On March 16, 2023, CMS issued Transmittal 11904, directing its contractors to adjust hospitals’ nursing and allied health education (NAH) payments associated with services furnished to Medicare Advantage (MA) enrollees. ...more
On November 8, 2021, the Eighth Circuit affirmed a district court order that denied an attempt to preliminarily block the Organ Procurement and Transplant Network’s (OPTN) policy changing the manner in which donor kidneys are...more
11/18/2021
/ Administrative Procedure Act ,
Appeals ,
Arbitrary and Capricious ,
Health Care Providers ,
Hospitals ,
Irreparable Harm ,
Notice and Comment ,
Organ Transplant Centers ,
Patients ,
Preliminary Injunctions ,
Rulemaking Process
On July 24, 2020, OIG issued an Advisory Opinion (AO), AO 20-04, regarding whether an arrangement where a charitable organization purchases or receives donations of unpaid medical debt from health care providers, and then...more
On Thursday, February 20, 2020, hospitals represented by King & Spalding that operate excepted off-campus provided-based outpatient departments (PBDs) filed their brief in federal appeals court to preserve the victory they...more
On October 9, 2019, President Trump issued an Executive Order aimed to curb agencies, such as CMS, from using informal guidance documents as de facto rules that have the binding effect of law. In a press conference...more
10/16/2019
/ Administrative Procedure Act ,
Azar v Allina Health Services ,
Centers for Medicare & Medicaid Services (CMS) ,
Corporate Counsel ,
Executive Orders ,
Health Care Providers ,
Medicare ,
New Guidance ,
Notice and Comment ,
Rulemaking Process ,
Trump Administration
On September 26, 2019, CMS issued a Final Rule that CMS intends will reform certain Medicare regulations related to standards and certifications that CMS identified as “unnecessary, obsolete, or excessively burdensome.” CMS...more
10/3/2019
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Emergency Management Plans ,
Final Rules ,
Health Care Providers ,
Healthcare Facilities ,
Home Health Care ,
Hospice ,
Hospitals ,
Medicare ,
Mental Health ,
Organ Transplant Centers ,
Regulatory Standards
On July 10, 2019, President Trump issued an Executive Order on Advancing American Kidney Health aimed at reducing the number of patients developing kidney failure, having fewer Americans receiving dialysis in dialysis...more
During a May 9, 2019 press event, President Trump urged Congress to pass legislation that would protect patients from surprise medical bills. “Surprise medical billing” occurs when a patient seeks care at an in-network...more
On April 23, 2019, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for FY 2020 (the Proposed Rule), which will affect...more
4/30/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Graduate Medical Education ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Inpatient Prospective Payment System (IPPS) ,
Long Term Care Facilities ,
Medicare ,
Proposed Rules ,
Quality Payment Program (QPP) ,
Regulatory Requirements
On January 18, 2019, a group of nearly 40 hospitals filed a lawsuit in the United States District Court for the District of Columbia challenging CMS’s rate cut to evaluation and management (E/M) services furnished by excepted...more
On November 2, 2018, CMS issued the 2018 Hospital Outpatient Prospective Payment System (“OPPS”) Final Rule (“Final Rule”) in which it finalized its proposal to pay the lower Physician Fee Schedule (“PFS”) rate rather than...more
On May 2, 2018, Georgia Governor Nathan Deal signed into law a bill allowing failed rural hospitals to be converted into “micro-hospitals.” The law comes as a response to a recent string of rural hospital closures and a...more
Physical therapy providers are the target of a recent HHS Office of Inspector General (OIG) report that identified millions of dollars in overpayments for improperly billed Medicare services. The OIG selected a stratified...more