News & Analysis as of

Medicare Self-Referral

Bricker Graydon LLP

A Long-Awaited Change: OIG Updates its Compliance Program Guidances

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From 1998-2008, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published compliance program guidelines for various industries in the Federal Register....more

Mintz - Health Care Viewpoints

OIG Issues Unfavorable Advisory Opinion on Common Arrangements between Physician Practices and Health Care Providers

On August 15, 2023, the Office of Inspector General for the Department of Health and Human Services (OIG) issued a negative Advisory Opinion regarding a turnkey physician-owned entity (Newco) operated by an existing provider...more

Epstein Becker & Green

Hidden in Plain Sight: Lesser-Known Exceptions Recently Adopted by Congress to the Federal Physician Self-Referral Law and...

Epstein Becker & Green on

At the end of 2022, Congress enacted the Consolidated Appropriations Act of 2023 (“CAA”), for which there has been much fanfare.   As it relates to health care, this legislation included provisions addressing issues such...more

Baker Donelson

COVID-19 Public Health Emergency Set to End May 11, 2023, Along with Many Waivers and Flexibilities

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After more than three years, the Public Health Emergency (PHE) related to COVID-19 is scheduled to end on Thursday, May 11, 2023. The PHE declaration under the Public Health Service Act has allowed the Secretary of the...more

Maynard Nexsen

Stark Law Group Practice Requirements

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The Centers for Medicare & Medicaid Services (CMS) published updates to the CMS Voluntary Self-Referral Disclosure Protocol (SRDP) on January 23, 2023. The SRPD is the CMS process for Medicare providers and suppliers to...more

Baker Donelson

CMS Requests Comments on Proposed Changes to Stark Law Self-Referral Disclosure Protocol Forms

Baker Donelson on

On June 9, 2022, the Centers for Medicare and Medicaid Services (CMS) solicited comments to proposed changes to the Self-Referral Disclosure Protocol (SRDP) for physician practices disclosing group practice noncompliance....more

Proskauer - Health Care Law Brief

Physician Fee Schedule Final Rule for Calendar Year 2022 – CMS Cuts Rates and Extends Telehealth

On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued its Calendar Year (CY) 2022 Physician Fee Schedule (“PFS”) Final Rule. In this post, we sample some key highlights from the Final Rule. ...more

Proskauer - Health Care Law Brief

CMS Corrects Inadvertent Omissions in Recent Stark Law Regulatory Amendments, Clarifies Reach of the Prohibition Related to...

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) released its final rules for the 2022 Medicare Physician Fee Schedule (PFS Final Rule) and 2022 Medicare Hospital Outpatient Prospective Payment System...more

Robinson+Cole Health Law Diagnosis

CMS Issues Advisory Opinion Clarifying Physician Self-Referral Law Group Practice Structure

In June 2021, the Centers for Medicare and Medicaid Services (CMS) issued a notable interpretation of the Physician Self-Referral Law (aka the Stark Law) in Advisory Opinion No. CMS-AO-2021-01 (Advisory Opinion) regarding...more

Nelson Mullins Riley & Scarborough LLP

What the New CMS Advisory Opinion Means for Providers

The Centers for Medicare & Medicaid Services (CMS) has issued Advisory Opinion No. CMS-AO-2021-01 on whether a wholly-owned physician practice that provides designated health services (“DHS”) through one or more wholly-owned...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes to Revise, Again, the Stark Law’s Definition of “Indirect Compensation Arrangement”: What Was Old is New Again

On July 13, 2021, the Centers for Medicare and Medicaid Services (“CMS”) released a Proposed Rule that proposes to amend certain regulations implementing the Physician Self-Referral Law, otherwise known as the “Stark Law”....more

The Volkov Law Group

Akron Ohio Health System Agrees to Pay Over $21 Million to Settle False Claims Act Violations for Improper Payments to Referring...

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Akron General Health Systems, a regional hospital system based in Akron, Ohio agreed to pay $21.25 million to resolve allegations under the False Claims Act that it maintained improper relationships with referring physicians,...more

Foley & Lardner LLP

Stark Law Changes Coming to Physician Compensation Models in 2022

Foley & Lardner LLP on

Medical groups that have division-based or service-level approaches to physician compensation should spend their summer evaluating their models in light of Stark Law revisions that go into effect on January 1, 2022. The...more

Foley Hoag LLP - Medicaid and the Law

A Deeper Dive into CMS’ Multiple Best Prices Policy

As my colleague Tom wrote about in a recent post, the Centers for Medicare & Medicaid Services (CMS) has finally responded to a growing chorus of stakeholders that government price reporting requirements, particularly...more

Manatt, Phelps & Phillips, LLP

[Webinar] Unpacking the Anti-Kickback and Stark Reforms: Promoting Value-Based Care and Easing Regulatory Compliance - January...

A New Manatt Webinar Guides You Through New Reforms Promoting Value-Based Care and Easing Regulatory Compliance—the Most Significant Changes to the Federal Fraud and Abuse Landscape in the Last Decade. On November 20,...more

Ballard Spahr LLP

More Value, Less Volume – CMS Makes Significant Changes to Clarify the Stark Law Regulations and Incentivize Provider...

Ballard Spahr LLP on

Summary - Publication of the Centers for Medicare and Medicaid Services recent final rule on the Physician Self-Referral Law—known as the Stark Law—may mark the end of the Trump administration’s Regulatory Sprint to...more

Alston & Bird

CMS and OIG Significantly Update the Physician Self-Referral Law and Anti-Kickback Statute

Alston & Bird on

Nearly a year ago, the Department of Health and Human Services proposed rules to implement part of its Regulatory Sprint to Coordinated Care by making significant updates to the Stark Law and Anti-Kickback Statute with new...more

Holland & Knight LLP

Healthcare Law Update: October 2020

Holland & Knight LLP on

Earlier this year, the Office of the National Coordinator for Health Information Technology (ONC) published a final rule (ONC Rule) addressing interoperability, information blocking and patient access to data. The ONC Rule...more

Manatt, Phelps & Phillips, LLP

[Webinar] 1135 Waivers in Action: Flexibilities, Limits and Next Steps for States and - April 21st, 1:00 pm - 2:00 pm ET

On March 30, the Centers for Medicare & Medicaid Services (CMS) swept aside dozens of federal healthcare requirements using its emergency waiver authority under Section 1135 of the Social Security Act. The waivers—addressing...more

Spilman Thomas & Battle, PLLC

Stark Blanket Waivers Issued During COVID-19 National Emergency

On March 30, 2020, the Secretary of the Department of Health and Human Services ("Secretary") announced a blanket waiver ("Waiver") of sanctions for violations of Section 1877 of the Social Security Act, also known as the...more

Winstead PC

CMS Issues COVID-19 Stark Law Blanket Waivers

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On March 30, 2020, pursuant to Section 1135 of the Social Security Act, the Centers for Medicare & Medicaid Services (“CMS”) issued “blanket waivers” concerning several Stark Law requirements in response to the COVID-19...more

Carlton Fields

CMS Issues Blanket Waivers From the Stark Law

Carlton Fields on

On March 30, 2020, in response to the public health emergency resulting from the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) issued blanket waivers from section 1877 of the Social Security Act (the...more

Robinson+Cole Health Law Diagnosis

DOJ Announces Physician Self-Referral (Stark) Law Settlement in Excess of $46 Million with California Health System and Surgical...

On November 15, 2019, the Department of Justice (DOJ) announced it had reached a settlement with Sutter Health (Sutter) and Sacramento Cardiovascular Surgeons Medical Group Inc. (Sac Cardio) to resolve alleged violations of...more

McGuireWoods Consulting

Washington Healthcare Update - November 2019 #2

McGuireWoods Consulting on

This week in Washington: House returns from recess and has scheduled hearing on caring for aging Americans; Senate to hold hearing on rising electronic cigarette use among youth and will hold a confirmation hearing for Dr....more

McGuireWoods Consulting

Washington Healthcare Update - October 2019 #4

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This week in Washington: Senate to hold a hearing on eligibility requirements under the Medicaid program, as well as a hearing to review a number of healthcare bills, including OTC drug safety, innovation and reform....more

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