Last week, HHS filed a motion asking the Fifth Circuit’s permission to voluntarily dismiss its appeal of a District Court order directing HHS to rescind its guidance restricting hospitals’ ability to track online traffic to...more
On July 31, 2024, CMS issued a final rule (the Final Rule) for fiscal year (FY) 2025 updating Medicare payment policies and rates for skilled nursing facilities (SNFs) under the SNF Prospective Payment System (PPS). Under the...more
The Government Accountability Office (GAO) issued a report this month finding that maternal health outcomes worsened during the COVID-19 pandemic and urging HHS to use its resources to address the maternal health crisis...more
Over the past month, CMS announced several updates to the Federal No Surprises Act IDR Process. On December 15, 2023, the Federal IDR portal was re-opened for all remaining disputes. The portal is now open for all disputes...more
The California Office of Healthcare Affordability (OHCA) released updated regulations this month pertaining to the healthcare transaction notice requirements that will apply to transactions that close on or after April 1,...more
HHS, the Department of Labor’s Employee Benefits Security Administration, and the Internal Revenue Service (IRS) (collectively, the Departments) issued a proposed rule on July 7, 2023, aimed at shoring up consumer protections...more
On April 17, 2023, OCR published a proposed rule (the Proposed Rule) that would expand protections for reproductive health information under the Health Insurance Portability and Accountability Act (HIPAA). The Proposed Rule...more
CMS announced on January 5, 2023, that Medicaid and CHIP will pay specialists who provide interprofessional consultations to other providers. Previously, CMS did not provide coverage for most interprofessional consultations...more
The United States District Court for the District of Columbia granted plaintiffs’ motion to vacate the 2022 OPPS Rule’s 340B rates on a prospective basis, meaning that HHS will pay 340B hospitals the drug’s average sales...more
On August 19, 2022, the Departments of Health and Human Services, Labor, and the Treasury (the Departments) issued a long-awaited final rule (the Final Rule) on the Independent Dispute Resolution (IDR) Process under the No...more
Last week, the Supreme Court requested the Solicitor General’s views on United States ex rel. Owsley v. Fazzi Associates Inc. et al.,signaling the Court’s interest in potentially resolving a longstanding Circuit split. The...more
Last week, the California Department of Managed Health Care (DMHC) issued an All-Plan Letter (APL) stating that California case law and the Knox-Keene Health Care Service Plan Act of 1975 (the Knox-Keene Act) constitute...more
On March 22, 2022, HHS announced that it had distributed more than $413 million in Provider Relief Fund (PRF) payments to more than 3,600 health care providers impacted by the COVID-19 pandemic. HHS directed its disbursement...more
A jury last week awarded TeamHealth $60 million in punitive damages and late last month awarded TeamHealth $2.65 million in compensatory damages against UnitedHealthcare for underpaying TeamHealth affiliates for...more
On November 2, 2021, CMS published the final rule to update the payment policies and rates for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more
On September 30, 2021, the Biden Administration issued the second set of implementing regulations under the No Surprises Act. The interim final rules, issued by the Departments of Health and Human Services, Labor, and...more
The D.C. Circuit Court overturned UnitedHealthcare’s victory in the lower court that resulted in vacatur of the Medicare Advantage 60-day overpayment rule (the Overpayment Rule). Last week, the D.C. Circuit Court held that...more
An Arizona District Court judge held last week that the court lacked subject-matter jurisdiction over a home health agency’s (HHA) procedural due process claim because the HHA had failed to present its claim to HHS first and...more
Last week, HHS issued a final rule setting expiration dates for regulations that are not retrospectively reviewed in a timely manner. The final rule requires HHS to review its regulations every 10 years to determine whether...more
On December 16, 2020, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), announced that the Centers for Medicare & Medicaid (CMS) will disallow $200 million in federal Medi-Cal funding next...more
Last week, Iowa Senator Chuck Grassley wrote a letter to the United States Senate Committee on Finance (the Letter) concentrating on nonprofit hospitals’ debt collection and financial assistance practices and price...more
On November 4, 2020, HHS issued a notice of proposed rulemaking that would require HHS to review its regulations every ten years to determine whether or not the regulations are subject to agency review under the Regulatory...more
During the COVID-19 pandemic, CMS has issued approximately $106 billion in loans to providers who were struggling with cash flows and financing in the early stages of the pandemic. This month, the Continuing Appropriations...more
This month, OCR announced that it had settled five more investigations and enforcement actions under its HIPAA Right of Access Initiative. OCR first announced its HIPAA Right of Access Initiative in 2019. The HIPAA Right of...more
On August 3, 2020, President Trump signed an Executive Order that could potentially extend the easing of restrictions on telemedicine that were put in place during the COVID-19 public health emergency (PHE) beyond the...more