Hospice Audit Series: Beyond Part D, OIG Scrutinizes the Hospice Industry to the Tune of $6.6 Billion
Hooper, Kearney and Macklin on Cutting Edge Topics in the False Claims Act
Earlier this week, President Biden released his Fiscal Year (FY) 2025 President’s Budget. As a reminder, every year, the White House releases a budget that serves as its official funding request to Congress for the following...more
Could 2024 bring renewed growth for the skilled nursing and senior housing market or will proposed regulatory changes and the lingering effects of COVID-19 stymie hopes for a potential rebound? With rising occupancy rates...more
On March 31, 2023, CMS issued a proposed rule updating Medicare hospice payments and policies and the aggregate cap amount for Fiscal Year (FY) 2024 (Proposed Hospice Rule). Additionally, on April 3, 2023, CMS issued a...more
On January 6, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs...more
The Provider Relief Fund (PRF) Application and Attestation Portal is now open for Phase 4 and American Rescue Plan (ARP) Rural Distribution applications. Distributions received can be used for changes in a provider’s...more
As previously discussed, many of the telehealth flexibilities in place during the COVID-19 pandemic are set to expire at the end of the federal Public Health Emergency (PHE), unless federal and state legislators act to make...more
On April 27, 2021, CMS issued the fiscal year (FY) 2022 proposed rule for the hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (the Proposed Rule). Among...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
Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more
This week in Washington: Washington’s focus has been on the presidential and Senate races....more
During the COVID-19 pandemic, CMS has issued approximately $106 billion in loans to providers who were struggling with cash flows and financing in the early stages of the pandemic. This month, the Continuing Appropriations...more
On October 8, the Centers for Medicare & Medicaid Services (CMS) released new details on repayment terms for the Medicare Accelerated and Advance Payments Program, a loan program that sent aid to Medicare Part A providers and...more
Under the Provider Relief Fund Terms and Conditions, each recipient is required to submit reports to HHS. This notice supplements HHS’ July 20, 2020 Post-Payment Notice of Reporting Requirements (previously reported on here)....more
Insurance payments for healthcare services and supplies are frequently based on projections of future costs, often measured against a baseline calculated on past costs. However, COVID-19 and its attendant changes to the...more
In accordance with the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the Center for Medicare and Medicaid Services (CMS) has expanded its current Accelerated and Advanced Payment Program for Medicare Part A...more
Today, the Department of Health and Human Services (HHS) announced the delivery of the initial $30 billion tranche from the $100 billion provider relief fund established under the Coronavirus Aid, Relief, and Economic...more
Congress passed and the President signed the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. 116-136) (“CARES Act”) on March 27, 2020. We recently provided guidance on how the CARES Act impacts hospitals. ...more
The Centers for Medicare & Medicaid Services (CMS) has expanded its accelerated and advance payment program to provide immediate interest-free cash support to Medicare providers during the COVID-19 public health emergency. ...more
In response to the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) announced on Saturday March 28, 2020, that it is expanding its Medicare Accelerated and Advance Payment Program (AAPP) to...more
As reported in Seyfarth’s April 2, 2020 COVID-19 Update, the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. 116-136) (“CARES Act” or “Act”)...more
The Centers for Medicare and Medicaid Services (CMS) and the Office of Personnel Management (OPM) issued guidance to their contracting carriers on various issues surrounding the novel coronavirus or COVID-19. These guidance...more
The Centers for Medicare and Medicaid Services (CMS) released several fact sheets on COVID-19 coverage and benefits, and announced a second Healthcare Common Procedure Coding System (HCPCS) code, U0002, for billing COVID-19...more