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
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
As discussed in a previous alert, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently issued a proposed rule amending provisions of its 2016 rule prohibiting certain forms of...more
On May 24, the U.S. Department of Health and Human Services Office for Civil Rights issued a proposed rule reversing certain provisions of its 2016 rule prohibiting certain forms of discrimination under Section 1557 of the...more
The healthcare private equity market continues to see high transaction multiples and unprecedented competition for transactions. These trends, along with continued growth in False Claims Act or qui tam cases, create...more
Last month, we wrote about Florida House Bill 1243 (HB 1243), focusing on the mandatory reporting of certain hospital or group practice mergers, acquisitions and other transactions. Since then the state’s legislative 2019...more
The next in our series of posts sharing key takeaways from panels at the Healthcare & Life Sciences Private Equity and Lending Conference discusses dermatology investing. It is authored by our colleagues Royce DuBiner,...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
Over the past six weeks, Florida’s House of Representatives introduced and passed a bill that could change the process and time needed for certain healthcare transactions. Here are five things dealmakers need to know about...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
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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
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
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
When investigating whether an individual or entity is excluded from the federal healthcare programs, healthcare organizations must be on the alert for yet another method for defrauding the government: alias names. Alias names...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
This year, Medicare providers and suppliers — including hospitals, ambulatory surgical centers (ASCs) and end-stage renal disease (ESRD) facilities — will need to develop emergency preparedness plans for both natural and...more
By October 16, 2016, healthcare providers and other covered entities must publish and disseminate nondiscrimination notices, including disclosures that they provide language assistance services for individuals with limited...more