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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

CMS Amends Medicare Loan Terms Allowing Providers More Time to Make Payments

During the COVID-19 pandemic, CMS has issued approximately $106 billion in loans to providers who were struggling with cash flows and financing in the early stages of the pandemic. This month, the Continuing Appropriations...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

CMS Issues New Section 1135 Waivers to Assist Healthcare Providers Combatting the COVID-19 Pandemic

Using its authority granted under Section 1812(f) of the Social Security Act, CMS has issued several new Section 1135 blanket waivers to waive or modify certain Medicaid, Medicare, CHIP, or HIPAA requirements when a federal...more

Coronavirus Update: CMS Guidance Issued this Month

As the number of coronavirus cases across the country continue to rise, CMS has issued several coronavirus-specific memorandums to healthcare providers and laboratories. In the past two weeks, CMS has issued disease-specific...more

Ohio Court of Appeals Holds that Price Transparency Law Is Unconstitutional Under the Ohio Constitution

The Ohio Legislature enacted a law that would have required healthcare providers to furnish patients with an estimate of their expected medical charges before receiving a medical service, but it enacted that statute as part...more

OIG Issues Advisory Opinion Permitting Drug Manufacturer to Provide Travel, Lodging, and Expenses to Patients in Limited...

On January 15, 2020, OIG issued Advisory Opinion No. 20-02 analyzing an arrangement between a pharmaceutical manufacturer and certain drug recipients whereby the manufacturer provides certain drug recipients with financial...more

Federal Government Funded for Fiscal Year 2020; Surprise Billing and Comprehensive Drug Pricing Legislation Postponed Until 2020

Last Friday, President Trump signed into law two bipartisan legislative packages that included all twelve Fiscal Year 2020 funding bills. Comprehensive surprise billing and drug pricing legislation were not included in the...more

DOJ Settles False Claims Act (FCA) Case Against Medicare Advantage Providers

On August 8, 2019, the DOJ announced a $5 million settlement with Beaver Medical Group L.P. (Beaver) and one of its physicians, Dr. Sherif Khalil, to resolve FCA allegations. Dr. David Nutter, a former employee, brought a...more

CMS Temporarily Pauses QIO Short Stay and Higher Weighted Diagnosis-Related Group Review

Effective May 8, 2019, CMS temporarily suspended Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) Short Stay reviews and Higher Weighted Diagnosis-Related Group (HWDRG) reviews. Reviews will be...more

New Medicare Policy and Payment Changes Proposed for Inpatient Rehabilitation Facilities

CMS released the Fiscal Year 2020 proposed rule (the Proposed Rule) outlining new Medicare policy and payment changes for inpatient rehabilitation facilities (IRFs) last Wednesday. The Proposed Rule proposes updating IRF...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

Colorado House Passes Hospital Expenditure Transparency Bill and Considers Free Standing Emergency Department Licensure

The Colorado House of Representatives recently passed a bill requiring Colorado hospitals to submit information regarding uncompensated care and certain expenditures to the Department of Health Care Policy and Financing...more

Pennsylvania Federal Judge Blocks Religious and Moral Exceptions to the Affordable Care Act’s (ACA’s) Contraceptive Mandate

A Pennsylvania federal judge granted Pennsylvania and New Jersey a nationwide preliminary injunction blocking two Trump administration final rules. The two final rules create exemptions for moral and religious objections to...more

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