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New OIG Report Suggests Medicare Remote Patient Monitoring Services May Face Increased Government Scrutiny

On September 24, 2024, the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) posted a report entitled, “Additional Oversight of Remote Patient Monitoring in Medicare is Needed.”...more

The Devil’s in the Details: Hospice Providers Face Claim Denials for Election Statement Technicalities

Since the Centers for Medicare & Medicaid Services (“CMS”) paused much of its audit activity during the COVID Public Health Emergency, the most recent rounds of Medicare audit activity may represent the first “look” at the...more

AGG Food & Drug Newsletter - August 2021

Arnall Golden Gregory LLP's Food & Drug Newsletter is a monthly update of legal and regulatory issues that affect the FDA-regulated community and highlights articles from members of our Food & Drug practice, as well as from...more

Takeaways from the American Health Law Association’s 2021 Medicare and Medicaid Payments Conference

On March 24 – 26, 2021, the American Health Law Association (AHLA) held a virtual Institute on Medicare and Medicaid Payment Issues. The program addresses legal and regulatory issues related to reimbursement and brings...more

October 1, 2020 Hospice Changes: Hospices Must Provide Beneficiaries Addenda Outlining Conditions, Services, and Drugs Not Covered...

In an effort to increase coverage transparency, for hospice elections beginning on or after October 1, 2020, the beneficiary, beneficiary’s representative, non-hospice providers, or Medicare contractors may request a written...more

COVID-19 Diligence on SNFs Now a Bit Easier: CMS Publishes COVID-19 Data in a Bid for Greater Public Transparency

The Centers for Medicare & Medicaid Services (CMS) posted its first set of nursing home coronavirus disease 2019 (COVID-19) data, including numbers of COVID-19 cases and deaths and infection control inspection results on June...more

CMS Waives Certain Medicare Physician Supervision Requirements to Afford Practitioners Greater Flexibility During COVID-19

On April 9, 2020, the Centers for Medicare and Medicaid Services (“CMS”) provided additional guidance on CMS’s waiver of certain Medicare physician supervision requirements in response to Coronavirus Disease 2019 (COVID-19). ...more

CMS Expands Authority to Revoke Providers’ Medicare Enrollment While Medicare Overpayment Appeals are Pending ALJ Review

On September 10, 2019, the Centers for Medicare and Medicaid Services (CMS) announced new authority to revoke providers’ Medicare enrollment and any corresponding provider agreements or supplier agreements through revisions...more

CMS Announces New Discharge Planning Requirements for Hospitals and HHAs with Implications for PAC Providers

On September 26, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a new Final Rule, Revisions to Discharge Planning Requirements (CMS-3317-F) in a bid to “improve engagement, choice and continuity of care...more

OIG Recommends Further Analysis of Counting Hospital Outpatient Time

In July, the Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its annual publication, Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG's Top Recommendations. ...more

Good News for Medicare Providers as CMS Expands Settlement Conference Facilitation and Introduces New Initiative for IRFs

The Centers for Medicare and Medicaid Services (CMS) made a number of recent changes to expand the Settlement Conference Facilitation (SCF) process for providers and suppliers mired in the backlog of appeals at the...more

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

CMS Issues New Standards for End Stage Renal Disease Faculties Providing Dialysis Services to Nursing Facility Residents

On August 17, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a Memorandum to state survey agency directors regarding Medicare-approved End Stage Renal Disease (ESRD) facilities that provide dialysis...more

CMS Proposes Pre-Claim Review Demonstration for Home Health Services

On May 29, 2018, the Centers Medicare and Medicaid Services (CMS) announced its intention to implement a revised Medicare demonstration project that will affect Home Health Agencies (HHAs) providing services to Medicare...more

New CMS Rural Health Strategy Aims to Make Rural Healthcare More Accessible, Affordable, and Accountable

On May 8, 2018, the Centers for Medicare and Medicaid Services (CMS) announced the agency’s first Rural Health Strategy (RH Strategy), which is designed to promote CMS policies that help make rural healthcare more accessible,...more

CMS to Use Enforcement Discretion to Help States Comply with the Medicaid Home Health Final Rule

On April 5, 2018, the Centers for Medicare & Medicaid Services (CMS) issued an Informational Bulletin regarding compliance with the Medicaid Home Health Final Rule (the “Medicaid HH Final Rule”). The Medicaid HH Final Rule...more

OIG Reports Reliance on HHA Patient Lists Creates Survey Vulnerabilities and Recommends CMS Action

In March 2018, the Office of Inspector General (OIG) issued a Risk Alert, noting that some home health agencies (HHAs) provide Medicare surveyors with patient lists that are missing active Medicare beneficiaries at their...more

CMS Announces Low Volume Appeal Settlement Option for Providers Mired in ALJ Backlog

On January 9, 2018, the Centers for Medicare and Medicaid Services (CMS) announced details on the new low volume appeal settlement option, which is the latest alternative available to Medicare Part A and Part B providers and...more

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