News & Analysis as of

Final Rules Enrollment

Mintz - Health Care Viewpoints

Unpacking CMS’s 2025 DSNP Changes: Considerations for Medicare Advantage Organizations

As part of its 2025 Medicare Advantage and Part D Final Rule (the Final Rule), the Centers for Medicare & Medicaid Services (CMS) made a number of enrollment changes impacting dual eligible special needs plans (DSNPs). The...more

King & Spalding

Biden Administration Streamlines CHIP and Medicaid Enrollment, Expands Protections for Covered Population

King & Spalding on

Last week, the Biden-Harris administration (the Administration) announced a new rule simplifying the process for enrolling in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP)....more

Ankura

Updates to the Translation and Accessibility Standards for Required Materials and Content in the Medicare 2024 Final Rule

Ankura on

Medicare Advantage Organizations and Part D sponsors have a responsibility to ensure they offer and provide their members and potential enrollees with content and materials in alternate languages or accessible formats for...more

Bass, Berry & Sims PLC

CY 2023 Medicare Physician Fee Schedule: Medicare Provider and Medicare Shared Savings Program

Bass, Berry & Sims PLC on

On November 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued CY 2023 Physician Fee Schedule Final Rule (Final Rule), implementing certain updates and policy changes for Medicare payments under the Physician...more

King & Spalding

CMS Publishes Frequently Asked Questions Regarding Medicare Advantage Marketing Policies

King & Spalding on

CMS released an FAQ document regarding marketing and communications requirements for the Part C and Part D programs. The FAQs seek to clarify rules issued by CMS in the 2023 Medicare Advantage and Prescription Drug Benefit...more

McDermott Will & Emery

Fun for the Whole Family: More ACA Subsidies Apply

McDermott Will & Emery on

On October 11, 2022, the US Department of Treasury (Treasury) and the Internal Revenue Service (IRS) issued final regulations to modify how affordability under the Affordable Care Act (ACA) is determined for an offer of...more

Baker Donelson

Medicare Revocation Consequences Worsened – Further Reenrollment Restrictions

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CMS recently finalized the most significant changes to enrollment since the 2006 enrollment rules were initially adopted. Overview of the New Rule - In its "Program Integrity Enhancements to the Provider Enrollment...more

Dorsey & Whitney LLP

New Disclosure Requirements to be Phased-In to CMS Enrollment and Revalidation Process

Dorsey & Whitney LLP on

On September 5, 2019, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) effective November 4, 2019, which increases disclosure requirements for the provider and supplier enrollment and...more

Nelson Mullins Riley & Scarborough LLP

CMS Publishes Final Rule Announcing New Enrollment and Participation Enforcement Authorities

The Centers for Medicare & Medicaid Services (“CMS”) recently issued a final rule with comment period (CMS-6058-FC) implementing statutory provisions that afford CMS new denial and revocation authorities related to Medicare...more

Steptoe & Johnson PLLC

CMS’ Expanded Revocation Authority Threatens Health Care Providers’ Medicare Enrollment

Steptoe & Johnson PLLC on

On September 5, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a final rule expanding CMS’ authority to deny or revoke enrollment in the Medicare program as a result of “bad actor” affiliations. Providers...more

McDermott Will & Emery

CMS Final Rule Strengthens Integrity of Medicare Provider Enrollment Process

McDermott Will & Emery on

On September 10, 2019, the US Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) expanding Medicare, Medicaid and Children’s Health Insurance Program...more

ArentFox Schiff

Guilt by Affiliation: New CMS Regulations Require Provider Disclosure of Past Association with “Bad Actors”

ArentFox Schiff on

On September 10, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a final rule with comment period, titled Program Integrity Enhancements to the Provider Enrollment Process (the “Final Rule”), which enhances...more

Bass, Berry & Sims PLC

Providers and Suppliers: Do You Have Skeletons in Your Enrollment Closet?

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On September 10, 2019, the Centers for Medicare & Medicaid Services (CMS) published a final rule significantly expanding its authority to deny or revoke participation in Medicare, Medicaid or the Children’s Health Insurance...more

Verrill

CMS Cracking Down on Health Care Fraud and Abuse

Verrill on

To increase provider and supplier transparency and accountability, the Centers for Medicare & Medicaid Services (“CMS”) recently issued a final rule (“Final Rule”) with comment period that allows CMS greater ability to...more

Mintz - Health Care Viewpoints

Key Takeaways from CMS’s Final Rule Requiring the Disclosure of Affiliates during Provider Enrollment

The Centers for Medicare & Medicare Services (CMS) recently published a final rule with comment period (the “Final Rule”) that is designed to increase CMS’s ability to identify and prevent bad actors from participating in...more

White and Williams LLP

Are You Your Brother’s Keeper? CMS Finalizes Rule to Reduce Fraud in Federal Health Insurance Programs

White and Williams LLP on

On September 10, 2019, the Centers for Medicare & Medicaid Services (CMS) published a final rule with comment, entitled “Program Integrity Enhancements to the Provider Enrollment Process” (Final Rule), which CMS claims will...more

Sheppard Mullin Richter & Hampton LLP

CMS Finalizes Rule Expanding its Authority to Deny and Revoke Medicare Program Enrollment, Among Other Changes

On September 5, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released a final rule with comment period entitled, “Program Integrity Enhancements to the Provider Enrollment Process” (the “Final Rule”). The...more

Robinson+Cole Health Law Diagnosis

CMS Updates Medicare Advantage and Part D (Prescription Drug Benefit)

On April 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule, updating Medicare Advantage (MA) and the prescription drug benefit program (Part D). ...more

Baker Donelson

Medicare Enrollment Rules - Expanded Enforcement Finalized in Regulations

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On December 5, 2014, CMS published final regulations that expand the bases for CMS to deny enrollment or revoke billing privileges of an enrolled provider or supplier. These final regulations also change the method to...more

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