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 March 28, 2024, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced that it is extending the temporary special enrollment period (the Unwinding SEP)...more
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
At the onset of the COVID pandemic in March of 2020, Congress made an important policy decision: continued access to health coverage was crucial, especially because, at the time, it was uncertain how the economy would...more
Enacted at the start of the COVID-19 pandemic, the Families First Coronavirus Response Act (FFCRA) required states to keep individuals continuously enrolled in their Medicaid programs throughout the public health emergency...more
Medicaid enrollment grew significantly during the public health emergency (PHE). States implemented expanded eligibility and enrollment as well as reduced cost sharing and premiums based on Medicaid program regulatory...more
Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...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 Families First Coronavirus Response Act (FFCRA) provides enhanced federal matching funds to states as a condition of maintaining Medicaid enrollment until the conclusion of the COVID-19 public health emergency (PHE).1 As...more
Editor’s Note: In a new expert perspective prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, reproduced below, Manatt Health outlines the time-limited targeted enrollment...more
Editor’s Note: The current Medicaid continuous coverage requirements enacted by the Families First Coronavirus Act (FFCRA) prohibit states from disenrolling individuals from Medicaid for the duration of the public health...more
We’ve previously discussed the numerous flexibilities CMS offered state Medicaid programs to respond to local outbreaks and address health concerns associated with the COVID-19 public health emergency (PHE). Back in...more
Over a year after the declaration of a nationwide public health emergency due to the Coronavirus Disease 2019 (“COVID-19”) pandemic, providers are in a position to offer patients a variety of COVID-19 medical services,...more
On Thursday, January 8, the U.S. Department of Health & Human Services (HHS) announced that the Public Health Emergency (PHE) declaration for COVID‑19 will be renewed for another 90 days, beginning on January 21 (the date the...more
The COVID-19 pandemic has stressed the M&A market at every stage of the deal-making process – from complicating on-site visits and intensifying the diligence process to introducing valuation gaps (relative to pre-COVID-19...more
As much of the nation’s economic activity ground to a halt at the beginning of the COVID-19 pandemic, millions of people lost jobs and many also lost their job-based healthcare coverage. Based on the experience in other...more
Back in March, Tom gave you, our readers, an overview of the Administration’s and Congress’ initial response to the COVID-19 pandemic, including the inclusion in the second Congressional package (the Families First...more
On Friday, October 2, the U.S. Department of Health & Human Services (HHS) announced that the Public Health Emergency (PHE) declaration for COVID-19 will be renewed for another 90 days, beginning on October 23 (the date the...more
On Thursday, July 23, the U.S. Department of Health & Human Services (HHS) announced that the Public Health Emergency (PHE) declaration for COVID-19 will be renewed for another 90 days through October 22. This update...more
Below are six reimbursement issues that health care providers should be on “high alert” for as the COVID-19 crisis persists. An increasing number of patients will be losing their health insurance coverage....more
As part of the ongoing effort to improve access to COVID-19 diagnostic testing, the Centers for Medicare & Medicaid Services (CMS) issued guidance outlining the requirement that private health insurers and employer group...more
During its first-ever remote session, members of the New York City Council have introduced a series of bills aimed at providing relief for individuals and businesses affected by the COVID-19 crisis....more
Congress Replenishes Paycheck Protection Program (PPP) Through its Phase Four Coronavirus Relief Package. On Tuesday, via unanimous consent, the Senate passed the Paycheck Protection Program Increase Act of 2020...more
Summary - Late yesterday, the Senate passed the Paycheck Protection Program Increase Act of 2020. The measure appropriates a total of $484 billion, mainly to refund the Paycheck Protection Program (PPP), but also to provide...more
Over the last few days, the Centers for Medicare & Medicaid Services (CMS) issued several clarifications to guide the implementation of the Families First Coronavirus Response Act (FFCRA, P.L. 116-127) and the Coronavirus...more
On April 11, 2020, the Centers for Medicare and Medicaid Studies (CMS), in conjunction with the Department of Treasury and the United States Department of Labor (DOL), released FAQs detailing certain coverage elements...more