Timothy Fry on Centers for Medicare & Medicaid Services (CMS)

What’s Next for Employers After the Supreme Court’s Vaccine Rulings?

Update (Jan. 15, 2022): After the Jan. 14, 2022, publication of this alert, the Centers for Medicare & Medicaid Services issued updated guidance to State Survey Agency directors providing 30 days (by Feb. 13) for facilities...more

1/17/2022 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Corporate Counsel , Employer Mandates , Healthcare Workers , Infectious Diseases , National Federation of Independent Business v Department of Labor and OSHA , OSHA , Popular , SCOTUS , Stays , Vaccinations , Virus Testing

Stop and Go — Supreme Court Halts Some (but Not Other) Employee Vaccine Mandates

On Jan. 13, 2022, the U.S. Supreme Court granted an emergency request for relief regarding one of the two Biden administration COVID-19 employee vaccine mandates on appeal before the Court...more

1/14/2022 / Centers for Medicare & Medicaid Services (CMS) , Constitutional Challenges , Coronavirus/COVID-19 , Employer Mandates , Healthcare Workers , Infectious Diseases , National Federation of Independent Business v Department of Labor and OSHA , OSHA , SCOTUS , Stays , Vaccinations , Virus Testing

Takeaways From New CMS Interim Rule Requiring COVID-19 Vaccination for Healthcare Providers and Suppliers

As McGuireWoods noted in a Sept. 10, 2021, alert, in Sept. 20 and Sept. 23 FAQs, and in Sept. 27 and Oct. 18 alerts, President Biden’s “Path Out of the Pandemic” employee COVID-19 vaccination mandates have three main...more

11/8/2021 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health and Safety , Health Care Providers , Healthcare Facilities , Healthcare Workers , Infectious Diseases , Vaccinations

Alleged Emergency Room Advanced Professional Practitioner Billing Scheme FCA Case Proceeds

In U.S. ex rel. Sonyika v. ApolloMD, Inc. et al., 2021 WL 1222379 (N.D. Ga. Mar. 31, 2021), a Georgia federal court allowed a relator’s Amended Complaint alleging a fraudulent scheme involving improper billing for services...more

5/5/2021 / Centers for Medicare & Medicaid Services (CMS) , False Claims Act (FCA) , Health Care Providers , Healthcare Fraud , Physicians , Relators

Stark Law 2020 Settlements Return to Pre-2019 Trend

The Centers for Medicare & Medicaid Services (CMS) recently announced 2020 settlements concerning past violation or potential violations of the physician self-referral law (the Stark Law) and the number and value of such...more

4/28/2021 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Physicians , Self-Referral , Stark Law

CMS Accelerated and Advance Payment Recoupment Begins

Recoupment has started or will soon begin for Medicare Part A and Part B providers and suppliers who received funds in 2020 under the Medicare Accelerated and Advance Payment (AAP) Program. The Centers for Medicare & Medicaid...more

4/7/2021 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Part A , Medicare Part B

CMS statement clarifies agency’s view that the Stark Law final rule is effective

Industry publication BVWire quoted a statement from the Centers for Medicare & Medicaid Services (CMS) that gives healthcare providers more certainty to rely on the much heralded final rule modernizing the physician...more

2/22/2021 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Final Rules , Health Care Providers , OIG , Physicians , Self-Referral , Stark Law

Fraud and Abuse Rules Part V: Easing Stark Law Compliance

As discussed in a previous McGuireWoods alert, the U.S. Department of Health and Human Services (HHS) published final rules that significantly amend the regulations to the Physician Self-Referral Law (Stark Law), the federal...more

2/17/2021 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Civil Monetary Penalty , Department of Health and Human Services (HHS) , Fraud and Abuse , Health Care Providers , Healthcare Fraud , Physicians , Stark Law

Fraud and Abuse Rules Part III: New Value-Based Arrangement Protections

As discussed in a previous McGuireWoods alert, the Department of Health and Human Services (HHS) published final rules, effective Jan. 19, 2021, that significantly amend the Physician Self-Referral Law (Stark Law), the...more

1/21/2021 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Civil Monetary Penalty , Department of Health and Human Services (HHS) , Fraud and Abuse , Health Care Providers , OIG , Physicians , Safe Harbors , Stark Law , Value-Based Care

Omnibus Appropriations Package – 15 Key Provisions for Healthcare Providers

Passed by Congress Dec. 21, 2020, and signed by President Donald Trump Dec. 27, 2020, the $1.4 trillion omnibus Consolidated Appropriations Act, 2021 (H.R. 133), includes numerous statutory provisions that directly affect...more

1/14/2021 / CARES Act , Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Department of Health and Human Services (HHS) , Health Care Providers , Medicare , Physician Fee Schedule , Telehealth

Stark Law and Anti-Kickback Statute Reform: Six Key Insights for Private Equity Healthcare Affiliations

Two new healthcare fraud and abuse final rules, effective Jan. 19, 2021, may increase flexibility for private equity firms exploring opportunities in the healthcare space as well as private equity-backed healthcare platforms...more

1/8/2021 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Civil Monetary Penalty , Fraud and Abuse , Health Care Providers , Investors , Private Equity , Stark Law

Omnibus Appropriations Package Includes Changes for Medicare and Medicaid Beneficiaries

Passed by Congress Dec. 21, 2020, and signed by President Donald Trump Dec. 27, 2020, the $1.4 trillion omnibus Consolidated Appropriations Act includes numerous provisions that directly impact Medicare and Medicaid...more

1/7/2021 / Centers for Medicare & Medicaid Services (CMS) , Consolidated Appropriations Act (CAA) , Department of Health and Human Services (HHS) , Medicaid , Medicare , Medicare Advantage , Medicare Part A , Medicare Part D

HHS Finalizes Stark Law, AKS Changes to Reduce Burdens on Healthcare Providers

On Nov. 20, 2020, the U.S. Department of Health and Human Services (HHS) published two long-awaited final rules significantly amending the Physician Self-Referral Law (Stark Law), the federal Anti-Kickback Statute (AKS) and...more

11/24/2020 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Civil Monetary Penalty , Department of Health and Human Services (HHS) , Health Care Providers , OIG , Stark Law

CMS Updates Medicare Accelerated and Advance Program Repayment Guidance and Start Date

The Centers for Medicare & Medicaid Services (CMS) recently issued an updated fact sheet and a FAQ page detailing the repayment terms for Medicare Part A providers and Part B suppliers who received payments under its...more

10/29/2020 / Advanced Payment Program , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare , Medicare Part A , Medicare Part B , Prepayments

HHS Extends Timeline to finalize Stark Law Changes and CMP Inflation Rule

In the last two weeks, the U.S. Department of Health and Human Services (HHS) published two notices in the Federal Register delaying the publication of certain final fraud and abuse rule reforms for up to a full year. First,...more

9/11/2020 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Civil Monetary Penalty , Department of Health and Human Services (HHS) , Health Care Providers , Inflation Adjustments , OIG , Stark Law

D.C. Circuit Reversal Upholds CMS’ Site-Neutrality Cuts for Off-Campus Provider-Based Departments

The U.S. Court of Appeals for the D.C. Circuit recently reversed a district court ruling and upheld the Centers for Medicare & Medicaid Services site-neutrality payment cuts for off-campus outpatient hospital clinic visits....more

8/6/2020 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Hospitals , Off-Campus Departments , OPPS , Outpatient Services , Payment Rates , Physicians , Site-Neutral Exception

CMS Recommendations for Non-Emergent Healthcare Reopening: Eight Key Points

The Centers for Medicare & Medicaid Services (CMS) recently released Phase II recommendations to guide healthcare facilities as they reopen to provide non-emergent procedures unrelated to the 2019 novel coronavirus...more

6/15/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Healthcare Facilities , Re-Opening Guidelines , Unnecessary Medical Procedures

New Provider Relief Fund Payments for Medicaid/CHIP Providers and Safety-Net/COVID-19 Hotspot Hospitals

On June 9, 2020, the U.S. Department of Health and Human Services (HHS) announced that it will distribute $25 billion from the Public Health and Social Services Emergency Fund (Provider Relief Fund) to healthcare providers...more

6/11/2020 / Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Health Care Providers , Hospitals , Medicaid

CMS Continues to Increase Flexibility in Quality Reporting Requirements

This alert is part of a series discussing the comprehensive actions taken by the Centers for Medicare & Medicaid Services in response to the COVID-19 pandemic that are most important to healthcare providers....more

5/11/2020 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Reporting Requirements

Healthcare Private Equity and COVID-19: Considerations as Provider Platforms Reopen

Businesses are starting to reopen as stay-at-home orders and business closures resulting from the novel coronavirus (COVID-19) begin to ease. Unfortunately, reopening likely will not be an immediate return to business as...more

5/7/2020 / Acquisitions , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Investment , Investors , Private Equity

CMS Issues Explanatory Guidance on Stark Law Blanket Waivers During COVID-19 Pandemic

On April 21, 2020, the Centers for Medicare & Medicaid Services (CMS) issued guidance on the scope and application of the blanket waivers to the Physician Self-Referral Law (Stark Law) issued by the Department of Health and...more

5/1/2020 / Anti-Kickback Statute , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Physicians , Stark Law

CMS Suspends Advance Payments and Re-evaluates Accelerated Payments

On April 26, 2020, the Centers for Medicare & Medicaid Services (CMS) announced it was immediately suspending its advance payment program to Part B suppliers, and re-evaluating the amounts that will be paid to providers under...more

4/28/2020 / Accelerated Payments , CARES Act , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers

Update #2: 10 Financial Support Opportunities for Healthcare Companies During the COVID-19 Crisis

This article was originally published April 2, 2020. It has been updated to reflect new guidance made available recently in federal responses to the COVID-19 pandemic and summarizes important interactions that healthcare...more

4/27/2020 / Advanced Payment Program , CARES Act , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Medicare

CMS Relaxes Guidance to Postpone Non-Essential Procedures: Six Key Points

The Centers for Medicare & Medicaid Services (CMS) recently released its first phase of recommendations regarding reopening medical facilities for the provision of non-emergent procedures unrelated to the 2019 novel...more

4/22/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Elective Surgical Procedures , Health Care Providers

HHS Begins Funding $30 Billion to Medicare Providers – Attestations to Be Required

Update: This article was originally published on April 9, 2020. It has been updated to reflect new guidance released on April 10, 2020, by the Department of Health and Human Services (HHS) regarding the delivery of the...more

4/13/2020 / Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Medicare

Timothy Fry

McGuireWoods LLP

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