As discussed in a previous alert from March 24, 2020, due to the 2019 novel coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) announced it would temporarily ease quality reporting...more
As countless U.S. businesses face unprecedented challenges due to the 2019 novel coronavirus (COVID-19), federal and state government and private organizations have mobilized to provide financial support to businesses...more
On March 30, 2020, Department of Health and Human Services Secretary Alex Azar issued blanket waivers to permit certain financial relationships and referrals that would otherwise be sanctioned by the Physician Self-Referral...more
Due to the novel coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) announced it would temporarily ease quality reporting requirements for clinicians, providers and healthcare facilities...more
As effects from the 2019 novel coronavirus (COVID-19) pandemic set in, stay-at-home orders and business closures are disrupting American lives and businesses. The healthcare industry is no exception, with the pandemic both...more
3/30/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Emergency Management Plans ,
Health Care Providers ,
Medicaid ,
Medical Reimbursement ,
Medicare ,
Public Health ,
Relief Measures ,
Telehealth ,
Telemedicine
As the 2019 novel coronavirus (COVID-19) pandemic continues to strain the healthcare industry, the Centers for Medicare & Medicaid Services (CMS) eased healthcare provider enrollment rules. CMS has significantly streamlined...more
3/30/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Emergency Response ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicare ,
OCR ,
Physicians ,
Public Health ,
Relief Measures ,
Telehealth ,
Telemedicine ,
Waivers
During this unprecedented public health emergency created by the novel coronavirus (COVID-19), in an effort to slow the spread, protect healthcare providers and consumers from exposure, and ensure healthcare resources remain...more
On March 13, 2020, the Trump administration announced a series of waivers and regulatory flexibilities designed to help healthcare providers and states in responding to and containing the spread of the 2019 novel coronavirus...more
The Deputy General Counsel and Chief Legal Officers at the U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) recently issued an Internal Memorandum clarifying that a recent...more
As discussed in an Oct. 9 alert, the Department of Health and Human Services announced two proposed rules to significantly amend the Physician Self-Referral Law (Stark Law), the federal Anti-Kickback Statute and the Civil...more
As discussed in a previous McGuireWoods alert, on Oct. 9, the Department of Health and Human Services announced two proposed rules to significantly amend the Physician Self-Referral Law (Stark Law), the federal Anti-Kickback...more
On Oct. 9, the Department of Health and Human Services announced two proposed rules to significantly amend the Physician Self-Referral Law (Stark Law), the federal Anti-Kickback Statute (AKS) and the Civil Monetary Penalties...more
On Sept. 17, 2019, a Washington, D.C. district court judge ruled that the Centers for Medicare & Medicaid Services (CMS) “exceeded its statutory authority when it cut the payment rate for clinic services at off-campus...more
The Centers for Medicare & Medicaid Services (CMS) recently issued its annual Physician Fee Schedule and Quality Payment Program Proposed Rule for calendar year 2020. Among other things, it addresses potential changes to...more
Last year, the Centers for Medicare & Medicaid Services (CMS) implemented a controversial payment cut to certain off-campus provider-based departments (PBDs) for the most commonly billed Outpatient Prospective Payment System...more
Last month, the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) released its annual Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG’s Top Recommendations. This...more
The Centers for Medicare & Medicaid Services (CMS) recently announced it will postpone implementation of the “exact match” validation edits to the hospital outpatient prospective payment system (OPPS) until October 2019. Once...more
The Centers for Medicare & Medicaid Services (CMS) recently took the next step in its Patients Over Paperwork initiative by publishing a second request for information (RFI). This RFI seeks public comment by Aug. 12 on ways...more
The Centers for Medicare & Medicaid Services (CMS) recently announced that it would soon deny claims based on a series of validation edits to Medicare enrollment systems. These validation edits will apply to hospital...more
The U.S. Department of Health and Human Services (HHS) has launched its “Regulatory Sprint to Coordinated Care” to accelerate the healthcare system’s transformation to a value-based system rewarding coordinated care. This...more
9/26/2018
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Comment Period ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Medicare Shared Savings Program ,
OIG ,
Physicians ,
Safe Harbors
Since the passage of the Bipartisan Budget Act of 2015, certain off-campus provider-based departments (PBDs) have seen their payment rates cut by nearly 60 percent. Now, in its recently released calendar year (CY) 2019...more
In an effort to “prevent fraud, fight identity theft, and keep taxpayer dollars safe,” the Centers for Medicare and Medicaid Services (CMS) is issuing new Medicare cards to Medicare enrollees beginning in April 2018. This...more
The Bipartisan Budget Act of 2018 (the Act) continues to ratchet up penalties for fraud and abuse violations under the Medicare and Medicaid programs. The Act doubles statutory civil fines and quadruples some criminal fines,...more
On Nov. 2, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized a rule changing reimbursement rates under the Medicare Physician Fee Schedule (MPFS) for certain non-excepted hospital off-campus provider-based...more
Non-excepted hospital off-campus provider-based departments (PBDs) may once again face cuts to reimbursement during calendar year 2018 (CY 2018) if the Centers for Medicare & Medicaid Services (CMS) finalizes proposed changes...more