News & Analysis as of

Civil Monetary Penalty Public Health Emergency

King & Spalding

CMS Issues Interim Final Rule for CMS Enforcement of State Compliance with Reporting and Federal Medicaid Renewal Requirements

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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

Epstein Becker & Green

HHS OIG’s 13 New FAQs Shed Light on Post-Public Health Emergency Enforcement

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On March 22, 2023, the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) updated its Frequently Asked Questions (“FAQs”), drafting 13 FAQs aimed at easing the transition from COVID-era...more

Bass, Berry & Sims PLC

OIG Offers Stakeholders a New Avenue for Informal Fraud and Abuse Guidance

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On March 23, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) announced a new, expanded frequently asked questions (FAQs) process. Although OIG has long maintained FAQs on...more

Holland & Hart LLP

Public Health Emergency Ends May 11, 2023: Check Your Readiness

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After three years, the federal public health emergency (PHE) will expire May 11, 2023. Most of the relaxed regulatory and payor standards will end on or within a few months after the deadline, including many relating to: ...more

Foley & Lardner LLP

Public Health Emergency Ends May 11: What Telehealth Companies Need to Know

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On January 30, 2023, the Biden Administration announced its intent to end the COVID-19 public health emergency (PHE) on May 11, 2023. The PHE has been in place for over three years during which time many telehealth and...more

Foley & Lardner LLP

OIG Special Fraud Alert on Arrangements with Telemedicine Companies

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On July 20, 2022, HHS-OIG published a new Special Fraud Alert on arrangements with telemedicine companies, setting forth seven characteristics OIG believes could suggest a given arrangement poses a heighted risk of fraud and...more

Robinson+Cole Health Law Diagnosis

Advisory Opinion 22-08: OIG Declines to Impose Sanctions for Loaning of Smartphones for Receipt of Telehealth Services

On April 27, 2022, the Office of Inspector General (OIG) published Advisory Opinion 22-08 (Advisory Opinion) in which it declined to impose sanctions against a federally qualified health center (Requestor) for an arrangement...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Final Rule for CY 2022

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On November 2, 2021, CMS published the final rule to update the payment policies and rates for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment...more

King & Spalding

CMS Issues Outpatient Prospective Payment System Proposed Rule for CY 2022

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On July 19, 2021, CMS published a proposed rule to update the payment policies, payment rates and other provisions for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory...more

King & Spalding

OIG Provides Additional Guidance Regarding Application of Administrative Enforcement Authorities to Arrangements Directly...

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On May 24, 2021, OIG provided additional guidance in the form of an FAQ as to whether an offer or provision of cash, cash-equivalent, or in-kind incentives or rewards to Federal health care program beneficiaries who receive...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 11. News Briefs: March 2021 #2

Report on Medicare Compliance 30, no. 11 (March 22, 2021) - University Medical Center of Southern Nevada has agreed to pay $128,820 in a civil monetary penalty settlement that stemmed from a self-disclosure. According to...more

K&L Gates LLP

K&L Gates Triage: CMS Cease and Desist Letters to COVID Labs and Reimbursement Dispute

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In this episode, Stephen Bittinger discusses the recent announcement that cease and desist letters from the Centers for Medicare & Medicaid Services (CMS) have been sent to 171 facilities testing for COVID-19 without proper...more

Baker Donelson

CMS Amps Up Penalties on Long Term Care Facilities for Failing to Report COVID-19 Data and Mandates Staff Testing for the Virus

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Effective September 2, 2020, the Centers for Medicare and Medicaid Services (CMS) implemented an interim final rule with comment period to bolster its regulatory authority in addressing a number of issues relating to CMS's...more

McAfee & Taft

New CMS regulations bolster enforcement of COVID-19 reporting by hospitals, long-term care facilities and labs

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On August 25, 2020 the Centers for Medicare & Medicaid Services (CMS) issued interim final regulations known as CMS-3401-IFC that become effective immediately upon publication in the Federal Register, scheduled for September...more

Holland & Knight LLP

CMS Releases Interim Rule that ties COVID-19 Data Reporting to Hospital Conditions of Participation

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On Aug. 25, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (IFR) as an emergency regulation under the public health emergency (PHE). Under the IFR, CMS will require all hospitals to which...more

Foley & Lardner LLP

COVID-19: Free Lodging, Free Testing, Free of OIG Enforcement?

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Not necessarily. In the past two weeks, the Office of Inspector General (OIG), the Department of Health and Human Services (HHS) watchdog, released two new FAQs regarding the Application of OIG’s Administrative Enforcement...more

Bricker Graydon LLP

[Webinar] Stark Law Blanket Waivers and Anti-Kickback Compliance in a COVID-19 World - May 6th, 11:00 am - 11:30 am EST

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Bricker attorneys Beth Kastner, Shannon DeBra and Claire Turcotte will explore how COVID-19 has—at least temporarily—changed Stark and Anti-Kickback compliance for health care providers. Topics to be discussed include: ...more

Troutman Pepper

Telehealth Coverage Expansions And Enforcement Waivers During The COVID-19 Pandemic

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On March 6, President Trump signed into law the Coronavirus Preparedness and Response Supplemental Appropriations Act (the Act). The Act includes a provision allowing the Secretary of the Department of Health and Human...more

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