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Court Dismisses FCA Retaliation Complaint Involving Speaker Fees

In U.S. ex rel. Manieri v. Avanir Pharmaceuticals, Inc., 2021 WL 857102 (N.D. Oh. Mar. 8, 2021), the Northern District of Ohio dismissed a relator’s claim that he had been improperly retaliated because he had raised concerns...more

HHS Delays Trump Administration’s Healthcare Regulatory SUNSET Rule

On March 22, 2021, the U.S. Department of Health and Human Services announced it was delaying the Securing Updated and Necessary Statutory Evaluations Timely (SUNSET) rule until March 22, 2022. A one-year delay is unusual....more

U.S. Senate Passes American Rescue Plan – 10 Key Updates for Healthcare Providers

On March 6, 2021, the U.S. Senate narrowly passed H.R. 1319, the American Rescue Plan Act of 2021, by a 50-49 vote, along entirely partisan lines. Sen. Dan Sullivan (R-AK) missed the vote after joining with all Republicans on...more

U.S. House Passes American Rescue Plan – 15 Provisions for Healthcare Providers

In the early morning of Feb. 27, 2021, the U.S. House of Representatives narrowly passed H.R. 1319, the American Rescue Plan Act of 2021, by a 219-212 vote. Two Democrats joined with a united Republican caucus to oppose the...more

First Provider Relief Fund Indictment

The U.S. Department of Justice (DOJ) announced charges this month against a Michigan woman, Amina Abbas, for embezzling government property. This indictment is the first in the nation related to the CARES Act public health...more

CMS statement clarifies agency’s view that the Stark Law final rule is effective

Industry publication BVWire quoted a statement from the Centers for Medicare & Medicaid Services (CMS) that gives healthcare providers more certainty to rely on the much heralded final rule modernizing the physician...more

Fraud and Abuse Rules Part V: Easing Stark Law Compliance

As discussed in a previous McGuireWoods alert, the U.S. Department of Health and Human Services (HHS) published final rules that significantly amend the regulations to the Physician Self-Referral Law (Stark Law), the federal...more

Fraud and Abuse Rules Part III: New Value-Based Arrangement Protections

As discussed in a previous McGuireWoods alert, the Department of Health and Human Services (HHS) published final rules, effective Jan. 19, 2021, that significantly amend the Physician Self-Referral Law (Stark Law), the...more

HHS Delays Provider Relief Fund Reporting — Five Updates for Healthcare Providers

The U.S. Department of Health and Human Services (HHS) announced on Jan. 15, 2021, that it was delaying both (i) the deadline for the initial final report from recipients of the Public Health and Social Services Emergency...more

Omnibus Appropriations Package – 15 Key Provisions for Healthcare Providers

Passed by Congress Dec. 21, 2020, and signed by President Donald Trump Dec. 27, 2020, the $1.4 trillion omnibus Consolidated Appropriations Act, 2021 (H.R. 133), includes numerous statutory provisions that directly affect...more

Fraud and Abuse Rules Part I: Changes to Patient Inducement and Kickback Policies

As discussed in a previous McGuireWoods alert, the U.S. Department of Health and Human Services (HHS) published final rules expected to be effective Jan. 19, 2021, that significantly amend the Physician Self-Referral Law...more

Omnibus Appropriations Package Includes Changes for Medicare and Medicaid Beneficiaries

Passed by Congress Dec. 21, 2020, and signed by President Donald Trump Dec. 27, 2020, the $1.4 trillion omnibus Consolidated Appropriations Act includes numerous provisions that directly impact Medicare and Medicaid...more

New Spending Package Includes Provider Relief Fund Reporting Changes and More Funding

On Dec. 27, 2020, President Trump signed the Consolidated Appropriations Act, 2021 (H.R. 133), an appropriations and stimulus package that includes changes to the Public Health and Social Services Emergency Fund (Provider...more

HHS Finalizes Stark Law, AKS Changes to Reduce Burdens on Healthcare Providers

On Nov. 20, 2020, the U.S. Department of Health and Human Services (HHS) published two long-awaited final rules significantly amending the Physician Self-Referral Law (Stark Law), the federal Anti-Kickback Statute (AKS) and...more

Health Department Updates Provider Relief Fund Reporting Guidance

The U.S. Department of Health and Human Services (HHS) recently issued updated reporting requirements, a policy update memo and answers to frequently asked questions (FAQs) addressing mandatory final reports from recipients...more

Provider Relief Fund: New $20 Billion Available Starting Oct. 5 and Reporting Guidance Issued

On Oct. 1, 2020, the U.S. Department of Health and Human Services, through the Health Resources and Services Administrative (HRSA), announced $20 billion in new Phase 3 General Distribution Funding for providers from the...more

HHS Extends Timeline to finalize Stark Law Changes and CMP Inflation Rule

In the last two weeks, the U.S. Department of Health and Human Services (HHS) published two notices in the Federal Register delaying the publication of certain final fraud and abuse rule reforms for up to a full year. First,...more

CARES Act Healthcare Provider Relief Fund Update: New Distribution and Extended Deadlines

On July 31, 2020 and August 10, 2020, the U.S. Department of Health and Human Services (HHS) issued press releases announcing a second chance to apply for funding for certain Medicare providers and extended application...more

Provider Relief Funds: New Dental Distribution and More for Safety-Net and Rural Hospitals

On July 10, 2020, the U.S. Department of Health and Human Services (HHS) announced it will allow dentists and other dental providers to apply for relief from the Public Health and Social Services Emergency Fund (Provider...more

HHS Finalizes Changes Easing Affordable Care Act Nondiscrimination Rules

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently issued a final rule amending provisions of its 2016 rule prohibiting certain forms of discrimination under Section 1557 of the...more

Recent Physical Therapy Enforcement Actions Highlight Compliance Concerns

The government has stepped up efforts to monitor physical therapy billing fraud and recoup overpayments. While the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) have long policed fraudulent...more

New Provider Relief Fund Payments for Medicaid/CHIP Providers and Safety-Net/COVID-19 Hotspot Hospitals (Updated)

Update (June 11, 2020): This article was originally published on June 9, 2020. It has been updated to reflect new guidance released on June 10, 2020, by the Department of Health and Human Services (HHS), through the updated...more

New Provider Relief Fund Payments for Medicaid/CHIP Providers and Safety-Net/COVID-19 Hotspot Hospitals

On June 9, 2020, the U.S. Department of Health and Human Services (HHS) announced that it will distribute $25 billion from the Public Health and Social Services Emergency Fund (Provider Relief Fund) to healthcare providers...more

HHS OIG Adds Audit of CARES Act Provider Relief Funds to Work Plan

On May 22, 2020, the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) updated its Work Plan to reflect its planned audit of the $50 billion disbursed by HHS to hospitals and other...more

June 3 Deadline for Provider Relief Fund and HHS Guidance for Acquisitions

General Distribution Portal Submission Closing on June 3, 2020 - The U.S. Department of Health and Human Services announced on May 20 that eligible providers have until June 3, 2020, to accept the Terms and Conditions and...more

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