On July 10, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule Proposed Rule (Proposed Rule) for the calendar year 2025. The Proposed Rule would implement certain provisions of the...more
The Department of Justice announced one if its most aggressive and wide-ranging enforcement actions to date, a coordinated two-week operation spanning 32 federal districts. The orchestrated effort involved the FBI, HHS-OIG,...more
Starting January 1, 2023, Medicare will cover telehealth-based treatment services delivered by federally-accredited opioid treatment programs (OTPs), commonly referred to as “methadone clinics.” This new reimbursement is...more
On June 6, 2022, the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), released its spring 2022 semiannual report to Congress. The semiannual report covers the period of October 1, 2021 to...more
Editor’s Note: The American Medical Association (AMA) and Manatt Health released a national roadmap in September 2019 to guide policymakers in taking action to help end the nation’s opioid epidemic. Based largely on in-depth...more
Payment misalignment in Medicare FFS for Substance Use Disorder (SUD) treatment as the subject of potential legislative and/or regulatory reforms - New opportunities for investor-backed behavioral health platforms in...more
The Medicare Physician Fee Schedule Final Rule for Calendar Year 2021 (the Final Rule) issued by the Centers for Medicare & Medicaid Services (CMS) on December 1, 2020, and published in the Federal Register on December 28,...more
Over the last 50 years, the use of medication-assisted treatment (MAT) for opioid use disorder (OUD) has evolved from a controversial therapy on the outskirts of accepted medical practice and drug abuse prevention strategy to...more
The CMS Proposed Rule to update the Medicare Physician Fee Schedule for Calendar Year 2021, published in the Federal Register on August 17, 2020 (85 Fed. Reg. 50074), proposes several updates to Medicare payment regulations...more
Amid the United States’ growing opioid crisis, the Equal Employment Opportunity Commission (“EEOC”) issued new guidance on employers’ obligations under the Americans with Disabilities Act (“ADA”) regarding job applicants or...more
Earlier this month, the U.S. Equal Employment Opportunity Commission (EEOC) released two new documents addressing concerns about the employment provisions of the Americans with Disabilities Act (ADA) and opioid use. Employers...more
It is no secret that America is in the midst of an opioid addiction crisis. It has been for quite awhile. A recent study revealed that in 2018 there were 128 deaths from opioid overdose per day in United States. A startling...more
The Equal Employment Opportunity Commission (“EEOC”) has released new informal guidance directed at employees regarding use of opioids and employer obligations under the Americans with Disabilities Act (“ADA”). The EEOC also...more
As Tennessee continues to look for options to expand access to opioid treatment services, a new Tennessee law expands the types of providers who may prescribe medication-assisted treatment and imposes certain financial...more
In the continued fight against opioid addiction, Pennsylvania enacted a new law, effective November 27, 2019, that requires prescribers in Pennsylvania to implement additional steps prior to treating a patient’s chronic pain...more
Recognizing the huge problems caused by opioid addiction in the United States, Medicare is adding a new outpatient opioid treatment benefit, paying for methadone and related treatment in certain facilities. Under a new...more
A software developer of an electronic health records system utilizing AI is the recent target in a DOJ fraud investigation. On January 27, 2020, the DOJ announced that Practice Fusion, Inc. entered into a deferred...more
On November 15, 2019, the Centers for Medicare & Medicaid Services (“CMS”) published its final rule outlining changes to the Medicare Physician Fee Schedule (“PFS”) for the Calendar Year (“CY”) 2020 (“Final Rule”)....more
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2019, published the Calendar Year (CY) 2020 Final Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B,...more
Recently, the Centers for Medicare & Medicaid Services (“CMS”) published its annual proposed rule outlining potential changes to the Medicare Physician Fee Schedule (“PFS”) for upcoming Calendar Year (“CY”) 2020 (“Proposed...more
Grounded in the bipartisan Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act designed to "alleviate the nationwide opioid crisis," CMS's proposed...more
On August 26, 2019, the Substance Abuse and Mental Health Services Administration, part of the U.S. Department of Health and Human Services (HHS), published its much-anticipated notice of proposed rulemaking to revise 42...more
On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) took the first steps toward welcoming opioid treatment programs (OTPs) into the Medicare program and expanding Medicare coverage of opioid use disorder...more
In October 2018, the President signed the SUPPORT for Patients and Communities Act, a portion of which is known as the “Eliminating Kickbacks in Recovery Act of 2018” or “EKRA.” EKRA, aimed at the ongoing opioid crisis, is...more
The growing concern over opioid abuse has prompted both the federal government and many states to address concerns over referrals for substance abuse treatment. Tennessee recently addressed the issue in House Bill No. 2068,...more