Eric Fader on Centers for Medicare & Medicaid Services (CMS)

Some COVID-Era Medicare Telehealth Waivers Extended through March 31

The American Relief Act, 2025, signed into law on December 21, included a short-term extension of certain telehealth waivers that went into effect in the early days of the COVID-19 Public Health Emergency. These waivers, for...more

1/17/2025 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Healthcare Reform , Medicaid , Medicare , New Legislation , Public Health Emergency , Regulatory Agenda , Telehealth , Telemedicine , Waivers

2024 Medicare Physician Fee Schedule Extends Telehealth Flexibilities

The 2024 Medicare Physician Fee Schedule final rule, released by the Centers for Medicare & Medicaid Services (CMS) earlier this month, extended certain telehealth-related flexibilities that were implemented during the early...more

12/1/2023 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Health Care Providers , Medicare , Physician Fee Schedule , Physicians , Telehealth

CMS Adds New Billing Code for Dental Surgeries

The American Dental Association (ADA) announced on November 15 that the Centers for Medicare & Medicaid Services (CMS) has agreed to create a new Healthcare Common Procedure Coding System (HCPCS) code G0330 for dental...more

11/18/2022 / Billing , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Dental Practice , HCPCS , Health Care Providers

21 Charged in Federal COVID-19 Fraud Sweep

On April 20, the U.S. Department of Justice (DOJ) announced criminal charges against 21 people across the country for COVID-19-related frauds. The defendants are accused of over $149 million in false billings to federal...more

4/28/2022 / CARES Act , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Counterfeiting , Department of Justice (DOJ) , False Billing , Federal Funding , Fraud , Kickbacks , Medicare , National Center for Disaster Fraud (NCDF) , Vaccinations

Omnibus Spending Bill Extends Telehealth Flexibilities

At the beginning of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services expanded Medicare coverage for telehealth nationwide, as discussed here. The $1.5 trillion omnibus spending bill signed into law by...more

3/15/2022 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Medicare , Telehealth , Telemedicine

New Proposed Bills Would Extend Telehealth Waivers, Modernize HIPAA

We don’t often cover brand-new proposed legislation on Rivkin Rounds, generally preferring to wait until it’s closer to becoming law. However, two bipartisan bills introduced in Congress last week are worthy of mention....more

2/15/2022 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Electronic Protected Health Information (ePHI) , Health Care Providers , Health Insurance Portability and Accountability Act (HIPAA) , Legislative Agendas , Medicare , PHI , Privacy Laws , Proposed Legislation , Telehealth

Provider Requirements Under the No Surprises Act

The federal No Surprises Act, effective January 1, 2022, established new requirements for healthcare providers, facilities, and providers of air ambulance services to protect consumers from “surprise” medical bills. These...more

1/7/2022 / Billing , Centers for Medicare & Medicaid Services (CMS) , Consumer Insurance Products , Health Care Providers , New Legislation , No Surprises Act (NSA) , Out of Network Provider , Surprise Medical Bills

Medicare Telehealth Use Increased 63-fold in 2020

A study recently released by the U.S. Department of Health and Human Services (HHS) found that the number of beneficiaries in the traditional Medicare program who used telehealth increased from 840,000 in 2019 to nearly 52.7...more

12/14/2021 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Health Care Providers , Medicare , Medicare Part B , Mental Health , Telehealth , Telemedicine

2022 Medicare PFS Extends Telehealth Services Expansion

The 2022 Medicare Physician Fee Schedule Final Rule released on November 2 by the Centers for Medicare & Medicaid Services (CMS) added certain services to the Medicare telehealth services list through December 31, 2023. Last...more

11/8/2021 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Public Health Emergency , Telehealth , Telemedicine

Hospitals Violate Price Transparency Rule; CMS Proposes Increased Penalties

A new federal hospital price transparency rule that took effect on January 1, 2021, requires hospitals to post all prices for services online in an easily accessible format. However, a report recently released by...more

8/2/2021 / Centers for Medicare & Medicaid Services (CMS) , Disclosure Requirements , Health Care Providers , Hospitals , Price Transparency

Proposed Physician Fee Schedule Adds Coverage For Remote Therapeutic Monitoring

The proposed 2022 Medicare Physician Fee Schedule released on July 13 by the Centers for Medicare & Medicaid Services (CMS) includes a new category of CPT codes for “remote therapeutic monitoring” (RTM). The new codes are in...more

7/21/2021 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Physician Fee Schedule , Telehealth

Proposed Physician Fee Schedule Includes Expanded Telehealth Reimbursement

The proposed 2022 Medicare Physician Fee Schedule, released on July 13 by the Centers for Medicare & Medicaid Services (CMS), includes expanded reimbursement for behavioral health services delivered by telehealth, including...more

7/15/2021 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Mental Health , Physician Fee Schedule , Reimbursements , Substance Abuse , Telehealth

OIG: Hospitals Need To Improve Oversight Of Cybersecurity For Networked Medical Devices

On June 23, the Department of Health and Human Services Office of Inspector General (OIG) posted on its website an Issue Brief entitled “Medicare Lacks Consistent Oversight of Cybersecurity for Networked Medical Devices in...more

6/30/2021 / Centers for Medicare & Medicaid Services (CMS) , Cybersecurity , Hackers , Hospitals , Medical Devices , OIG , Popular

CMS Clarifies RPM Reimbursement

The Centers for Medicare & Medicaid Services (CMS) recently released corrections to its 2021 Physician Fee Schedule final rule that was published on December 28. Some of the corrections clarify reimbursement requirements for...more

1/28/2021 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Physician Fee Schedule , Physicians , Telehealth

Medicare Physician Fee Schedule Expands Telehealth Coverage

The 2021 Physician Fee Schedule (PFS) final rule recently released by the Centers for Medicare & Medicaid Services (CMS) includes the addition of 60 new telehealth services that will be covered and reimbursed by Medicare. The...more

12/11/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Final Rules , Health Care Providers , Health Technology , Medicare , Physician Fee Schedule , Physicians , Reimbursements , Telehealth , Telemedicine

Final Stark Law And Anti-Kickback Rules Released

On November 20, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services’ Office of Inspector General (OIG) announced the issuance of long-awaited final rules to modernize the Stark...more

11/24/2020 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Fraud , Health Care Providers , Physicians , Stark Law

OIG Issues Special Fraud Alert On Speaker Programs

The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert on November 16, warning that speaker programs organized by pharmaceutical and medical device companies pose...more

11/23/2020 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Department of Justice (DOJ) , Fraud , Health Care Providers , Medical Devices , OIG , Pharmaceutical Industry , Speaker Programs

Medtronic Settles Kickback And Open Payments Violations For $9.2M

The U.S. Department of Justice (DOJ) announced on October 29 that Medtronic USA Inc. agreed to pay $8.1 million to settle allegations that it violated the False Claims Act (FCA) and federal Anti-Kickback Statute by paying...more

11/13/2020 / Affordable Care Act , Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Civil Monetary Penalty , Department of Justice (DOJ) , Enforcement Actions , False Claims Act (FCA) , Health Care Providers , Healthcare Fraud , Medical Devices , Medicare

Eric Fader

Rivkin Radler LLP

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