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The 340B Rebate Pilot: Voluntary for Manufacturers, Costly for 340B Covered Entities

Key Takeaways - HRSA’s 340B rebate pilot shifts financial and operational burden to covered entities, requiring upfront drug purchases with delayed, uncertain rebate recovery....more

8/7/2025 / Administrative Procedure Act , Covered Entities , Department of Health and Human Services (HHS) , Drug Pricing , Health Insurance Portability and Accountability Act (HIPAA) , Medicaid , Medicare , Pharmaceutical Industry , Rebates , Section 340B

The OIG’s Concerns with Potentially Fraudulent Medicare Advantage Marketing

The HHS Office of Inspector General (“OIG”) released a Special Fraud Alert to inform health care professionals (“providers”) and Medicare Advantage Organizations (“MAOs”) about the OIG’s view of potentially abusive marketing...more

12/20/2024 / Compliance , Department of Health and Human Services (HHS) , Fraud , Health Care Providers , Medicare , Medicare Advantage , Medicare Advantage Organizations (MAOs) , OIG , Risk Management

Medicare Continues its Updates to Provider Enrollment Policies as Part of Efforts to Enhance Program Integrity and Transparency

The Centers for Medicare & Medicaid Services (“CMS”) continued its efforts to increase oversight of the Medicare program by updating Medicare provider enrollment regulations and policies through recent regulatory and...more

12/19/2023 / Centers for Medicare & Medicaid Services (CMS) , Enrollment , Health Care Providers , Health Insurance , Healthcare , Medicare , Policies and Procedures

CMS Announces Period of Enhanced Oversight for New Hospices in Arizona, California, Nevada, and Texas

Recently the Centers for Medicare & Medicaid Services (“CMS”) announced in a newly released MedLearn Matter (MLN7867599, July 2023) that effective as of July 13, 2021, any “new hospice agency” located in the states of Texas,...more

8/9/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Health Insurance , Healthcare , Hospice , Long Term Care Facilities , Medicare , Regulatory Oversight

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Eleanor Brown