News & Analysis as of

Office of the Inspector General Accountable Care Organizations

Faegre Drinker Biddle & Reath LLP

Long-Awaited Disincentives Rule for Providers Gives the Information Blocking Rule Teeth

On June 24, 2024, the Department of Health and Human Services (HHS) finalized the Establishment of Disincentives for Health Care Providers That Have Committed Information Blocking (Disincentive Rule) under the 21st Century...more

BakerHostetler

Healthcare Providers Beware: Finalized Disincentives Sharpen the Teeth of Information Blocking Rule

BakerHostetler on

On June 24, 2024, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) at the Department of Health and Human Services (HHS) issued the 21st...more

Rivkin Radler LLP

HHS OIG Issues Information-Blocking Disincentives for Certain Health Care Providers

Rivkin Radler LLP on

On June 24, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) announced a final rule that establishes disincentives for certain health care providers that have committed information...more

Holland & Knight LLP

HHS Is Primed to Enforce Information Blocking Conduct

Holland & Knight LLP on

The U.S. Department of Health and Human Services (HHS) continued its commitment to timely and full access to health records on June 24, 2024, through the finalization of its information blocking disincentives rule for...more

Holland & Knight LLP

Key Value-Based Care Developments to Watch in 2024

Holland & Knight LLP on

The goal of value-based care (VBC) is to promote better care for individual patients and improved health outcomes for communities at reduced costs. This is an important and admirable purpose as many VBC stakeholders attempt...more

Mintz - Health Care Viewpoints

HHS Proposes Appropriate Disincentives for Health Care Providers That Commit Information Blocking

In coordination with the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (HHS) and Office of the National Coordinator for Health Information Technology (ONC) proposed a...more

BCLP

HHS Proposes Rule to Establish Penalties for Committing Information Blocking: What Providers Need to Know

BCLP on

On October 30, 2023, the U.S. Department of Health and Human Services (HHS) released a proposed rule (Proposed Rule) to establish disincentives for healthcare providers that engage in information blocking under the 21st...more

Bass, Berry & Sims PLC

HHS Proposes Rule to Establish Disincentives for Healthcare Providers That Engage in Information Blocking

Bass, Berry & Sims PLC on

In 2020, when the U.S. Department of Health and Human Services (HHS) published its Final Rule to implement the information blocking prohibitions of the 21st Century Cures Act, HHS left healthcare providers wondering what...more

Nelson Mullins Riley & Scarborough LLP

Using the New Value-Based Rules to Enhance Your ACO

In November 2020, the Centers for Medicare & Medicaid Services (CMS) finalized value-based exceptions under the Stark law, and the Office of Inspector General (OIG) finalized value-based safe harbors under the Anti-Kickback...more

ArentFox Schiff

Searching for Safe Harbors? CMS-Sponsored Model Participants Receive Anti-Kickback Statute Protection

ArentFox Schiff on

Enrolling in such a CMS-sponsored innovation model now has an added benefit: a new Anti-Kickback Statute (AKS) safe harbor. ...In its mission to reward value over volume, the Centers for Medicare & Medicaid Services’ (CMS)...more

Jones Day

HHS Finalizes New AKS Safe Harbors for Patient Engagement and CMS-Sponsored Arrangements

Jones Day on

The Situation: As health care providers transition to value-based care models, they have often been forced to rely on safe harbors under the Anti-Kickback Statute, or AKS, that were never designed with value-based payment...more

ArentFox Schiff

New Stark Law and Anti-Kickback Reforms Aimed at Value-Based Care

ArentFox Schiff on

OIG and CMS, through a coordinated effort, have issued sweeping and much-anticipated final changes to the Anti-kickback and Stark rules. These changes are generally industry-friendly. Introduction - On November 20,...more

Faegre Drinker Biddle & Reath LLP

Patient Engagement Tools and Supports: Analysis of the New Anti-Kickback Statute Regulatory Safe Harbor

Providers have a new tool in their toolbox to promote population health. The Health and Human Services Office of Inspector General (OIG) has adopted a new, extremely broad safe harbor that allows certain providers to give...more

Mintz - Health Care Viewpoints

HHS Proposes Sweeping Changes to AKS and Stark Law, Part 6: Proposed Changes to the AKS Related to Beneficiary Inducement

As reported previously, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently published two proposed rules that seek to implement wholesale changes to the Anti-Kickback Statute (AKS) and...more

Seyfarth Shaw LLP

New Safe Harbors In A Storm of Risk and Regulations: A Review of the OIG’s Proposed Changes to the Federal Anti-Kickback Laws

Seyfarth Shaw LLP on

In an effort to modernize and clarify a statute that looms large in the minds of health care providers across the nation, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) recently...more

Polsinelli

Unique Opportunity to Influence Anti-Kickback Statute Rules

Polsinelli on

Starting today, the industry has 75 days to provide input on the proposed rules published in the Federal Register regarding the future enforcement of the Anti-Kickback Statute (AKS). ...more

Ballard Spahr LLP

CMS and OIG Release Long-Awaited Stark Law and Anti-Kickback Statute Proposed Rules

Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) recently released two proposed rules restructuring the Physician Self-Referral...more

King & Spalding

OIG Highlights Top 25 Unimplemented Recommendations to Reduce Fraud, Waste, and Abuse in HHS Programs

King & Spalding on

OIG recently released its annual publication of Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG’s Top Recommendations (July 2019 Edition). In the July 2019 Edition, OIG focused on the top 25 unimplemented...more

Arnall Golden Gregory LLP

OIG Study Highlights How High-Performing ACOs Controlled Costs and Improved Quality by Working Collaboratively with SNFs and HHAs

On July 19, 2019, the Office of Inspector General (OIG) noted seven successful strategies used by twenty high-performing Accountable Care Organizations (ACOs) to reduce spending and improve quality of care. ...more

McDermott Will & Emery

2018 Digital Health Year in Review: Focus on Care Coordination and Reimbursement

In 2018, even more than in recent years, federal lawmakers and regulators continued the push toward modernizing the existing legal framework to support and encourage digital health adoption in the context of care coordination...more

Bass, Berry & Sims PLC

Stark Under the Microscope: Congress and HHS Examine Reform of the Stark Law for a Value-Based System

Bass, Berry & Sims PLC on

On July 17, 2018, the U.S. House of Representatives' Ways and Means Committee Subcommittee on Health ("Subcommittee") expressed its commitment to modernizing the Stark Law during a hearing in which industry and government...more

Baker Donelson

OIG June 2018 Work Plan Update

Baker Donelson on

The OIG added eight new items to its Work Plan in the June 2018 update. Among the items addressed are contingency planning for information technology systems, denials and appeals in Medicare Part D, review of certain home...more

Baker Donelson

OIG Unveils New Work Plan Process: Assessing the Impact on Compliance Risk Assessment

Baker Donelson on

On June and July 17, 2017, the Department of Health and Human Services, Office of Inspector General (OIG) released new Work Plan initiatives and, in doing so, announced its intent to update its Work Plan monthly, in lieu of a...more

Mintz - Health Care Viewpoints

Pharmaceutical Manufacturers and Healthcare Leaders cite Fraud and Abuse Laws as Obstacle to Value-Based Arrangements

As the healthcare industry moves towards value-based purchasing, pay-for-performance, and other payment reform models, industry leaders have identified federal fraud and abuse laws as a barrier to full implementation of such...more

King & Spalding

CMS and OIG Issue Notice of Amended Waivers for Next Generation ACO Model

King & Spalding on

On December 29, 2016, CMS and OIG issued a Notice of Amended Waivers of Certain Fraud and Abuse Laws in Connection with the Next Generation ACO Model (the 2016 Notice). The 2016 Notice does not change or limit arrangements...more

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