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
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
Hospitals everywhere in the United States should take note: CMS announced on March 26, 2020, that it is lifting its extended 30-day survey suspension for hospitals. Survey activity will now resume. COVID-19’s impact on...more
The Centers for Medicare and Medicaid Services (CMS) notified state survey agency directors that it has lifted previously imposed hospital survey suspensions and resumed routine hospital reaccreditation and recertification...more
The Centers for Medicare and Medicaid Services (CMS) notified state survey agency directors of renewed hospital survey limitations and notification expectations for states and hospitals during the ongoing COVID-19 crisis in...more
In a January 4, 2021 revision to a June 1, 2020 Quality, Safety and Oversight memorandum, the Centers for Medicare and Medicaid Services (CMS) revised the criteria for focused infection control (FIC) surveys in nursing...more
On August 17, 2020, the Centers for Medicare and Medicaid Services (CMS) announced in a memo to State Survey Agency Directors (QSO-20-35-ALL) the resumption of certain routine surveys and inspections of healthcare providers...more
On August 17, 2020, CMS encouraged State Survey Agencies to resume some of their normal enforcement activities. Maintaining a Medicare provider agreement is paramount for acute care hospitals, and that process includes...more
On August 17, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a Guidance Memorandum (Guidance) setting forth revised state survey agency priorities as well as providing information regarding the resumption...more
According to an April 13, 2020 Press Release issued by the National Association of ACOs (“NAACOS”), a recent NAACOS survey shows that 56% of the survey-participating at-risk accountable care organizations (“ACOs”) – i.e.,...more
On June 1, CMS issued guidance to states on new requirements for nursing homes in light of the COVID-19 pandemic. Since March 6, 2020, CMS has relied on State Survey Agencies to perform Focused Infection Control surveys of...more
Approximately one week after announcing $4.9 billion in supplemental payments under the Public Health and Social Services Emergency Fund (the "Relief Fund") to skilled nursing facilities ("SNFs") for “critical needs such as...more
Since the early stages of the Coronavirus (COVID-19) pandemic, long term care facilities (LTCFs) have been an epicenter of transmission. Medicare Requirements for Participation for LTCFs include an obligation to establish and...more
On June 1, 2020, CMS issued guidance to state survey agency directors regarding survey activities. The guidance allows for expanded survey activities of all providers and suppliers and makes significant changes to nursing...more
Long-term care facilities, including nursing homes, (collectively, LTCF) have been a hot spot for the transmission of the novel coronavirus disease (COVID-19). In an effort to balance quality, transparency and infection...more
After receiving approval from the Office of Management and Budget (OMB) on April 23, 2020, the Centers for Medicare and Medicaid Services (CMS) released a survey on April 24, 2020, to collect information on 340B hospitals’...more
The Centers for Medicare and Medicaid Services (CMS) issued a memorandum to State Survey Agency Directors that provides further guidance regarding survey priorities for health care facilities, providers, and clinical...more
The President's declaration of a national emergency gave the Secretary of the Department of Health and Human Services the ability to authorize waivers or modifications of certain requirements of Section 1135 of the Social...more
The Centers for Medicare & Medicaid Services (CMS) previously issued guidance suspending non-emergency survey inspections in order to allow surveyors to focus on the most current and serious health and safety threats, like...more
In response to the threat of the spread of the coronavirus (COVID-19), the Centers for Medicare and Medicaid Services (CMS) has issued a memorandum to State Survey Agencies and Accrediting Organizations, suspending all...more
On February 7, 2020, the Centers for Medicare and Medicaid Service (CMS) published a notice signaling that it has submitted its previously published September 2019 proposed survey of hospital 340B drug costs for Office of...more
On January 13, 2020, the Centers for Medicare & Medicaid Services (CMS) announced a new streamlined survey and certification process for psychiatric hospitals as part of the agency’s “Patients over Paperwork” initiative. ...more
OIG recently updated its interactive map that displays details on nursing home complaint trends to incorporate data from 2016 through 2018. OIG had previously conducted a study and published an interactive map showing...more
On July 9, 2019, the US Department of Health and Human Services, Office of Inspector General (OIG) released two reports addressing hospice deficiencies and the risks, potential harm, and actual harm those deficiencies posed...more
The veil of secrecy may soon be lifted from the reports of accreditation organizations like The Joint Commission if a proposal in the April 28, 2017 Inpatient Prospective Payment System (IPPS) Proposed Rule is finalized. As...more
CMS authorizes Massachusetts waiver supporting transition to a Medicaid ACO model; Oregon CCOs use “flexible service” funds to invest in housing-related services; and enrollment for 2017 Marketplace coverage begins....more