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Report: $10 Billion in Provider Relief Funds Diverted to Operation Warp Speed For Vaccine Development

According to an exclusive report from STAT, sometime last year, federal officials decided to redirect billions in funds from the $175 billion CARES Act’s Provider Relief Fund to the “Operation Warp Speed” (OWS) vaccine...more

HHS Sending New Round of COVID-19 Funding to Safety Net Hospitals and Medicaid and Children's Health Insurance Program Providers

On June 9, 2020, HHS announced that it will distribute, through the Health Resources and Services Administration (HRSA), two new rounds of funding to healthcare providers treating low-income and uninsured patients during the...more

CMS Issues Final Rule for CY 2020 Home Health Payments, CY 2021 Home Infusion Therapy Benefit

On October 31, 2019, CMS issued a final rule with comment period (Final Rule), CMS-1711-FC, updating the payment rates for home health agencies (HHAs) for calendar year (CY) 2020...more

New York Anesthesiologist Indicted in Alleged Telemedicine Fraud Scheme

On July 9, 2019, the Department of Justice (DOJ) announced it has indicted and arraigned a New York-based anesthesiologist for her alleged role in a $7 million telemedicine conspiracy to fraudulently bill Medicare, Medicare...more

OIG Advisory Opinion Rejects Pharma Company’s Proposed Free-Products-to-Hospitals Arrangement

On November 13, 2018, the Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion No. 18-14 advising a drug company that its proposal to provide a drug to inpatients without charge...more

Federal Court Vacates CMS’s Medicare Advantage Overpayment Rule Due to “Crucial Data Mismatch” and Other Failings

On September 7, 2018, the United States District Court for the District of Columbia vacated CMS’s 2014 Overpayment Rule for Medicare Advantage insurers at 79 Fed. Reg. 29,844, 29,918-25 (the 2014 Overpayment Rule), ruling...more

CMS Updates Rules for Reporting Adverse Legal Action

On June 1, 2018, CMS issued further guidance for reporting and reviewing final adverse legal actions (ALAs) in provider enrollment applications. In Transmittal 797, which replaces Transmittal 784 to the Medicare Program...more

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