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Medicaid › New Guidance

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Hanson Bridgett

CMS Announces Care Compare Changes That Could Lead to Major Five-Star Impacts for Certain SNFs

Hanson Bridgett on

On June 18, Centers for Medicare and Medicaid Services published new guidance announcing a major change to the way Care Compare will display survey information and the methodology for calculating the health inspection score...more

Nelson Mullins Riley & Scarborough LLP

Attention SNFs: Enhanced 855A Disclosure Requirement Deadline Extended to August 1, 2025

Nelson Mullins Riley & Scarborough LLP on

This article is an update to a December 2024 client alert. On April 17, 2025, the Centers for Medicare and Medicaid Services ("CMS") extended the revalidation deadline for its 855A skilled nursing facility...more

Bricker Graydon LLP

CMS Extends Mandatory SNF Off-Cycle Revalidations to August 1, 2025

Bricker Graydon LLP on

On April 17, 2025, the Centers for Medicare and Medicaid Services (CMS) formally announced an extension for the mandatory off-cycle revalidation deadline for skilled nursing facilities (SNFs)....more

Polsinelli

CMS Extends Revalidation Deadline for Skilled Nursing Facilities to August 1, 2025

Polsinelli on

In its April 17 MLN Newsletter, the Centers for Medicare and Medicaid Services (CMS) once again extended the deadline for skilled nursing facilities (SNF) to submit their off-cycle revalidation from May 1 to August 1, 2025....more

Polsinelli

CMS Spring Provider Enrollment Updates

Polsinelli on

Centers for Medicare & Medicaid Services (CMS) released several pieces of Medicare provider enrollment guidance this spring, both emphasizing current policy and requirements as well as providing guidance and clarification...more

Arnall Golden Gregory LLP

AGG Talks: Cross-Border Business Podcast - Episode 27: U.S. Healthcare Reimbursement Guidance for Foreign Life Sciences Companies

Arnall Golden Gregory LLP on

In this episode, Mike Burke, AGG Corporate partner and co-chair of the firm’s International practice, is joined by Andrew Tsui, AGG Healthcare Litigation partner, to explore the intricacies of reimbursement in the U.S....more

McDermott+

Breaking Down the New No Surprises Act FAQs Post-TMA III

McDermott+ on

On January 14, 2025, the US Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM), jointly issued Part 69 of a series of...more

Lathrop GPM

OIG Issues New Nursing Facility Compliance Guidance, Comes on the Heels of Enhanced Medicare Enrollment Requirements for SNFs

Lathrop GPM on

The Office of Inspector General at the U.S. Department of Health and Human Services (OIG) recently followed up on a 2023 commitment to supplement its General Compliance Program Guidance (GCPG) by publishing its first...more

King & Spalding

OIG Issues Nursing Facility Compliance Guidance

King & Spalding on

On November 20, 2024, OIG released new compliance program guidelines for nursing facilities titled, “Nursing Facility Industry Segment-Specific Compliance Program Guidance” (the Nursing Facility ICPG or the Guidance). The...more

McDermott Will & Emery

CMS Issues Guidance on Usage of AI in Making Coverage Determinations

McDermott Will & Emery on

On February 6, 2024, the US Centers for Medicare & Medicaid Services (CMS) issued a letter to all Medicare Advantage (MA) organizations and Medicare-Medicaid plans. The letter covered frequently asked questions and answers...more

Foley & Lardner LLP

“Let’s Talk Compliance”: OIG’s General Compliance Program Guidance: How to Refresh Compliance Programs

Foley & Lardner LLP on

Editor’s Note: PYA and Foley & Lardner hosted the 6th Annual “Let’s Talk Compliance” two-day Virtual Conference on January 18 and 19, 2024. Panelists included Foley & Lardner attorneys and PYA experts. The event was hosted by...more

King & Spalding

OCR Provides Guidance Regarding Patient Visitation Rights

King & Spalding on

On January 25, 2024, HHS Office for Civil Rights (OCR) issued guidance and responses to frequently asked questions regarding nondiscrimination regulations related to patient visitation. Hospitals, long term care facilities,...more

McNees Wallace & Nurick LLC

The OIG Releases Updated General Compliance Program Guidance

McNees Wallace & Nurick LLC on

As 2023 came to a close, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released an updated General Compliance Program Guidance (GCPG) manual, which serves as a reference guide for...more

Warner Norcross + Judd

Benefit Plan Guidance for the End of the Public Health Emergency and “Outbreak Period”

Warner Norcross + Judd on

With President Joseph Biden’s administration having announced its intent to end the presidential COVID-19 National Emergency on May 11, 2023, and with the COVID-19 Public Health Emergency ("Public Health Emergency") set to...more

King & Spalding

CMS Issues Guidance for Medicare Contractors to Pay For Section 1115 Day

King & Spalding on

On March 16, 2023, CMS issued Change Request 12669, which contains instructions for Medicare Administrative Contractors (MACs) to begin the process of retroactively reimbursing DSH hospitals for inpatient days attributable to...more

Robinson & Cole LLP

Health Law Diagnosis - CMS Issues Guidance for Providers on Waivers, Flexibilities and End of COVID-19 Public Health Emergency

Robinson & Cole LLP on

The Centers for Medicare & Medicaid Services (CMS) recently issued a Fact Sheet (Fact Sheet) providing guidance on the impact of the end of the federal COVID-19 Public Health Emergency (PHE) on certain regulatory waivers,...more

Robinson+Cole Health Law Diagnosis

CMS Issues Guidance for Providers on Waivers, Flexibilities and End of COVID-19 Public Health Emergency

Robinson+Cole Health Law Diagnosis on

The Centers for Medicare & Medicaid Services (CMS) recently issued a Fact Sheet (Fact Sheet) providing guidance on the impact of the end of the federal COVID-19 Public Health Emergency (PHE) on certain regulatory waivers,...more

McDermott Will & Emery

CMS Issues New Policy Allowing Medicaid and CHIP Coverage of Interprofessional Consultations

McDermott Will & Emery on

The Centers for Medicare and Medicaid Services (CMS) has revised its policy guidance on the coverage and payment for interprofessional consultations under Medicaid and the Children’s Health Insurance Program (CHIP)....more

Holland & Knight LLP

Holland & Knight Health Dose: February 7, 2023

Holland & Knight LLP on

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. This week's topics include ... ...more

Nelson Mullins Riley & Scarborough LLP

CMS Releases New REH Conversion Guidance

Nelson Mullins Riley & Scarborough LLP on

The Centers for Medicare and Medicaid Services (“CMS”) recently released new guidance about the process for converting to a Rural Emergency Hospital (“REH”) – a new Medicaid provider type effective Jan. 1, 2023. REHs are...more

Sheppard Mullin Richter & Hampton LLP

CMS Issues Interprofessional Consultation Guidance

Sheppard Mullin Richter & Hampton LLP on

Introduction: Defining Interprofessional Consultation - In a January 5, 2023, letter to state health officials, the Centers for Medicare & Medicaid Services (“CMS”) clarified a Medicaid and Children’s Health Insurance...more

Sheppard Mullin Richter & Hampton LLP

CMS Augments “In Lieu Of Services” Medicaid Guidance to Support State Medicaid Managed Care Efforts to Address Social Determinants...

Sheppard Mullin Richter & Hampton LLP on

Social determinants of health (“SDOH”) consider the non-clinical factors that can profoundly impact an individual’s well-being. They are extensive and often overlap, including housing instability, food insecurity, the...more

Holland & Knight LLP

Holland & Knight Health Dose: December 13, 2022

Holland & Knight LLP on

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. This week's topics include: ...more

Foley & Lardner LLP

Medicaid: New Guidance from CMS Finds there are Significant Misunderstandings on Ground Emergency Medical Transportation...

Foley & Lardner LLP on

On August 17, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a bulletin (Bulletin) to states addressing potentially inappropriate cost-based proposals and practices related to governmental ambulance...more

Mintz - Health Care Viewpoints

White House Issues Telehealth Guidance on Substance Use Disorder Services

Mintz - Health Care Viewpoints on

On June 22, 2022, the White House Office of National Drug Control Policy (ONDCP) issued guidance advocating for Congress and federal agencies to make permanent certain telehealth access measures for people struggling with...more

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