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Reporting Requirements Centers for Medicare & Medicaid Services (CMS) Medicaid

Arnall Golden Gregory LLP

CMS Issues Final Rule Mandating New Minimum Staffing Standards for Long-Term Care Facilities

On April 22, 2024, The Centers for Medicare & Medicaid Services (“CMS”) issued the “Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency...more

Foley & Lardner LLP

Medicaid: CMS Final Rules Aim to Expand Access, Provide Parity with Commercial Markets

Foley & Lardner LLP on

The Centers for Medicare & Medicaid Services (CMS) published two significant updates to its Medicaid regulations on May 10, 2024. The two Final Rules, a Medicaid Access Rule and a Medicaid Managed Care Rule, impose new...more

King & Spalding

CMS Issues Interim Final Rule for CMS Enforcement of State Compliance with Reporting and Federal Medicaid Renewal Requirements

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On December 4, 2023, CMS issued an interim final rule (the Interim Rule) (RIN 0938-AV26) to implement new enforcement authorities that CMS may use if states fail to comply with new reporting requirements or with federal...more

Rivkin Radler LLP

New HHS Rule for Nursing Home Ownership and Manager Disclosure

Rivkin Radler LLP on

A new rule will require nursing homes enrolled in Medicare or Medicaid to make disclosures about certain facility ownership, management and other operational information. The U.S. Department of Health and Human Services (HHS)...more

Venable LLP

Looming CTA Disclosure Requirements and Healthcare Providers

Venable LLP on

The Federal Corporate Transparency Act (the CTA), 31 U.S.C. §5336, will soon require certain entities to disclose to the U.S. Treasury's Financial Crimes Enforcement Network (FinCEN) certain pieces of identifying information...more

Troutman Pepper

CMS Publishes Final Rule on Civil Monetary Penalties for Section 111 Reporting

Troutman Pepper on

The Centers for Medicare and Medicaid Services (CMS) published the final rule outlining how civil monetary penalties will be calculated and imposed when Responsible Reporting Entities (RRE) fail to meet their Medicare...more

McDermott+

CMS Releases Proposed Rule: Medicaid and CHIP Managed Care Access, Finance, and Quality

McDermott+ on

The proposed rule would make transparency-related updates to state directed payments (SDPs). It would also require states to submit an annual payment analysis that compares managed care plans’ payment rates for routine...more

McDermott+

CMS Releases Proposed Rule: Medicaid Program; Ensuring Access to Medicaid Services

McDermott+ on

On May 3, 2023 the Centers for Medicare & Medicaid Services (CMS) published the proposed rule Medicaid Program; Ensuring Access to Medicaid Services. The proposed rule seeks to increase transparency in payment rates,...more

King & Spalding

CMS Eyes State Medicaid Programs as Part of the Biden Administration’s Plan to Improve Nursing Home Care

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For the Biden administration, the over 200,000 COVID-related deaths of nursing home residents and staff have served as a powerful signal for the need for nursing home reform. As part of the administration’s reform efforts,...more

Goodwin

Pharma Manufacturer Federal Government Price Reporting: Recent Litigation and Settlements

Goodwin on

​​​​​​​Litigation involving drug price reporting under the Medicaid Drug Rebate Program (MDRP)  has been very active in 2022. Most recently, on August 3, 2022, an Illinois federal jury levied a $61 million verdict against Eli...more

Hogan Lovells

Fourth Circuit: Safeco Defense Applies to FCA Claims and Dooms Medicaid Best Price Qui Tam

Hogan Lovells on

In a split decision issued January 25, 2022, the Fourth Circuit strongly endorsed a defense to False Claims Act liability for entities that submit claims to the government in today’s complex regulatory environment, finding:...more

Bricker Graydon LLP

Skilled nursing facility operator settles false claims case involving allegations that the company failed to report and return...

Bricker Graydon LLP on

On June 29, 2021, the Department of Justice (DOJ) announced a settlement with California skilled nursing facility operator Plum Healthcare Group LLC and facility Azalea Holdings LLC dba McKinley Park Care Center (Plum) to...more

King & Spalding

CMS Issues New Rule Imposing Education About, and Access to, COVID-19 Vaccines and Reporting Requirements for Nursing Home and...

King & Spalding on

On May 11, 2021, CMS issued an interim final rule requiring that nursing homes and other congregate care facilities: (1) educate all residents and staff about COVID-19 vaccines; (2) offer COVID-19 vaccines to all residents...more

Holland & Knight LLP

CMS Releases FY 2022 IPPS and LTCH Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) on April 27, 2021, released the Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) Prospective Payment...more

Foley & Lardner LLP

Congress Requires New Medicaid Payment Reporting

Foley & Lardner LLP on

As part of the omnibus Federal appropriations bill enacted into law on December 27, 2020, Congress established new reporting requirements for states that make Medicaid supplemental payments. The new requirements follow on the...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 Managed Care Compliance Conference - February 1st - 3rd, 9:30 am - 3:45 pm CST

The first ever VIRTUAL Managed Care Compliance Conference will have the great speakers and content you have come to expect from the in-person event. Each year, we look forward to hosting compliance professionals at our...more

Sheppard Mullin Richter & Hampton LLP

Clarity on Reporting and Enforcement: CMS Issues Guidance Regarding Hospital COVID-19 Reporting Requirements

On October 6, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released guidance regarding the requirements and enforcement process for hospital reporting of COVID-19 data elements (the “Guidance”). The Guidance...more

King & Spalding

CMS Announces 14-Week Timeline for Hospitals to Comply with Daily COVID-19 Reporting Requirements or Risk Termination from...

King & Spalding on

On October 6, 2020, CMS announced new enforcement measures to ensure hospitals report daily COVID-19 data, with the exception of psychiatric and rehabilitation hospitals that must report weekly, to the federal government...more

Jackson Walker

CMS Implements Stricter COVID-19 Testing Regulations on Nursing Homes

Jackson Walker on

As part of a broader Trump administration announcement made on August 25, 2020, the Centers for Medicare & Medicaid Services (CMS) issued sweeping oversight changes in the form of an Interim Final Rule with Comment Period...more

Spilman Thomas & Battle, PLLC

COVID-19: Impacts and New Guidance for Skilled Nursing Facilities

The COVID-19 pandemic has had a disproportionate impact on skilled nursing and assisted living facilities. While the following CMS recommendations and guidelines identify nursing homes as the target recipients, they are...more

Holland & Knight LLP

Comments on CMS Proposed Rule on Medicaid Fiscal Accountability Due Feb. 1, 2020

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Nov. 18, 2019, published a proposed Medicaid Fiscal Accountability rule that would amend existing regulations related to 1) base and supplemental payments, 2)...more

King & Spalding

CMS Issues Proposed Rule Aimed at Increasing Transparency and Reducing Medicaid Program Spending

King & Spalding on

On November 18, 2019, CMS published the proposed Medicaid Fiscal Accountability Rule (the Proposed Rule) which, if finalized, would result in dramatic changes to the Medicaid program. Through the Proposed Rule, CMS aims to...more

Dorsey & Whitney LLP

New Disclosure Requirements to be Phased-In to CMS Enrollment and Revalidation Process

Dorsey & Whitney LLP on

On September 5, 2019, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) effective November 4, 2019, which increases disclosure requirements for the provider and supplier enrollment and...more

Foley & Lardner LLP

CMS Proposes Enhanced Scrutiny over Medicaid Supplemental Payments

Foley & Lardner LLP on

On November 18, 2019, the Centers for Medicare & Medicaid Services (CMS) proposed changes to federal Medicaid rules that, if implemented, would affect billions of dollars of Medicaid payments nationwide, creating new...more

Mintz - Health Care Viewpoints

CMS Finalizes Changes Expanding the Scope of the Open Payments Program

On November 15, 2019, the Centers for Medicare & Medicaid Services ("CMS") finalized changes to the Open Payments Program as part of the CY 2020 Physician Fee Schedule Final Rule. The Open Payments reporting requirements,...more

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