News & Analysis as of

Healthcare Facilities Department of Health and Human Services (HHS)

King & Spalding

CMS Issues Final Rule for Updates to Medicare Payment Rates for Skilled Nursing Facilities Under the Skilled Nursing Facility...

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On August 4, 2025, CMS issued a final rule (Final Rule) updating payment rates, policies, and quality programs for Skilled Nursing Facilities (SNFs) under the Medicare Prospective Payment System (SNF PPS) for Fiscal Year (FY)...more

Ropes & Gray LLP

Hospital and Health Systems Reimbursement Check July 2025

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In the early days of the second Trump Administration, several federal funding agencies announced caps to indirect cost (“IDC”) rates for federally funded research awards. In many cases, these caps would substantially reduce...more

Rivkin Radler LLP

OCR Announces $800,000 HIPAA Settlement with Florida Health System

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The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) has announced another settlement for alleged violations of HIPAA. OCR investigated BayCare Health System, which serves central Florida, after a...more

Fisher Phillips

Minimum Staffing Rules for Long-Term Care Facilities Tossed Out by Federal Courts and Budget Bill: Key Points for Medicare and...

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A federal judge in Iowa recently struck down key parts of a Biden-era final rule that set new minimum staffing standards for long-term care facilities as a condition of participation in Medicare or Medicaid programs. The June...more

King & Spalding

OIG Audit of Provider Relief Fund Payments to Hospitals Finds Substantial Noncompliance with Federal Requirements

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On June 13, 2025, OIG announced the results of an audit it conducted of 30 hospitals that received provider relief fund (PRF) payments during COVID-19 (the Audit). OIG found that 11 of the 30 audited hospitals failed to...more

Epstein Becker & Green

OIG Says Medical Device Company's Proposal to Pay for Exclusion Screening for Customers May Violate the Anti-Kickback Statute

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On June 20, 2025, the Department of Health and Human Services’ Office of Inspector General (“OIG”) issued an unfavorable advisory opinion - OIG Advisory Opinion 25-04 (“AO 25-04”)....more

Maynard Nexsen

In Surprise Move, DHHS Appeals District Court Decision to Strike Down Long Term Care Staffing Mandates

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On April 7, 2025, U.S. District Judge Matthew J. Kacsmaryk of the Northern District of Texas struck down the Biden administration’s final rule related to federally imposed minimum staffing requirements for long term care...more

Proskauer - Health Care Law Brief

Disproportionate Impact: Supreme Court Narrows Disproportionate Share Hospital Reimbursement to Supplemental Security Income Cash...

The U.S. Supreme Court has issued a significant ruling affecting hospitals that serve low-income Medicare beneficiaries, narrowing the interpretation of the Disproportionate Share Hospital (“DSH”) payment formula. In...more

Chambliss, Bahner & Stophel, P.C.

What Impact Could the HHS Downsizing Have on Older Adults?

The U.S. Department of Health and Human Services (HHS) has been undergoing organizational changes and layoffs in recent weeks. These changes include the dismantling of such agencies as the Administration for Community...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - May 2025 #1

News Briefs - Hospitals Lose Supreme Court HHS Payment Case - The U.S. Supreme Court sided with the U.S. Department of Health and Human Services in a lawsuit brought by more than 200 hospitals that serve low-income...more

King & Spalding

Supreme Court Holds that Those “Entitled to Supplemental Security Income Benefits” Means Receiving Cash Payment for Hospital DSH...

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Last week, the Supreme Court issued its opinion in Advocate Christ Medical Center v. Kennedy, siding with the government and holding that, for purposes of the Medicare disproportionate share hospital (DSH) calculation,...more

Robinson+Cole Health Law Diagnosis

U.S. Supreme Court Denies DSH Hospitals’ Attempts to Seek Higher Medicare Payments

On April 29, 2025, the U.S. Supreme Court issued an opinion upholding the formula the U.S. Department of Health and Human Services (HHS) utilized to calculate Medicare hospitals’ disproportionate share hospital (DSH) payment...more

Epstein Becker & Green

Similar Language But a Different Outcome: Medicare DSH Payments after Advocate Christ Medical Center v. Kennedy

Hospitals that serve a high number of indigent patients are faced with a dilemma: they must provide high-quality care but fixed Medicare reimbursement rates often do not take into account the higher operating costs that they...more

McDermott Will & Schulte

PointClickCare Denied En Banc Hearing to Overturn PI

On April 23, 2025, the US Court of Appeals for the Fourth Circuit denied PointClickCare Technologies, Inc.’s petition for en banc review in Real Time Medical Systems, LLC v. PointClickCare. A Fourth Circuit panel previously...more

Dorsey & Whitney LLP

The Supreme Court Update - April 30, 2025

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On Tuesday, April 29, the Supreme Court of the United States issued one decision: Advocate Christ Medical Center v. Kennedy, No. 23-715: This case addresses the proper method for calculating the “disproportionate share...more

Epstein Becker & Green

A Common Denominator Governs the Medicare Fraction - SCOTUS Today

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In its 2022 decision in Becerra v. Empire Health Foundation, for Valley Hospital Medical Center, the U.S. Supreme Court held that the phrase “entitled to [Medicare Part A] benefits” applied to “all those qualifying for the...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decides Advocate Christ Medical Center, et al. v. Kennedy

On April 29, 2025, the U.S. Supreme Court decided Advocate Christ Medical Center, et al. v. Kennedy, No. 23-715, holding that for purposes of calculating the Medicare fraction, an individual is entitled to supplemental...more

Arnall Golden Gregory LLP

Court Strikes Down Nursing Home Minimum Staffing Rule

On April 7, 2025, the United States District Court for the Northern District of Texas ruled in favor of the American Health Care Association (“AHCA”) in its lawsuit against Health and Human Services (“HHS”) Secretary Robert...more

Alston & Bird

Health Care Week in Review | House and Senate Agree to Budget Resolution; CMS Releases Inpatient and Post-Acute Payment Proposed...

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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

Sheppard Mullin Richter & Hampton LLP

New York State Releases Much Anticipated Guidance on Reporting Requirements for Material Healthcare Transactions as Budget...

On August 1, 2023, the New York State’s Department of Health (the “DOH”) began implementation of Public Health Law Article 45-A, the State’s new statutory requirement for advance notice and public disclosure of certain...more

Bass, Berry & Sims PLC

[Webinar] Healthcare Regulatory & Compliance Summit - May 1st - 2nd, 9:00 am - 12:45 pm CT

Please join us for the inaugural Healthcare Regulatory & Compliance Summit, hosted by Bass, Berry & Sims. The in-person event will take place in our Nashville office on Thursday, April 24 from 8:30 a.m. to 5:30 p.m. CT. The...more

Bass, Berry & Sims PLC

[Event] Healthcare Regulatory & Compliance Summit - April 24th, Nashville, TN

Please join us for the inaugural Healthcare Regulatory & Compliance Summit, hosted by Bass, Berry & Sims. The in-person event will take place in our Nashville office on Thursday, April 24 from 8:30 a.m. to 5:30 p.m. CT. The...more

Health Care Compliance Association (HCCA)

Healthcare Industry Segment-Specific Compliance Program Guidances (ICPGs)

In addition to releasing its General Compliance Program Guidance, the OIG at HHS announced plans to publish a series of Industry Segment-Specific Compliance Program Guidances (ICPG). The first of these, addressing nursing...more

Alston & Bird

Health Care Week in Review | HHS Announces Significant Workforce Reductions and Reorganization; FDA and NIH Nominees are Confirmed

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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

Rivkin Radler LLP

Quality of Care Considerations in OIG’s Nursing Facility Compliance Guidance

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In November 2024, the U.S. Department of Health and Human Services’ Office of the Inspector General (“OIG”) published the long-awaited Industry Segment-Specific Compliance Program Guidance for Nursing Facilities (“Nursing...more

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