News & Analysis as of

Medicaid Home Health Care Health Care Providers

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
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

Littler

New York Court Issues Decision and Order Declaring the DOH’s August 2024 Reimbursement Rate Adjustment for Fiscal Intermediaries...

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On March 20, 2025, a New York Supreme Court Justice in Albany County issued a decision and order declaring the New York State Department of Health (NY DOH)’s August 2024 implementation of an administrative rate reimbursement...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

Littler

New York Court Issues Temporary Restraining Order in Connection with the Single Statewide Fiscal Intermediary Program

Littler on

Earlier this week, New York State and Public Partnerships LLC (PPL), the entity selected to become the Statewide Fiscal Intermediary (SFI) as of April 1, 2025, suffered another roadblock in their efforts to transition New...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

Husch Blackwell LLP

Hospice Insights Podcast: What’s the Latest on UPICs? Highlights from Recent Audit Activity, Part I

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UPIC activity is picking up, and the UPICs are reviving some old tactics. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss these trends which include extrapolation, Medicaid nursing home room and...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

McCarter & English, LLP

New Jersey Statutory Update Part II

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

Bond Schoeneck & King PLLC

Enacted Budget Makes Major Changes to Consumer Directed Personal Assistance Program

The Fiscal Year 2025 enacted budget will significantly change the Consumer Directed Personal Assistance Program (CDPAP), a program of self-directed home care that allows seniors and individuals with disabilities to hire their...more

McDermott+

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

McDermott+ on

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

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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

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

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Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

Proskauer - Health Care Law Brief

The Key Health Care Initiatives Proposed in Governor Hochul’s Fiscal Year (FY) 2025 Executive Budget

This year’s Health and Mental Hygiene Bill (“HMH Bill”) (part of the Governor’s FY 2025 Executive Budget, which proposes a $233 billion balanced budget), includes $35.5 billion to fund Medicaid, $4.8 billion to address...more

Littler

New York Department of Health Sets New Due Dates for Submission of Home Care Worker Wage Parity Compliance Certifications and...

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On September 21, 2023, the New York Department of Health (DOH) issued guidance addressing the due dates for Medicaid Managed Care Organizations (MMCOs), Certified Home Health Agencies (CHHAs), Licensed Home Care Services...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

Robinson+Cole Health Law Diagnosis

CMS Proposes New Rule that Would Require 80% of Payment to Go Toward Home Care Worker Compensation

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

Sheppard Mullin Richter & Hampton LLP

Tracking the Waivers: Implications of the Wind Down of the COVID-19 Public Health Emergency

The White House recently announced that the COVID-19 national emergency and public health emergency (PHE) declarations will end on May 11, 2023. These declarations have been in place since the beginning of the COVID-19...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

Saul Ewing LLP

2022 Health Care Predictions

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​COVID-19 – and its variants Delta and Omicron – continue to wreak havoc around the world. Thousands of individuals have died and continue to die, and millions more have been diagnosed as having COVID-19. Many sectors of the...more

King & Spalding

OIG Determines That an Online Platform to Search for Home-Based Health Care Providers is Not Subject to Sanctions

King & Spalding on

On December 16, 2021, OIG issued an advisory opinion (Advisory Opinion No. 21-20) to a requestor (Requestor) regarding a proposal to create an online search platform for users to find and contact home-based health care...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 8. News Briefs: March 2021

Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more

Rivkin Radler LLP

CMS Proposes Permanent Expansion of Telehealth Services

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In response to the COVID-19 pandemic since mid-March, the Centers for Medicare and Medicaid Services (CMS) worked quickly to issue emergency guidance that allowed temporary expansion of payment for telehealth services and...more

Roetzel & Andress

Review Choice Demonstration To Resume On Home Health Care Agencies

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Effective August 3, 2020, the Centers for Medicare & Medicaid (“CMS”) will resume Home Health Review Choice Demonstration (“RCD”) on home healthcare agencies located in Illinois, Ohio, Texas, North Carolina, and Florida. CMS...more

Ruder Ware

Wisconsin Medicaid Divisor Staying Put. For Now.

Ruder Ware on

Every year before July 1st, Wisconsin publishes an updated Medicaid divisor to be in effect starting on July 1st of that year until June 30th of the next year. This year, Wisconsin has not yet updated its Medicaid divisor due...more

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