The CMS Interoperability and Prior Authorization Rules
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Findings from Gibbins’ Annual Healthcare Bankruptcy Report
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Transparency and the Open Payments Program
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Behind the Curtain: Enhanced Provider Enrollment Oversight
Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences
Inflation Reduction Act’s Drug Price Negotiation Provisions – What Now? – Diagnosing Health Care Podcast
A Glimpse Into the Other Side: Understanding the Perspective of Government Enforcers
I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules
Podcast: Inflation Reduction Act’s Drug Price Negotiation Provisions – What’s Next? - Diagnosing Health Care
On December 4, 2023, CMS issued an interim final rule (the Interim Rule) (RIN 0938-AV26) to implement new enforcement authorities that CMS may use if states fail to comply with new reporting requirements or with federal...more
On July 27, 2023, CMS issued a final rule updating Medicare payments and policies under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the IRF Quality Reporting Program for FY 2024 (Final IRF...more
On May 1, 2023, the Biden Administration announced the end of COVID-19 vaccination requirements for federal employees, contractors, CMS-certified facilities, and others, because, “we are now in a different phase of our...more
On May 31, 2023, CMS issued a final rule (Final Rule) repealing COVID-19 vaccination requirements for staff and testing requirements for staff and patients of long-term care (LTC) facilities. These were previously required...more
The United States Department of Health and Human Services (“HHS”), through the Centers for Medicare and Medicaid Services (“CMS”), published a final rule on June 5 (the “Final Rule”), which, among other important actions,...more
On May 1, 2023, the Biden administration announced that it would be ending all of its various COVID-19 vaccination requirements on May 11, 2023, the same date as the COVID-19 national emergency and public health emergency...more
CMS released guidance for surveyors that provides leeway in surveying for compliance with the November 2021 interim final rule with comment that imposed a vaccination mandate for most staff at certain covered provider types....more
The Big Picture - On September 23, the Centers for Medicare & Medicaid Services (CMS) reopened the comment period for a November 2020 interim final rule (IFR) titled “Additional Policy and Regulatory Revisions in Response...more
The Centers for Medicare & Medicaid Services (CMS) calendar year 2023 rule proposing changes to payment policies under the Physician Fee Schedule (PFS) and Medicare Part B (the Proposed Rule) will officially be published in...more
On April 29, 2022, CMS issued its final rule for Medicare Advantage (MA) and Part D plans with updates including reduced out-of-pocket costs for prescription drugs and improved consumer protections. CMS published the final...more
There is a lot going on right now for healthcare employers. The first phase of CMS’s vaccine mandate is in full effect nationwide (now including Texas), the CDC has changed masking guidance in some circumstances, and it has...more
In a February 14, 2022, press release, The Joint Commission (Joint Commission) announced that it began surveying affected facilities for compliance with the Centers for Medicare and Medicaid Services (CMS) interim final rule...more
The DE OFCCP Week in Review (WIR) is a simple, fast and direct summary of relevant happenings in the OFCCP regulatory environment, authored by experts John C. Fox, Candee Chambers and Jennifer Polcer. In today’s edition, they...more
Following the Supreme Court’s decision in Biden v. Missouri, CMS will require several states to be compliant with the “Phase 1” requirements of its Interim Final Rule (“IFC”) as of January 27, 2022. These states include...more
Key Takeaways: ..The Rule only applies to Medicare- or Medicaid-certified facilities and their contractors having contact with patients or staff ..The Rule does not apply to school districts receiving Medicare or...more
The U.S. Occupational Safety and Health Administration’s (OSHA) COVID-19 Vaccination and Testing Emergency Testing Standard (ETS) met its demise at the Supreme Court of the United States on January 13, 2022. That same day,...more
In our last alert, we discussed the Sixth Circuit dissolving the Fifth Circuit’s nationwide injunction on OSHA’s Emergency Temporary Standard (“ETS”) and that the Supreme Court (“the Court”) would be holding a special hearing...more
In the wake of the Supreme Court’s mixed ruling on federal vaccination mandates, the Centers for Medicare & Medicaid Services has released three separate guidances for three groups of states. Our Labor & Employment and Health...more
On January 13, 2022, the U.S. Supreme Court (“Court”) issued split decisions regarding Federal vaccine mandates issued by the Centers for Medicare and Medicaid Services (CMS) and the Occupational Safety and Health...more
Health care employers are not alone in feeling overwhelmed by the constantly changing legal status of the various federal vaccine mandates. On Thursday afternoon, the Supreme Court made its rulings on two preliminary...more
National Federation of Independent Businesses v. Department of Labor, Nos. 21-244, 21-247: Numerous challenges were brought against the emergency rule issued on November 5, 2021, by the Occupational Safety and Health...more
On December 28, 2021, the Centers for Medicare and Medicaid Services (“CMS”) announced that it will begin enforcement of the COVID-19 vaccine mandate, as set forth in the Interim Final Rule published on November 5, 2021, in...more
While most healthcare providers have been struggling with staffing during the holidays, the Centers for Medicare and Medicaid Services (“CMS”) has been active in providing an enforcement update on the Omnibus COVID-19 Health...more
Despite continuing disputes as to the legality and enforcement of the CMS vaccine mandate for certified providers and suppliers, CMS has indicated it will proceed with enforcement of the mandate in those states where it is...more