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
On April 15, 2025, President Trump signed an executive order (EO) aimed at addressing the cost of prescription drugs. This EO, titled “Lowering Drug Prices by Once Again Putting Americans First,” outlines specific directives...more
Hospital at Home (“HaH”) programs received renewed interest during the COVID-19 pandemic as a way to relieve hospital capacity issues and allow patients to receive effective care outside of the traditional hospital setting....more
On December 7, 2023, the Senate Budget Committee (the “Committee”) launched a bipartisan investigation into the reality of private equity ownership of hospitals in the United States. This investigation stems from concerns...more
After months of relative uncertainty, the Health Resources and Services Administration (HRSA) published a Notice confirming the end to a COVID-19 pandemic-era flexibility that allowed unregistered child sites to utilize 340B...more
As many are aware, compliance with price transparency requirements continues to lag. Under the final rule, effective January 1, 2021, hospitals are required to provide clear, accessible pricing information online about the...more
Starting July 1, 2023, The Joint Commission (TJC) will set health equity as a National Patient Safety Goal for certain TJC-accredited organizations and roll out a new Health Care Equity certification program to recognize and...more
When the surge of COVID-19 patients threatened to strain the nation’s health care systems, the Centers for Medicare & Medicaid Services (“CMS”) implemented the Acute Hospital Care at Home Program, or Hospitalization at Home...more
On December 1, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released the annual Physician Fee Schedule final rule (“Final Rule”) which, among other things, aimed to further President Trump’s October 3, 2019...more
Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more
Halloween or HIPAA: Which is Scarier? HIPAA and the Pandemic - Telehealth: - On Friday, March 20, 2020, OCR announced it will “exercise its enforcement discretion and will not impose penalties for noncompliance with...more
In a December 12, 2017 Advisory Board article, “The 340B drug pricing controversy, explained,” Scott Orwig wrote, “the 340B Drug Pricing Program is one of the most contentious issues in health care: Its critics say it ‘hurts...more
Patient standards of care have always been a moving target, dependent on specialty, circumstances, and resources. Add in a global pandemic and this standard for the treatment of COVID-19 is in a constant state of flux. Novel...more
On March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) announced additional blanket waivers and temporary rule changes designed to assist the health care system in coping with patient surges due to the novel...more
On January 13, 2020, the Centers for Medicare & Medicaid Services (CMS) announced a new streamlined survey and certification process for psychiatric hospitals as part of the agency’s “Patients over Paperwork” initiative. ...more
As part of the 2019 Medicare Physician Fee Schedule Final Rule (Final Rule) published on November 23, 2018, the Centers for Medicare & Medicaid Services (CMS) took significant steps toward modernizing Medicare to expand...more
Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more
As discussed in our previous blog, “CMS Pushes for Hospital Price Transparency in Proposed Rule”, on April 24, 2018, the Centers for Medicare & Medicaid Services (“CMS”) announced a proposed rule (CMS-1694-P) aimed at...more
The Centers for Medicare & Medicaid Services (CMS) is proposing a redesign of incentives under the Merit-Based Incentive Payment System (MIPS) as part of the 2019 Updates to the Quality Payment Program (QPP). This affects...more
On July 27, 2018, the Centers for Medicare & Medicaid Services (CMS) published its proposed annual update to the Medicare Physician Fee Schedule, which includes proposals that would give a big boost to telehealth services...more
In this episode, Gary Qualls discusses a recent development in payer litigation, regarding a provider’s recovery of Medicare Advantage payments pursuant to a Medicare Advantage contract. Specifically, a recent federal case...more
In September 2017, the Centers for Medicare & Medicaid Services (CMS) released a Survey and Certification memo which created interpretive guidelines for compliance with the statutory requirement that hospitals be “primarily...more
On April 24, 2018, the Centers for Medicare & Medicaid Services (“CMS”) announced a new proposed rule (CMS-1694-P) (“Proposed Rule”). In an attempt to “empower patients through better access to hospital price information,”...more
On April 24, 2018, the Centers for Medicare and Medicaid Services (CMS) issued for comment a 1883-page proposed rule (CMS-1694-P) (the "Proposed Rule") that aims, among other goals, to increase transparency relating to...more
San Francisco (January 11, 2018) – The final day of the 2018 JP Morgan Healthcare Conference gave us food for thought about the topic of healthcare navigation, as well as updates on the home health sector. Post-acute has...more
CMS issued a memo to state survey agency directors on December 28, 2017, to clarify CMS’s position on texting patient information. The memo, which indicates that it is effective “immediately,” states that CMS prohibits...more