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Health Care Providers Centers for Medicare & Medicaid Services (CMS) Home Health Care

Holland & Knight LLP

CMS Releases CY 2026 Medicare Physician Fee Schedule Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) on July 14, 2025, issued the calendar year (CY) 2026 Proposed Rule, which proposes payment policies and other outpatient services covered under Medicare Part B. Comments are...more

King & Spalding

CMS Escalates Aggressive Rates Cut in Home Health Prospective Payment System Proposed Rule for CY 2026

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On June 30, 2025, CMS issued its annual Home Health Prospective Payment System Proposed Rule for Calendar Year (CY) 2026 (the Proposed Rule). The Proposed Rule continues the agency’s policy of using provisions of the...more

Arnall Golden Gregory LLP

AGG Talks: Home Health & Hospice Podcast - Episode 8: Hospice Special Focus Program: Pumping the Brakes

In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss the hospice special focus program and CMS’ announcement that it will cease implementing the program in the face of litigation filed by providers and...more

McDermott Will & Schulte

CMS Updates Scope of Providers Subject to Provisional Period of Enhanced Oversight

The Centers for Medicare & Medicaid Services’ (CMS) 2025 Home Health Prospective Payment System final rule (Final Rule) expanded the scope of providers subject to a provisional period of enhanced oversight (PPEO) to include...more

Goodwin

Medicare Part C Under Scrutiny: Upcoding, Enforcement, and Future Changes

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A new inspector general report finds that Medicare Part C reimbursement to private insurers increased by $4.2 billion in 2023 for diagnoses from home visits despite leading to no additional treatment. ...more

Nelson Mullins Riley & Scarborough LLP

Federal Regulatory Update: CMS Medicare Payment Changes & Congressional Next Steps

The Centers for Medicare & Medicaid Services (CMS) have released significant updates affecting Medicare payments for 2025. The changes, outlined in two final rules, will impact both physicians and hospitals, eliciting strong...more

Alston & Bird

Health Care Week in Review: CMS Releases PFS, OPPS, ESRD, and Home Health Final Rules; Senators Cassidy and Hassan Release a...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - August 2024 #1

News Briefs - CMS Increases Acute Care Inpatient Hospital Payments by $2.9B - HHS has finalized the fiscal year 2025 Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System rule. The rule...more

McDermott+

Policy Update - CMS Releases Final Rule: Medicaid Program; Ensuring Access to Medicaid Services

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On April 22, 2024 the Centers for Medicare & Medicaid Services (CMS) published the Medicaid Program; Ensuring Access to Medicaid Services final rule. The rule has a particular focus on home- and community-based services...more

Polsinelli

The 80/20 Rule is Here: CMS Finalizes HCBS Care Worker Payment Requirements

Polsinelli on

In May 2023, the Centers for Medicare and Medicaid Services (“CMS”) proposed a series of rule changes intended to help promote the availability of home and community-based services (“HCBS”) for Medicaid beneficiaries. Chief...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - April 2024 #3

News Briefs - House Subcommittee Considering 15 Bills to Expand Telehealth - A major House subcommittee is considering 15 bills to expand access to telehealth services as the clock ticks on a Dec. 31 deadline on pandemic-era...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - April 2024 #1

News Briefs - More Nonprofit Hospitals Adding Concierge Physician Practices - Nonprofit hospitals created largely to serve the poor are adding concierge physician practices, charging patients annual membership fees of $2,000...more

McGuireWoods LLP

Ounce of Prevention: Is a Selling Hospice or Home Health Agency Ready for the 36-Month Rule?

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Applicable Provider Types: Hospice; Home Health Agency - Is Your Entity in Compliance? The Centers for Medicare & Medicaid Services (CMS) finalized and expanded its so-called 36-month rule with certain changes...more

Morgan Lewis - Health Law Scan

Medicare’s New Dementia GUIDE Model: How Can Physicians, Hospices, and Home Health Agencies Participate?

If you have had a loved one suffer from dementia, you know the emotional, physical, and financial toll of this terrible disease. With advancements in dementia treatment, however, there is renewed hope on addressing this...more

Arnall Golden Gregory LLP

The Devil’s in the Details: Hospice Providers Face Claim Denials for Election Statement Technicalities

Since the Centers for Medicare & Medicaid Services (“CMS”) paused much of its audit activity during the COVID Public Health Emergency, the most recent rounds of Medicare audit activity may represent the first “look” at the...more

McDermott Will & Schulte

CMS Finalizes Important Changes to Medicare Enrollment Requirements for Hospice, Home Health Providers

The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare enrollment regulations applicable to hospices and home health agencies (HHAs), including increasing the level of screening that...more

Husch Blackwell LLP

Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP

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In this episode, Husch Blackwell’s Meg Pekarske is joined by friend and industry veteran Kim Skehan. In this wide-ranging conversation, they explore not only the recent survey reforms but the ways in which Kim’s decades of...more

Benesch

2024 Outlook: Behavioral Health Trends

Benesch on

Healthcare systems are facing significant challenges in recruiting and retaining talent within the burgeoning field of behavioral health services, primarily due to competition from telehealth providers and inconsistent...more

Stevens & Lee

Hospital at Home Programs Are Sticking Around

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Health systems and hospitals have implemented “hospital at home” programs for several years, but the trend increased in popularity during the COVID-19 pandemic due to a Centers for Medicare & Medicaid Services (“CMS”) waiver....more

Husch Blackwell LLP

A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program

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Centers for Medicare & Medicaid Services (CMS) devised a “Special Focus Program” to identify poor performing hospices and help them improve through more frequent surveys and technical assistance. CMS would also impose...more

Robinson+Cole Health Law Diagnosis

CMS Announces 0.8 Percent Aggregate Home Health Payment Increase in 2024

On Wednesday, November 1, the Center for Medicare & Medicaid Services (CMS) released its Home Health Prospective Payment System Rate Update final rule for CY 2024 (the Final Rule). The Rule estimates that the aggregate...more

Husch Blackwell LLP

Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals

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For a variety of unfortunate reasons, some hospices found themselves facing a 4% rate reduction for non-compliance with either Hospice Item Set (HIS) or Consumer Assessment of Healthcare Providers & Systems (CAHPS)...more

Husch Blackwell LLP

This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims

Husch Blackwell LLP on

CMS has criticized hospices for underutilizing general inpatient care (GIP) but has also specifically targeted GIP claims for audit and medical review. In addition to CMS’s standard tools for reviewing GIP claims, such as...more

Baker Donelson

CMS Hospital Discharge Requirements to Post-Acute Care Providers

Baker Donelson on

On June 6, 2023, the Center for Medicare and Medicaid Services (CMS) provided a Quality Safety & Oversight (QSO) memorandum outlining CMS-identified concerns with respect to the patient discharge process (Memo). As set forth...more

Arnall Golden Gregory LLP

Home Health & Hospice Quarterly - Q3

AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more

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