The State of Healthcare Enforcement
Hospice Insights Podcast - Election Inspection: Be Proactive to Avoid Costly Election Statement Denials
Medicaid Cuts: Potential Challenges and Legal Implications for Long-Term Care Facilities — Assisted Living and the Law Podcast
False Claims Act Insights - How Payment Suspensions Can Impact FCA Litigation
Federal Court Strikes Down FDA Rule on LDTs - Thought Leaders in Health Law®
UPIC Audits
AGG Talks: Home Health & Hospice Podcast - Episode 8: Hospice Special Focus Program: Pumping the Brakes
Hospice Insights Podcast - Upping the Ante: Will CMS’s Enhanced Oversight Efforts Cause Hospices to Fold?
Podcast — Drug Pricing: What’s in the New CMS Medicaid Final Rule?
Hospice Insights Podcast - What a Difference No Deference Makes: Courts No Longer Bow to Administrative Agencies
Preparing for CMS Staffing Mandates — Assisted Living and the Law Podcast
Hospice Insights Podcast - Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
Podcast — Drug Pricing: Takeaways From the Chicago Medicaid Drug Rebate Program Summit
Podcast — Drug Pricing: How the Demise of Chevron Deference and Other Litigation May Impact the Pharmaceutical Industry
The CMS Interoperability and Prior Authorization Rules
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Findings from Gibbins’ Annual Healthcare Bankruptcy Report
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
The Centers for Medicare & Medicaid Services recently published the calendar year (“CY”) 2026 proposed rule for Medicare payment for services provided in hospital outpatient departments under the Outpatient Prospective...more
On July 16, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule for the Ambulatory Specialty Model (ASM), a mandatory, five-year alternative payment model for select specialists who regularly treat...more
On December 10, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule, which, if finalized as proposed, has potentially significant implications for Medicare Advantage (MA) plans and Medicare...more
Watchful Waiting: Three Weeks Left in Lame Duck - Congress returns on Tuesday to begin the remaining three weeks of the lame duck session. Lawmakers have a packed agenda, and they have 18 days to pass a bill funding the...more
Welcome to our seventh issue of The Health Record - our healthcare law insights e-newsletter. This will be our final issue of 2024. When we started this publication earlier this year, our goal was to provide our clients,...more
A key element of the Medicaid Redesign Team 1115 Waiver amendment is the Medicaid Hospital Global Budget Initiative (GBI), a reimbursement model tied very closely to the States Advancing All-Payer Health Equity Approaches and...more
If you have been following the implementation of the No Surprises Act independent dispute resolution (IDR) process, you have likely seen a bunch of new rules, guidance documents and deadline extensions come out recently and...more
On October 27, 2014, the Centers for Medicare & Medicaid Services (CMS) made a concession—a very small one—to hospitals racing against the looming October 31, 2014, deadline for accepting the offer of 68 cents on the dollar...more
With the June 30 deadline for Phase 2 Sunshine Act reports by pharmaceutical and medical device manufacturers (“Applicable Manufacturers”) and group purchasing organizations (“GPOs’) quickly approaching, the Centers for...more
CMS will begin to enforce what could be significant penalties on manufacturers who fail to report required data. The Centers for Medicare & Medicaid Services (CMS) has announced a short timeframe before detailed...more
On October 1, 2014, all HIPAA-covered persons and entities must be compliant with the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM and ICD-10-PCS,...more
As the final days of 2013 passed and the sunset of the Stark Law exception and anti-kickback law safe harbor for electronic health record (EHR) donations loomed nearer, the U.S. Department of Health and Human Services (HHS)...more
With less than 50 days until open enrollment begins, tensions in Washington and around the country are high among health care stakeholders. ...more
With the August 1 deadline for data collection under the Physician Payments Sunshine Act (the “Act”) looming, CMS recently released two mobile applications (“Apps”) to help physicians and industry track payments and transfers...more
The Obama administration announced yesterday it was delaying the Affordable Care Act’s (ACA) Employer Mandate, which requires employers with 50 or more full-time workers to provide affordable health insurance to its employees...more
The countdown is on now. Less than 100 days until the Affordable Care Act’s (ACA) main provisions go into effect, and Organizing for Action and Enroll America kicked outreach efforts to the uninsured into high gear last week....more