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CMS Issues Home Health Prospective Payment System Final Rule

On October 31, 2018, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule (CMS-1689-FC) (the “Final Rule”) that makes significant changes to the Home Health Prospective Payments System (“PPS”). These...more

OIG Issues Favorable Advisory Opinion Regarding Medicaid MCO’s Incentive Payment Program

On October 18, 2018, the Office of Inspector General (OIG) issued a favorable advisory opinion to a Medicaid managed care organization (MCO) regarding its proposal to incentivize the MCO’s contracted providers to increase the...more

10/31/2018  /  Beneficiaries , MCOs , Medicaid , OIG

CMS Issues FY 2019 SNF Proposed Rule

On April 27, 2018, CMS issued a proposed rule that would update the payments rates under the prospective payments system (PPS) for skilled nursing facilities (SNFs). Additionally, the proposed rule includes proposals for the...more

Key Takeaways from Final 2019 Payment Notice Rule

Last week, CMS issued a final rule which aims to relax certain Affordable Care Act (ACA) health plan regulations, found at 45 C.F.R. Parts 147, 153, 154, 155, 157, and 158, while increasing marketplace competition. In...more

Hospital, Cardiology Group Settle False Claims Act Allegations for $20.75 Million

As reported previously, Hamot Medical Center (“Hamot”) and Medicor Associates, Inc. (“Medicor”) entered into a preliminary settlement agreement under which they agreed to pay $20.75 million to resolve kickback allegations...more

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