On August 1, 2023, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule for FY 2024 (the Final Rule). In the Final Rule, CMS,...more
8/9/2023
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
DSH ,
Final Rules ,
Food and Drug Administration (FDA) ,
Inpatient Prospective Payment System (IPPS) ,
Long-Term Care ,
Medicaid ,
Medicare ,
Rural Health Care Providers ,
Social Security Act ,
Stark Law ,
Waivers
On October 3, 2022, the Attorneys General for California, New York, and Massachusetts, in collaboration with Attorneys General from 18 other states and the District of Columbia (State Attorneys General) submitted a comment...more
10/14/2022
/ Affordable Care Act ,
Algorithms ,
Anti-Discrimination Policies ,
Decision-Making Process ,
Department of Health and Human Services (HHS) ,
Healthcare ,
Medicaid ,
Medicare ,
Proposed Rules ,
Request For Information ,
Risk Mitigation ,
State Attorneys General
Last week, HHS launched the application for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments. As described in the September 13, 2021 Health Headlines, HHS made $25.5 billion in new funding...more
On September 17, 2020, HHS announced details about its $2 billion Provider Relief Fund (PRF) performance-based incentive payment distribution program for nursing homes and skilled nursing facilities originally announced on...more
OIG has updated its FAQs regarding the application of its administrative enforcement authorities to arrangements directly connected with COVID-19 with the addition of two new FAQs. On August 4, 2020, the OIG issued an FAQ...more
8/26/2020
/ Anti-Kickback Statute ,
Beneficiary Inducement ,
Clinical Laboratories ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Emergency Use Authorization (EUA) ,
Federal Health Care Programs (FHCP) ,
Food and Drug Administration (FDA) ,
OIG ,
Public Health ,
Public Health Emergency ,
Virus Testing
Health plans and their delegated IPAs are using a number of different tactics to deny payment for inpatient services by improperly classifying inpatient claims as observation or other types of outpatient status. Payers are...more
8/19/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Class Action ,
Constitutional Challenges ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Hospitals ,
Inpatient Billing ,
Managed Care Contracts ,
Medi-Cal ,
Medicare ,
Medicare Part A ,
Medicare Part B ,
Two-Midnight Rule ,
Underpayment