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
Quick Takeaways From the 2024 Proposed Hospice Wage Index Rule
As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more
The Center for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC) have published guidance on survey procedures and enforcement of the COVID-19 vaccine requirement for hospitals and health care facilities after...more
The United States Department of Health and Human Services Office of Inspector General (“OIG”) recently issued a report concerning the use of telehealth to render behavioral health services to Medicaid enrollees, calling for...more
The use of telehealth has become indispensable across the country in recent months due to the COVID-19 public health emergency (PHE) and Centers for Medicare and Medicaid Services (CMS)’s temporary expansion of payment for...more
As a follow up to our legal alert posted on April 7, 2020, the Federal Communications Commission ("FCC") announced that it is accepting applications for its $200 million COVID-19 Telehealth Program as of April 13, 2020. As a...more
Update 04.10.2020: The FCC has launched an online portal explaining the application process for grants from the $200 million in funding to support telehealth services described in this client update. The FCC will begin...more
The Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (HHS), the Office for Civil Rights (OCR), the Office of the Inspector General (OIG), and other Federal and State agencies and...more
With crisis comes uncertainty, and even the best-intentioned regulations can leave those combating the current COVID-19 public-health emergency out in the cold. Many have asked whether the recent Declaration under the...more
Recognizing the need to make health services available during the current state of emergency, California Governor Gavin Newsom issued Executive Order N-43-20 (the “Order”) on April 3, 2020. The Order temporarily expands the...more
The COVID-19 outbreak inevitability has spurred unprecedented progress on a paradigm shift to telemedicine. According to a recent study by the Boston Consulting Group, China is already the world’s third largest Med Tech...more
The Program will guide disbursement of $200 million to health care providers for connected care services. Health care providers interested in receiving funds must complete a three-step process that requires advance planning....more
As we previously reported, Congress passed and the President signed the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. 116-136) (“CARES Act”) on March 27, 2020. We recently provided guidance on how the CARES Act...more
On March 30, 2020, CMS through its blanket 1135 waiver authority implemented a “Hospital without Walls” policy to allow hospitals to provide and bill for hospital services in other healthcare facilities and sites, such as...more
As the COVID-19 pandemic has emerged over the past month, state insurance departments have issued directives in reaction to the crisis, requiring such actions as a temporary moratorium on cancellations and coverage for...more
The Centers for Medicare & Medicaid Services, (“CMS”) announced this week that it will pay claims for designated health services related to COVID-19 that would ordinarily violate the Stark Law. On March 30, 2020, the...more
Prior to the COVID-19 public health emergency, telehealth services were generally restricted to routine visits for patients residing in rural areas. This was in part to prevent health care fraud and abuse....more
The updated waivers build upon the more limited set of Section 1135 waivers issued on March 13, 2020, and address common concerns among Medicare providers and suppliers as they deal with the Coronavirus (COVID-19) pandemic....more
On Monday, the Chairman of the Federal Communications Commission (FCC), Ajit Pai, circulated a plan to his fellow Commissioners detailing how the $200 million the agency will receive via the CARES Act should be deployed for a...more
On March 30, 2020, CMS issued updates to its March 9, 2020, memo from the Quality Safety and Oversight (QSO) Group on controlling and preventing the spread of Coronavirus (COVID-19) in dialysis facilities and other...more
On Monday, March, 30, 2020, CMS released a blanket waiver (the “Waiver”) of the physician self-referral law under section 1135 of the Social Security Act to enable health care provider responses to the COVID-19 outbreak. ...more
On March 23, 2020, the New York State (NYS) Department of Health issued updated guidance regarding use of telehealth by Medicaid providers, Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services...more
As the 2019 novel coronavirus (COVID-19) pandemic continues to strain the healthcare industry, the Centers for Medicare & Medicaid Services (CMS) eased healthcare provider enrollment rules. CMS has significantly streamlined...more
Since the outbreak of COVID-19, the Department of Health and Human Services Office for Civil Rights (OCR) has issued various guidance documents on compliance with the Health Insurance Portability and Accountability Act of...more
On March 6, Congress passed the Coronavirus Supplemental Appropriations Act (H.R. 6074), which included a $500 million authorization to enhance telehealth services. The legislation gives the U.S. Department of Health and...more
Unsurprisingly, COVID-19 has greatly liberalized federal and state telehealth requirements previously in place. What has not changed is the fact that telehealth services are governed by a number of different laws and...more