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
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
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
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
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
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
3/20/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Diagnostic Tests ,
Emergency Rooms ,
EMTALA ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Medicare Part C ,
Medicare Part D
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
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
1/31/2020
/ Advisory Opinions ,
Anti-Kickback Statute ,
Beneficiary Inducement ,
CMP Law ,
Health Care Providers ,
Hospitals ,
Manufacturers ,
Medical Expenses ,
Medical Monitoring ,
OIG ,
Patient Safety ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Travel Expenses
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
12/31/2019
/ Affordable Care Act ,
Appropriations Bill ,
Cadillac Tax ,
Community Health Systems ,
Congressional Committees ,
Drug Pricing ,
Federal Budget ,
Federal Funding ,
Health Insurance ,
Medicaid ,
Medicare ,
Pharmaceutical Industry ,
Surprise Medical Bills
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
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
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
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
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
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