the Centers for Medicare &...more
If the looming threat of the Review Choice Demonstration which recently began in Illinois was not sufficient to make home health agencies a little anxious, the U.S. Department of Health and Human Services, Office of Inspector...more
The Centers for Medicare and Medicaid Services (CMS) made a number of recent changes to expand the Settlement Conference Facilitation (SCF) process for providers and suppliers mired in the backlog of appeals at the...more
If the looming threat of the Review Choice Demonstration which recently began in Illinois was not sufficient to make home health agencies a little anxious, the U.S. Department of Health and Human Services, Office of Inspector...more
Every year, health lawyers, providers, consultants, and government experts from across the country convene in Baltimore for the American Health Lawyers Association’s Institute on Medicare and Medicaid Payment Issues, the most...more
In July 2018, the Department of Health and Human Services’ Office of Inspector General (OIG) issued a report entitled, Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity...more
On October 13, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a CMS Transmittal to update the Medicare Program Integrity Manual (MPIM) on recent regulatory changes in the Office of Medicare Hearings and...more
On November 17, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a Memorandum to State Survey Agency Directors outlining the process by which Medicare will eliminate existing Home Health Agency (HHA)...more
In the wake of the presidential declaration of the opioid crisis as a national public health emergency, the Department of Health & Human Services (HHS) Office for Civil Rights (OCR) released a new guidance document on October...more
The Texas Health and Human Services Commission, on behalf of the Department of Aging and Disability Services (DADS), has adopted revised regulations that impact the Change of Ownership (CHOW) process and requirements for...more
Effective September 12, 2017, the Centers for Medicare & Medicaid Services (CMS) will implement changes to ensure that complex reviews for coverage determinations are performed by Registered Nurses (RNs), therapists, or...more
On July 7, 2017, the Centers for Medicare & Medicaid Services (CMS) announced a final rule to delay the effective date of the new conditions of participation (CoPs) for home health agencies, which is scheduled to be published...more
In August 2016, the Centers for Medicare & Medicaid Services (CMS) initiated a three-year Pre-Claim Review Demonstration for home health agencies (HHA) in Illinois, with plans to expand the demonstration shortly afterwards to...more