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D.C. Circuit Upholds Dismissal of Proposed Class Action Against HHS for Home Health Aid Shortage

On August 9, 2024, the U.S. Court of Appeals for the District of Columbia upheld a lower court’s decision to dismiss a proposed class action accusing HHS of causing a shortage of home health aides willing to assist Medicare...more

Physician Fee Schedule Proposed Rule Proposes New Quality-Driven Payment Policies

Within its proposed CY 2025 Physician Fee Schedule (PFS) rule (the Proposed Rule), CMS is proposing to implement new payment policies intended to advance health equity and support whole-person care. CMS expects these new...more

Florida Magistrate Judge Rules Against Florida’s Efforts to Prohibit CMS from Enforcing an Informational Bulletin on Health...

On January 29, 2023, a Florida Magistrate Judge recommended denying the State of Florida’s Motion for Preliminary Injunction and granting CMS’s Motion to Dismiss in connection with the implementation and enforcement of its...more

New California Law Raises Minimum Wage for Health Care Workers Beginning June 1, 2024

On October 13, 2023, California Governor Gavin Newsom signed California Senate Bill No. 525 (SB 525) into law, which gradually raises the minimum wage to $25 for California health care workers....more

CMS Issues Proposed Rule on Minimum Staffing Requirements for Long-Term Care Facilities

On September 1, 2023, CMS issued the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule (the Proposed Rule), which imposes nurse staffing...more

Hospice Care Saves Medicare Upwards of $3.5B Annually, According to Report

A joint report published on March 22, 2023 found the total costs of care for Medicare beneficiaries who used hospice was 3.1 percent lower than those who did not, and that earlier enrollment in hospice and longer lengths of...more

3/31/2023  /  Hospice , Medicare , Medicare Advantage , MedPAC

CMS Issues Initial Guidance for Medicare Drug Price Negotiation for 2026

On March 15, 2023, CMS released initial guidance detailing the requirements and parameters on key elements of the new Medicare Drug Price Negotiation Program for 2026, which is the first year that negotiated prices will apply...more

Group of Agency Inspectors General Publishes Report on Program Integrity Risks Across Certain Health Care Programs During the...

On December 1, 2022, the Pandemic Response Accountability Committee (PRAC) Health Care Subgroup published a report about the use of telehealth in selected health care programs across six federal agencies during the first year...more

CMS Issues CY 2023 Physician Fee Schedule Final Rule

Last week, CMS released the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) final rule (the Final Rule). Under the Final Rule, CMS finalized a number of updates, revisions, and changes to Medicare payment policies for...more

Accreditation Organizations are Required to Notify CMS of Change of Ownership Under Final Rule

On April 29, 2022, CMS published a final rule requiring Accreditation Organizations (AOs) to notify CMS of changes of ownership (CHOWs). Effective June 28, 2022, an AO will need to notify CMS when undergoing or negotiating a...more

D.C. Circuit Rejects Critical Access Hospital’s Appeal for Medicare Payments to On-Call Specialty Physicians

On April 15, 2022, the D.C. Circuit affirmed the denial of a California hospital’s request to obtain critical access hospital cost reimbursement from Medicare for the costs incurred to keep non-emergency specialty physicians...more

D.C. District Court Upholds HHS’s Audits of Hospitals’ Worksheet S-10 and Resulting Adjustments When Determining Medicare DSH...

On August 30, 2021, the United States District Court for the District of Columbia ruled in favor of HHS and dismissed claims related to improper audits that resulted in adjustments to plaintiff hospitals’ Worksheet S-10 that...more

CMS Issues Medicare IPPS and LTCH Final Rule for FY 2022

On August 2, 2021, CMS published the Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule for federal fiscal year (FY) 2022. The final...more

Fifth Circuit Affirms Government’s Unilateral Dismissal of FCA Claims Despite Initially Declining to Intervene

On July 7, 2021, a Fifth Circuit panel upheld a decision by the U.S. District Court for the Eastern District of Texas to grant the government’s dismissal of two qui tam actions under the False Claims Act (FCA) in Texas,...more

Clinical Laboratory Agrees to Settlement with HHS for Potential HIPAA Security Rule Violations Despite Not Being Involved in Data...

On May 25, 2021, HHS announced that Peachstate Health Management, LLC, doing business as AEON Clinical Laboratories (Peachstate), agreed to a $25,000 settlement and adoption of a comprehensive Corrective Action Plan for...more

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