The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-13 (the “Opinion”) to a pharmaceutical manufacturer (the...more
1/24/2025
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Food and Drug Administration (FDA) ,
Health Care Providers ,
Healthcare Fraud ,
Manufacturers ,
Medicaid ,
Medicare ,
OIG ,
Pharmaceutical Industry ,
Physicians ,
Travel Expenses
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-12 (the “Opinion”) to a pharmaceutical manufacturer (the...more
Medicare coverage of telehealth services is reaching a critical point as many pandemic-era flexibilities are set to expire on December 31, 2024. As it stands, after the close of the year, Medicare coverage for telehealth...more
The Biden administration’s controversial Final Rule establishing minimum staffing requirements for nursing homes is under new attack. The Final Rule, long decried by nursing home industry leaders as a one-size-fits-all...more
10/17/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Incentives ,
Labor Shortage ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Nurses ,
Nursing Homes
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released an unfavorable advisory opinion, OIG Advisory Opinion No. 24-08 (the “Opinion”), to a Medicare Advantage Organization (“MAO”)....more
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-07 (the “Opinion”), to a nonprofit tax-exempt grant-making...more
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-02 (the “Opinion”) to a nonprofit organization that provides...more
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-01 (the “Opinion”), to a Medicare Supplemental Health Insurance...more
3/14/2024
/ Anti-Kickback Statute ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Hospitals ,
Insurance Industry ,
Medicare ,
Medicare Beneficiaries ,
Medigap ,
OIG ,
Preferred Hospital Networks Arrangement ,
Social Security Act
AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more
A New Jersey hospice provider must continue its long fight against whistleblowers alleging it violated the False Claims Act (“FCA”) by seeking Medicare reimbursement for patients whose documentation did not support hospice...more
The U.S. Centers for Medicare & Medicaid Services (“CMS”), the agency that administers the Medicare hospice benefit, has announced increased scrutiny of hospice programs in the wake of growing concerns over hospice service...more
The Medicare Payment Advisory Commission (“MedPAC”) will hold a public virtual meeting on December 8, 2022, to assess payment adequacy and updating payments for hospice services. By law, each year MedPAC reviews Medicare’s...more