On April 7, Centers for Medicare and Medicaid Services Administrator Seema Verma announced during a White House briefing that the United States Department of Health and Human Services would be distributing $30 billion to...more
The federal government granted North Carolina permission on March 23 for health care providers across the state to temporarily avoid compliance with certain federal Medicaid requirements. The idea is to reduce bureaucracy...more
Hospitals and other behavioral health services providers in North Carolina will face new regulations next year concerning the involuntary commitment and voluntary admission of patients undergoing mental health crises. In...more
Shortly after Memorial Day 2018, the federal government announced its plan to bring back a payment review project that puts significant administrative burdens on home health agencies. Originally called the Pre-Claim Review...more
A federal appeals court issued a significant ruling last week in relation to the ongoing backlog of Medicare claims appeals. It potentially gives providers a new way to seek relief when Medicare comes to collect money that an...more
The North Carolina Department of Health and Human Services recently laid out a road map for improving behavioral health services in the state. The report to the state legislature was the result of numerous stakeholder...more
The Trump administration is putting the brakes on a payment model that gained steam across the health care industry under the Obama administration.
The Centers for Medicare & Medicaid Services announced yesterday it is...more
The federal government recently awarded new contracts for Medicare recovery audits, and recovery audit contractors (“RACs”) will start showing up at hospitals, home health providers, and other facilities any time. But this...more
We both recently returned from presenting to groups of health care providers on creating and implementing effective compliance programs. Although compliance plans and compliance programs are not new to the health care realm,...more
Medicaid expansion has already had a huge impact on whether mental health needs are treated in certain populations. That may not be at the top of all the stories lately about the U.S. House of Representatives passing its...more
While much of the attention related to health care this week is focused on our nation’s capital, all 50 state governors have received a letter from recently confirmed U.S. Health & Human Services Secretary Tom Price and...more
Individuals should be cautious about sharing personally identifiable information when contacted via phone, including by health care agencies. The Centers for Medicare & Medicaid released an alert earlier this week warning of...more
The Affordable Care Act (sometimes referred to as Obamacare) included a requirement for providers to report and return all Medicare and Medicaid overpayments within 60 days of identification. Although this requirement has...more
5/3/2016
/ 60-Day Rule ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
False Claims Act (FCA) ,
Final Rules ,
Health Care Providers ,
Medicare Part A ,
Medicare Part B ,
Overpayment ,
Reporting Requirements
Yesterday, the United States Supreme Court issued an opinion that denies providers the right to challenge low Medicaid reimbursement rates by suing state agencies in federal court.
In Armstrong v. Exceptional Child...more
The media coverage in the run-up to today’s Supreme Court oral arguments in King v. Burwell has described King as an attack on Obamacare. That isn’t quite right. Understandably, some of the imprecise language is due to the...more