Publicizing home health agency and hospice agency ownership information furthers President Biden’s goal to promote competition and make data more transparent for consumers, as noted in his July 2021 Executive Order.
A link...more
On January 18, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a Memorandum to all state survey agency directors addressing erroneous schizophrenia coding and increased transparency of Nursing Home Care...more
The Biden Administration has embraced an aggressive and multi-part agenda designed to improve the safety and quality of care nationally in skilled nursing facilities (SNFs). The Biden Administration’s nursing home agenda...more
12/16/2022
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Compliance ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Medicaid ,
Medicare ,
OIG ,
Quality of Care Standards ,
Skilled Nursing Facility
- CMS estimates its proposal will result in a decrease of $320 million in Medicare Part A payments to skilled nursing facilities.
- CMS is seeking stakeholder input on the effects of direct-care staffing requirements for...more
Click the link below for our complete analysis of recent updates to the Stark Law and Anti-Kickback Statute and their impact on health care providers.
...more
3/3/2021
/ 21st Century Cures Act ,
Anti-Kickback Statute ,
Bonuses ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Commercially Reasonable Efforts ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Fair Market Value ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Medicare Part D ,
OIG ,
Pharmacy Benefit Manager (PBM) ,
Profit Sharing ,
Safe Harbors ,
Stark Law ,
Value-Based Care
The Final Rule of the Stark Law revises the definitions of Fair Market Value and includes a definition of General Market Value to better align with actual practices without unduly restricting innovative relationships between...more
On September 18, 2020, under the authority of the Center for Medicare and Medicaid Innovation, CMS finalized the new Radiation Oncology Alternative Payment Model (Model), with a new payment methodology for radiation therapy...more
On August 17, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a Guidance Memorandum (Guidance) setting forth revised state survey agency priorities as well as providing information regarding the resumption...more
After a four-month hold, CMS announced on August 6 that it would resume Medicare Fee-For Service (FFS) medical reviews.
On March 30, 2020, CMS announced that it was stopping the majority of FFS medical reviews during the...more
CMS issued an MLN Matters Special Edition Article on April 17, 2020, regarding waivers for rural health clinics (RHCs) and federally qualified health centers (FQHCs) permitting flexibility during the COVID-19 Public Health...more
To address provider shortages, CMS issued a declaration on April 9, 2020, setting forth new “Blanket Waivers,” which, among other things, allow practitioners to practice across state borders (if permitted by the state) and at...more
The Centers for Medicare and Medicaid Services (CMS) issued a memorandum to State Survey Agency Directors that provides further guidance regarding survey priorities for health care facilities, providers, and clinical...more
On July 9, 2019, the US Department of Health and Human Services, Office of Inspector General (OIG) released two reports addressing hospice deficiencies and the risks, potential harm, and actual harm those deficiencies posed...more
7/15/2019
/ Abuse and Neglect ,
Centers for Medicare & Medicaid Services (CMS) ,
Citations ,
Conditions of Participation (CoP) ,
Deficiency Notices ,
Department of Health and Human Services (HHS) ,
Employee Training ,
Health Care Providers ,
Hospice ,
Information Reports ,
Long Term Care Facilities ,
Medicare Beneficiaries ,
Mismanagement ,
OIG ,
Quality of Care Standards ,
Reporting Requirements ,
Substantial Risk of Harm ,
Surveys