News & Analysis as of

Healthcare Department of Health and Human Services (HHS) Healthcare Facilities

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

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

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

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

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

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

Dentons

Ep. 51 – Building Effective Compliance Committee Agendas

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Many healthcare organizations understand the importance of having a Compliance Committee but some struggle to use their committee effectively. The key to ensuring the Compliance Committee is effective is building smart...more

Robinson+Cole Health Law Diagnosis

Trump Administration Issues Executive Order Prioritizing Hospital Price Transparency Enforcement

On February 25, 2025, President Donald Trump issued an Executive Order titled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information” (the 2025 Order). The...more

Dickinson Wright

Arizona’s New Behavioral Healthcare Laws – Part 3

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In 2024, the Arizona legislature passed five new Arizona laws directly affecting behavioral health care in Arizona. These laws run the gamut between refining definitions, requiring peer specialist trainings, new requirements...more

Alston & Bird

Health Care Week in Review | Senate Passes First Budget Resolution; DOJ Opts to Continue Defense in Braidwood SCOTUS Case

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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

Husch Blackwell LLP

ICE at Healthcare Facilities: What Should You Do

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In 2003, Congress created the Department of Homeland Security (DHS). Within the DHS is the interior enforcement arm, U.S. Immigration and Customs Enforcement (ICE), that enforces federal laws governing border control,...more

Stotler Hayes Group, LLC

CMS Cracks Down on Responsible Party Liability in LTC Admission Agreements

A nursing facility that participates in the Medicaid or Medicare programs may not require a third party to guarantee payment for a resident’s admission or continued stay. However, facilities are allowed to require a resident...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - January 2025 #2

News Briefs - Hospitals Urged to Check for Accuracy as AI Use Increases -About 65 percent, or 1,696, of U.S. hospitals surveyed reported using artificial intelligence or predictive models integrated with their electronic...more

Rivkin Radler LLP

Federal Agencies Express Concerns About Health Care Market Consolidation and Role of Private Equity

Rivkin Radler LLP on

On January 15, 2025, the Federal Trade Commission (FTC), Department of Justice (DOJ), and Department of Health and Human Services (HHS) released a joint report continuing their collaborative initiative to address...more

Husch Blackwell LLP

New Legislation Revises Massachusetts' Determination of Need Statute

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On January 8, 2025, Massachusetts Governor Maura Healey signed into law “An Act Enhancing the Health Care Market Review Process.” Part of this sweeping healthcare oversight law includes changes to the Determination of Need...more

Brownstein Hyatt Farber Schreck

Bipartisan AI Task Force Report Sets the Stage for Health Care AI Action in 2025

The House Task Force on Artificial Intelligence (AI) released a comprehensive 253-page report providing a roadmap for Congress as it develops policies to regulate and optimize the use of this rapidly advancing technology. The...more

Burr & Forman

HHS OIG Launches Segment-Specific Compliance Guidance for Nursing Facilities

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On November 20, 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued the Nursing Facility Industry Segment-Specific Compliance Program Guidance (Nursing Facility ICPG). This...more

Alston & Bird

Health Care Week in Review: Congress Races to Avert Government Shutdown; Senators Announce Launch of Make America Healthy Again...

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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

OIG Updates Compliance Guidance for Nursing Facilities

In 1998, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services began issuing voluntary, compliance program guidance for various segments of the healthcare industry. Recently, the OIG has...more

Dentons

Ep. 42 – Implementing the OIG’s Nursing Facility Compliance Program Guidance

Dentons on

Last month the Office of Inspector General for the U.S. Department of Health & Human Services (OIG) released its first industry-specific compliance program guidance aimed at nursing facilities (both skilled and non-skilled)....more

Health Care Compliance Association (HCCA)

Privacy Briefs: November 2024

Change Healthcare Inc. has amended its initial breach report to the HHS Office for Civil Rights (OCR) to state that 100 million individuals were impacted by its mammoth ransomware attack and breach. However, as of Oct. 24,...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - October 2024 #5

News Briefs - 20 AGs Seek Immediate Injunction Over Nursing Home Staffing Rule - A group of 20 attorneys general asking a federal court to strike down the nursing home staffing rule also has now asked the court for an...more

Alston & Bird

Health Care Week in Review: HHS Released Proposed Rules Enhancing Coverage of Preventive Services; OIG Released Report on...

Alston & Bird on

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

Alston & Bird

Health Care Week in Review: HHS Released Final Guidance for the Second Cycle of Medicare Drug Price Negotiations; CMS Released...

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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

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