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Supreme Court Decision Is A Win for Preventative Services Providers

Last week, in a 6-3 decision, the Supreme Court overturned a Fifth Circuit decision holding that HHS-appointed United States Preventative Task Force (USPTF) members are inferior officers that do not need to be approved by the...more

Affordable Care Act Preventative Care Mandate At Risk Pending Supreme Court Decision

A case pending before the Supreme Court could jeopardize the Affordable Care Act’s (ACA) mandate that certain preventive services be provided on a first dollar coverage basis to plan members. Kennedy v. Braidwood Management...more

HHS Abandons Appeal of AHA’s Lawsuit Challenging HHS Website-Tracking Guidance

Last week, HHS filed a motion asking the Fifth Circuit’s permission to voluntarily dismiss its appeal of a District Court order directing HHS to rescind its guidance restricting hospitals’ ability to track online traffic to...more

GAO Issues Report Urging HHS to Address Worsening Maternal Health Outcomes

The Government Accountability Office (GAO) issued a report this month finding that maternal health outcomes worsened during the COVID-19 pandemic and urging HHS to use its resources to address the maternal health crisis...more

CMS Makes Several Updates to the Federal Independent Dispute Resolution (IDR) Process

Over the past month, CMS announced several updates to the Federal No Surprises Act IDR Process. On December 15, 2023, the Federal IDR portal was re-opened for all remaining disputes. The portal is now open for all disputes...more

Joint Proposed Rule Aims to Increase Consumer Protections Under the Affordable Care Act

HHS, the Department of Labor’s Employee Benefits Security Administration, and the Internal Revenue Service (IRS) (collectively, the Departments) issued a proposed rule on July 7, 2023, aimed at shoring up consumer protections...more

Court Rules HHS Must Pay 340B Hospitals the Correct Outpatient Drug Reimbursement Rate for the Remainder of the Year

The United States District Court for the District of Columbia granted plaintiffs’ motion to vacate the 2022 OPPS Rule’s 340B rates on a prospective basis, meaning that HHS will pay 340B hospitals the drug’s average sales...more

Departments Issue Final No Surprises Act Dispute Resolution Rule and Other Guidance

On August 19, 2022, the Departments of Health and Human Services, Labor, and the Treasury (the Departments) issued a long-awaited final rule (the Final Rule) on the Independent Dispute Resolution (IDR) Process under the No...more

$413 Million Distributed in Phase 4 Provider Relief Fund Payments

On March 22, 2022, HHS announced that it had distributed more than $413 million in Provider Relief Fund (PRF) payments to more than 3,600 health care providers impacted by the COVID-19 pandemic. HHS directed its disbursement...more

Biden Administration Issues Additional No Surprises Act Guidance in New Interim Final Rules

On September 30, 2021, the Biden Administration issued the second set of implementing regulations under the No Surprises Act. The interim final rules, issued by the Departments of Health and Human Services, Labor, and...more

Home Health Agency Unable to Block HHS From Recouping $2.8 Million in Alleged Overpayments

An Arizona District Court judge held last week that the court lacked subject-matter jurisdiction over a home health agency’s (HHA) procedural due process claim because the HHA had failed to present its claim to HHS first and...more

Final Rule Requires Retrospective Review of HHS Regulations

Last week, HHS issued a final rule setting expiration dates for regulations that are not retrospectively reviewed in a timely manner. The final rule requires HHS to review its regulations every 10 years to determine whether...more

California Medicaid Set to Lose $200 Million in Funding Next Quarter for its Universal Abortion Coverage Mandate

On December 16, 2020, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), announced that the Centers for Medicare & Medicaid (CMS) will disallow $200 million in federal Medi-Cal funding next...more

Proposed Rule Would Require Retroactive Review of HHS Regulations

On November 4, 2020, HHS issued a notice of proposed rulemaking that would require HHS to review its regulations every ten years to determine whether or not the regulations are subject to agency review under the Regulatory...more

OCR’s HIPAA Right of Access Initiative Enforcement Trend Continues with Five New Settlements

This month, OCR announced that it had settled five more investigations and enforcement actions under its HIPAA Right of Access Initiative. OCR first announced its HIPAA Right of Access Initiative in 2019. The HIPAA Right of...more

Executive Order Looks to Extend Access to Telemedicine Beyond the Pandemic and Increase Access to Care in Rural Communities

On August 3, 2020, President Trump signed an Executive Order that could potentially extend the easing of restrictions on telemedicine that were put in place during the COVID-19 public health emergency (PHE) beyond the...more

2020 Federal Government Budget Proposes Reducing Medicare and Medicaid Spending

President Trump’s 2020 budget proposal (the Budget) released last Monday cuts the Department of Health and Human Services’ (HHS) budget by 12% from last year. The Budget requests $87.1 billion for HHS and proposes $1,248.8...more

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