Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 244: The Future of Independent Physician Practices with Ray Waldrup of The Leaders Rheum
Navigating Legal Strategies for Covering GLP-1s in Self-Insured Medical Plans — Employee Benefits and Executive Compensation Podcast
CareYaya: A Revolutionary Approach to Elder Care
Top Healthcare Compliance Priorities for 2025
AGG Talks: Healthcare Insights Podcast - Episode 8: What Healthcare Companies Need to Know When the Government Comes Knocking
AGG Talks: Healthcare Insights Podcast - Episode 7: National MultiPlan Litigation: A Guide for Healthcare Providers
Defending HIMP-1 Claims in New York
Understanding Pharmacy Benefit Managers: The PBM Landscape Explained
DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program
AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Updates to Statute 1557 that Healthcare Providers Need to Know
The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
Opting Out of Medicare: When and How to Do It
The Burr Broadcast April 2023 - The Official End of COVID-19 Emergencies
Video: Health Care's Past, Present, and Future - Diagnosing Health Care Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 106: Dr. James McElligott, MUSC & Dr. Shawn Stinson, BlueCross BlueShield of SC
Sen. Ward Floats Temporary Budget Amid Ongoing Stalemate - Senate President Kim Ward (R-Westmoreland) has proposed a six-month budget to keep Pennsylvania operating as the legislative stalemate over school choice and mass...more
The healthcare mergers and acquisitions (M&A) market began 2025 with a slower start than expected given the easing headwinds and building momentum at the end of last year, with the number of deals reported in Q1 lower than...more
New York State has a long-standing commitment to supporting its most vulnerable populations through Medicaid-funded services for older adults and those requiring long-term care. However, rising costs and an increasingly...more
Updated November 18, 2024 – The Consolidated Appropriations Act (CAA), 2023 (Public Law 117-328), signed into law on December 29, 2022, extended certain key telehealth flexibilities instituted during the COVID-19 public...more
Certain Medicaid programs impose a transfer penalty on applicants who have transferred resources (assets) for less than fair market value within five (5) years preceding the Medicaid application. Simply stated, the transfer...more
One of the biggest misconceptions related to Community (Home Care) Medicaid is the idea that one thinks they and/or their loved one is not eligible for services because “they make too much money.” In New York State, for one...more
Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more
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
The Florida Regular Legislative Session began on January 9, 2024, and ended on March 8, 2024. Below is a summary of relevant health care laws that will be effective July 1, 2024, if they are approved by Governor DeSantis....more
The Elder Law Practice Group at Falcon Rappaport & Berkman would like to share some important Elder Law legal updates with our clients and professional partners that will impact Medicaid eligibility for applicants/recipients...more
Medicaid is a joint federal and state program that provides health coverage to millions of Americans. Federal law requires states to comply with certain minimum requirements, but New York is considered a maximum state in that...more
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
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
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
On April 27, 2023, the Centers for Medicare & Medicaid Services (CMS) released a Notice of Proposed Rulemaking entitled Ensuring Access to Medicaid Services (Proposed Rule) which would, among other things, establish...more
By now, we are all familiar with the concepts of value-based care and the transition away from a payment system built primarily on a fee-for-service reimbursement methodology to a patient centered model that focuses on...more
On November 4, 2022, the Centers for Medicare & Medicaid Services (CMS) published the calendar year 2023 Home Health Prospective Payment System Rate final rule, which updates Medicare payment policies and rates for home...more
For better and for worse, Medicaid is the primary method of paying for nursing home care in the United States. But navigating the Medicaid system is complicated and confusing. Here are the basics. ...more
When New York adopted a wage parity law setting minimum wage and benefit levels for home care workers, innovative home health care agency companies created a captive plan structure to meet the benefits requirements. Although...more
Appropriations committee reviews health care workforce bill - The House Appropriations committee reviewed H.607 on Tuesday, a bill aimed at increasing the health care workforce in Vermont. The bill requires the Vermont...more
Report on Medicare Compliance Volume 28, Number 40. (November 11, 2019) - - In a new Medicare compliance review, the HHS Office of Inspector General (OIG) said Angels Care Home Health in Salina, Kansas, didn’t comply with...more
Class action attorneys recently filed a first-of-its-kind class action against Edison Home Health Care (“Edison”) and Preferred Home Care of New York (“Preferred”) alleging that the home care agencies used a “captive”...more
A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more
Medicare is supposed to provide up to 35 hours a week of home care to those who qualify, but many Medicare patients with chronic conditions are being wrongly denied such care, according to Kaiser Health News. For a variety of...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