To offset the cost of other provisions in the bill, the One Big Beautiful Bill Act (OBBBA) includes significant reforms to Medicaid, Medicare, and Affordable Care Act (ACA) premium tax credits that are expected to result in...more
On September 1, 2020, CMS published a proposed rule that would define “reasonable and necessary” for purposes of coverage under Part A and Part B of the Medicare program, and that would establish a new expedited Medicare...more
On May 11, 2020, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for FY 2021 (the Proposed Rule), which will affect...more
As the number of coronavirus cases across the country continue to rise, CMS has issued several coronavirus-specific memorandums to healthcare providers and laboratories. In the past two weeks, CMS has issued disease-specific...more
3/20/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Diagnostic Tests ,
Emergency Rooms ,
EMTALA ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Medicare Part C ,
Medicare Part D
On December 17, 2019, OIG published Advisory Opinion 19-06 approving a supermarket’s expansion of a loyalty program to allow customers to earn rewards points on out-of-pocket costs paid in connection with the purchase of...more
1/3/2020
/ Advisory Opinions ,
Anti-Kickback Statute ,
Civil Monetary Penalty ,
Customer-Loyalty Programs ,
Grocery Stores ,
Medicaid ,
Medicare ,
OIG ,
Pharmacies ,
Prescription Drugs ,
Retailers
On October 31, 2019, in the face of a federal lawsuit, the Indiana Family and Social Services Administration suspended its enforcement of work requirements under the state’s Medicaid waiver project, the Healthy Indiana Plan...more