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On May 28, 2025, the Centers for Medicare & Medicaid Services (CMS) sent a letter to “select hospitals” that provide gender-affirming care services, requesting information about how those hospitals adhere to quality standards...more
On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced significant changes in its risk adjustment data validation (RADV) audits. The changes focus on speed, the volume of targeted contracts, and...more
Assisted Living and the Law, hosted by Troutman Pepper Locke attorneys Cal Stein and Emma Trivax, offers timely insights and practical advice on navigating the complex and evolving legal landscape of the long-term care...more
Long-term care facilities, embattled by rising costs and potential Medicaid cuts, are seeing some relief on the horizon following a recent federal court ruling that struck down portions of the Centers for Medicare & Medicaid...more
The topic of “food as medicine” has gained increased attention recently, driven by a growing recognition of the role nutrition plays in preventing and managing chronic diseases. This article provides a high-level overview of...more
To state the obvious, a lot has happened in healthcare over the first 100 days of President Trump’s second term. But how much? ...more
On April 11, 2025, the Centers for Medicare & Medicaid Services (“CMS”) published its annual proposed rule for the federal fiscal year (“FFY”) 2026 inpatient prospective payment system (“IPPS”) and long-term care hospital...more
The contentious Nursing Home Minimum Staffing Rule (Rule), which established minimum staffing requirements for federally funded long-term care facilities (LTC) such as skilled nursing facilities (SNFs) for Medicare and...more
This issue of McDermott’s Healthcare Regulatory Check-Up highlights key regulatory and enforcement activity for March 2025. This month features: - Noteworthy enforcement actions demonstrating that the Anti-Kickback Statute...more
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
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
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
Mandatory Medicare reporting for skilled nursing facilities (“SNFs”) has been delayed to August 1, 2025, to the relief of many in the industry. As a reminder, the Centers for Medicare & Medicaid Services (“CMS”) required the...more
The Trump administration and 119th Congress are preparing to reduce federal expenditures by targeting Medicare and Medicaid fraud, waste, and abuse. Medicare enrollment revocations, Medicaid enrollment terminations, and...more
Earlier last week, Hon. Matthew J. Kacsmaryk of the U.S. District Court for the Northern District of Texas vacated two key provisions of CMS’s 2024 nationwide staffing mandate, the requirements that skilled nursing facilities...more
In a major victory for nursing homes and long-term care industry advocates, on Monday, April 7, 2025, Judge Matthew J. Kacsmaryk of the US District Court for Northern Texas struck down a Centers for Medicare & Medicaid...more
Introduction The Alabama Community Pharmacy Relief Act, Senate Bill 252, has successfully passed the Alabama Senate and is now advancing to the House for consideration. This legislation aims to regulate pharmacy benefits...more
Key Points: No formal liability for payment of work-related medical expenses is triggered on the part of the employer/insurer until such expenses are properly submitted in accordance with the terms and provisions of the...more
In a significant development for fiscal intermediaries (FIs) and the Consumer Directed Personal Assistance Program (CDPAP), a New York Supreme Court Justice ruled on March 20, 2025, that the New York State Department of...more
On March 14, 2025, the Seventh Circuit Court of Appeals ruled en banc (i.e., in a decision by the full court) that a Chicago hospital cannot sue the State of Illinois for injunctive/declaratory relief that would compel the...more
Earlier this week, Senate Bill 316 (the “Bill”) was filed in the North Carolina state legislature. The Bill covers a large swathe of healthcare-related issues, and the additional regulatory elements of the Bill would likely...more
On March 20, 2025, a New York Supreme Court Justice in Albany County issued a decision and order declaring the New York State Department of Health (NY DOH)’s August 2024 implementation of an administrative rate reimbursement...more
In a case brought by Bond, Schoeneck & King, the Albany County Supreme Court has overturned hundreds of millions of rate cuts implemented at the direction of the New York State Department of Health. The court, fully adopting...more
In recent months, Executive Orders issued by the current Administration regarding gender-affirming care of minors have been the subject of much debate and litigation. The crux of these lawsuits is largely two Executive...more
On March 14, 2025, the Connecticut Office of Health Strategy (OHS) issued its biennial Statewide Health Care Facilities and Services Plan (the “Plan”), with an effective date of March 15, 2025....more