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OIG Determines That Providing Free Hearing Aids to Bimodal-Hearing Candidates Implicates the Anti-Kickback Statute and Beneficiary...

On October 20, 2023, the Office of Inspector General of the Department of Health and Human Services (“OIG”) issued an unfavorable Advisory Opinion No. 23-08 to a supplier of cochlear implants coupled with external sound...more

Ultimate Authority and the Transfer of Nursing Facilities that Receive UPL Payments Under Georgia Medicaid

One fallout of the COVID-19 pandemic is that some, already struggling skilled nursing facilities may now be becoming financially unviable. As a result, owners and operators of such facilities may be actively seeking to...more

Hospital Facility Fees and Telehealth During COVID-19 Pandemic Revisited

As we reported earlier, the Centers for Medicare & Medicaid Services (CMS), as part of its blanket waivers issued on March 30, 2020,2 has waived the location requirement for provider-based status for the duration of the...more

OIG Recommends Further Analysis of Counting Hospital Outpatient Time

In July, the Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its annual publication, Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG's Top Recommendations. ...more

Georgia Certificate of Need Bill Passed by General Assembly

After an attempt at passing sweeping changes to Georgia Certificate of Need (CON) laws failed to pass the House before Crossover Day, the Georgia Senate has revived another CON bill with less sweeping, albeit significant...more

Georgia House Votes Down Certificate of Need Bill

House Bill 198, proposed this year to amend Georgia’s Certificate of Need (“CON”) laws, has failed to garner the necessary votes in the House, missing the crucial Crossover Day deadline needed to pass the legislation. In...more

CMS Issues New Rules for Inpatient Hospital Payment System

On August 17, 2018, the Centers for Medicare and Medicaid Services (CMS) published its final rule for the Hospital Inpatient Prospective Payment System (IPPS) for fiscal year 2019. ...more

OIG Issues Favorable Advisory Opinion Regarding Medigap Insurers Contracting with Preferred Hospital Networks to Discount...

On June 14, 2018, the Office of the Inspector General (OIG) issued an advisory opinion regarding a proposed contractual arrangement between offerors of Medicare Supplemental Health Insurance policies, commonly referred to as...more

Senate Bill Would Lift Stark Ban on Physician-Owned Hospital Expansion

A recent Senate bill would lift the ban on expansion of physician-owned hospitals imposed by the Patient Protection and Affordable Care Act (PPACA). Senator James Lankford (R-OK) introduced this bill on May 16, 2017. The...more

GAO Recommends Congress Reduce Incentives for Prescribing 340B Drugs

The United States Government Accountability Office (GAO) recently released a report entitled “Medicare Part B Drugs: Action Needed to Reduce Financial Incentives to Prescribe 340B Drugs at Participating Hospitals” (“the...more

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