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CMS Increases Oversight and Scrutiny of Hospices

In its continued effort to curb fraud and abuse in the hospice industry, on Aug. 22, 2023, the Centers for Medicare & Medicaid Services (CMS) announced it was making unannounced site visits to every Medicare-enrolled hospice...more

CMS Proposes 36-Month Rule for Medicare-Enrolled Hospices

The Centers for Medicare & Medicaid Services (CMS) proposed new rules intended to strengthen the integrity of the Medicare hospice enrollment process due to CMS’ view of fraud and abuse concerns in the hospice industry....more

CMS Publicly Releases Ownership Data for Medicare-Certified Hospice and Home Health Agencies

On April 20, 2023, the Centers for Medicare & Medicaid Services (CMS) announced the release of ownership data for all Medicare-enrolled hospice and home health agencies. This release is consistent with the Department of...more

End of COVID-19 Emergency: Legal Implications for Healthcare Providers

On Jan. 30, 2023, President Joe Biden announced that the COVID-19 public health emergency (PHE) will end May 11, 2023. Under the PHE, the federal government implemented a range of modifications and waivers impacting Medicare,...more

Outdated Medicare Enrollment Data? Caution: CMS Verifying Ownership

In recent weeks, the Centers for Medicare & Medicaid Services (CMS) has been contacting certain Medicare-enrolled providers and suppliers (hereinafter “providers”) to verify that their ownership information, as reported in...more

CMS Accelerated and Advance Payment Recoupment Begins

Recoupment has started or will soon begin for Medicare Part A and Part B providers and suppliers who received funds in 2020 under the Medicare Accelerated and Advance Payment (AAP) Program. The Centers for Medicare & Medicaid...more

CMS Updates Medicare Accelerated and Advance Program Repayment Guidance and Start Date

The Centers for Medicare & Medicaid Services (CMS) recently issued an updated fact sheet and a FAQ page detailing the repayment terms for Medicare Part A providers and Part B suppliers who received payments under its...more

Payment Advances For Medicare Providers, Suppliers May Ease Liquidity Issues – Six Key Points

On March 28, 2020, the Centers for Medicare & Medicaid Services (CMS) released guidance expanding its Accelerated and Advanced Payment Program, which now allows most Medicare Part A and Part B providers and suppliers to...more

CMS Eases Healthcare Provider Enrollment Process in Response to COVID-19 Crisis

As the 2019 novel coronavirus (COVID-19) pandemic continues to strain the healthcare industry, the Centers for Medicare & Medicaid Services (CMS) eased healthcare provider enrollment rules. CMS has significantly streamlined...more

Value-Based Purchasing and the False Claims Act: Tenth Circuit Finds Falsified Quality Data Immaterial Under Escobar

Last month, the Tenth Circuit upheld a grant of summary judgment in U.S. ex rel. Janssen v. Lawrence Memorial Hospital, 2020 WL 594508 (10th Cir. Feb. 7, 2020), applying the “rigorous” and “demanding” standard of materiality...more

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