On July 26, 2024, CMS issued Change Request (CR) No. 13413 providing instructions and timelines for Medicare Administrative Contractors (MACs) for the processing of SSI realignment requests for cost reporting periods before...more
On February 1, the Federal Trade Commission (“FTC”) announced its first enforcement action under the Health Breach Notification Rule (“HBNR” or “Rule”) against GoodRx, a direct-to-consumer digital healthcare and prescription...more
2/22/2023
/ Application Programming Interface (APIs) ,
Breach Notification Rule ,
Data Privacy ,
Enforcement ,
Federal Trade Commission (FTC) ,
Final Rules ,
FTC Act ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Notification Requirements ,
Popular ,
Social Security Act
On February 1, 2023, CMS published its final rule addressing the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. CMS uses RADV audits to identify whether Medicare made overpayments to MA plans by...more
On November 1, 2022, CMS published a final rule to update the payment policies, payment rates, and other provisions for services furnished under the Medicare Outpatient Prospective Payment System (OPPS) and the Ambulatory...more
11/16/2022
/ Ambulatory Surgery Centers ,
American Hospital Association et al v Becerra Secretary Of Health And Human Services et al ,
Centers for Medicare & Medicaid Services (CMS) ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Final Rules ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
Payment Systems ,
Physician Fee Schedule ,
Public Health Emergency ,
Rural Health Care Providers ,
SCOTUS ,
Section 340B
On August 19, 2022, the Departments of Health and Human Services, Labor, and the Treasury (the Departments) issued a long-awaited final rule (the Final Rule) on the Independent Dispute Resolution (IDR) Process under the No...more
On July 15, 2022, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule to update the payment policies, payment rates, and other provisions for services furnished under the Medicare Outpatient...more
7/22/2022
/ Ambulatory Surgery Centers ,
American Hospital Association et al v Becerra Secretary Of Health And Human Services et al ,
Centers for Medicare & Medicaid Services (CMS) ,
Consolidated Appropriations Act (CAA) ,
Final Rules ,
Hospitals ,
Medicare ,
Outpatient Prospective Payment System (OPPS) ,
PECOS ,
Proposed Rules ,
Public Health Emergency ,
SCOTUS ,
Stark Law