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Health Care Providers Medicare 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

Bradley Arant Boult Cummings LLP

Alabama CON Report - June 2025

I. Certificate of Need Program - A. AL2024-031, Springhill Hospital, Inc. d/b/a Springhill Medical Center, Mobile County, AL: Proposes to add twenty (20) inpatient rehabilitation beds to an existing eighteen (18) bed...more

Holland & Knight LLP

Preliminary Injunction Agreement Balances CDPAP Transition and Consumer Care

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Following Judge Frederic Block's March 31, 2025, issuance of a temporary restraining order (TRO) temporarily halting New York state's push to consolidate the Consumer Directed Personal Assistance Program (CDPAP) under a...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

Goodwin on

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

Dentons

Ep. 32 – An Easy Audit Tip to Help Avoid Overpayments

Dentons on

Looking for a simple, easy-to-implement way to lower your risk of overpayments? We have one on this week’s podcast!...more

The Volkov Law Group

Gentiva Pays $19.4 Million for False Claims Act Violations Involving Hospice Care

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Gentiva, the renamed former Kindred at Home, agreed to pay $19.4 million to resolve claims that its predecessor company, Kindred at Home and related companies, violated the False Claims Act by retaining overpayments for...more

Husch Blackwell LLP

Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain

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Until recently, deactivation of a hospice’s Medicare provider number seemed like an action reserved for egregious conduct. But with law changes and an enhanced focus on enrollment, good hospices have found themselves facing a...more

Segal McCambridge

Deciphering Reimbursement: Insights from the Central Home Health Care Servs Inc v. Progressive Mich Ins Co Decision

Segal McCambridge on

Introduction - The Michigan Court of Appeals has concluded that for purposes of MCL 500.3157, providers of in-home healthcare services are not subject to reimbursement based on their charge description master or other...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

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

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

Arnall Golden Gregory LLP

CMS Addresses Benefit Integrity Issues Related to Hospice Care

The U.S. Centers for Medicare & Medicaid Services (“CMS”), the agency that administers the Medicare hospice benefit, has announced increased scrutiny of hospice programs in the wake of growing concerns over hospice service...more

Holland & Knight LLP

Holland & Knight Health Dose: July 11, 2023

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

Nelson Mullins Riley & Scarborough LLP

Payment Cuts and Program Changes: CMS Issues Calendar Year 2024 Home Health Prospective Payment System Proposed Rule

On June 30, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule for the Home Health Prospective Payment System for the 2024 calendar year. The proposed rule aims to permanently update the payment...more

McDermott Will & Schulte

HHS Releases Ownership Data of Medicare-Certified Hospices and Home Health Agencies

On April 20, 2023, the US Department of Health and Human Services (HHS) made ownership data of all Medicare-certified hospices and home health agencies publicly available for the first time. This move is consistent with the...more

Baker Donelson

Making Sense of the Varying End Dates of Telehealth Waivers and Flexibilities When the PHE Ends on May 11th

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With the COVID-19 Public Health Emergency (PHE) ending on May 11th, providers and practitioners must carefully consider the dates when various telehealth waivers and flexibilities end. This requires understanding the...more

Nelson Mullins Riley & Scarborough LLP

CMS Continues Transparency Efforts for Home Health and Hospice

The Centers for Medicare & Medicaid Services (CMS) announced on April 27, 2023, that it will publicly release all ownership information of home health and hospice agencies. This move is aimed at increasing transparency and...more

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