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Medicare New Guidance

Venable LLP

OIG Issues Favorable Advisory Opinion on Physician-Telehealth Arrangement

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On June 11, 2025, the Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion No. 25-03 (Opinion), which provided favorable guidance for physician practices seeking to contract with...more

Hanson Bridgett

CMS Announces Care Compare Changes That Could Lead to Major Five-Star Impacts for Certain SNFs

Hanson Bridgett on

On June 18, Centers for Medicare and Medicaid Services published new guidance announcing a major change to the way Care Compare will display survey information and the methodology for calculating the health inspection score...more

Mintz - Health Care Viewpoints

CMS Sheds Light on its Timeline for Expedited RADV Audits

Shortly following its announcement of sweeping changes to RADV audits, CMS shared industry guidance last week regarding upcoming deadlines for the submission of risk adjustment data corrections in advance of RADV sampling....more

Nelson Mullins Riley & Scarborough LLP

Attention SNFs: Enhanced 855A Disclosure Requirement Deadline Extended to August 1, 2025

This article is an update to a December 2024 client alert. On April 17, 2025, the Centers for Medicare and Medicaid Services ("CMS") extended the revalidation deadline for its 855A skilled nursing facility...more

Bricker Graydon LLP

CMS Extends Mandatory SNF Off-Cycle Revalidations to August 1, 2025

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On April 17, 2025, the Centers for Medicare and Medicaid Services (CMS) formally announced an extension for the mandatory off-cycle revalidation deadline for skilled nursing facilities (SNFs)....more

Foley & Lardner LLP

Skilled Nursing Facilities: CMS Extends Medicare Revalidation Deadline

Foley & Lardner LLP on

On April 17, 2025, the Centers for Medicare and Medicaid Services (CMS) announced another extension of the deadline by which skilled nursing facilities (SNFs) must revalidate their Medicare enrollments: Enrolled skilled...more

Polsinelli

CMS Extends Revalidation Deadline for Skilled Nursing Facilities to August 1, 2025

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In its April 17 MLN Newsletter, the Centers for Medicare and Medicaid Services (CMS) once again extended the deadline for skilled nursing facilities (SNF) to submit their off-cycle revalidation from May 1 to August 1, 2025....more

Benesch

Off-Cycle Medicare Revalidations for SNFs – Deadline Extended to August 1, 2025

Benesch on

On April 17, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced via a Medicare Learning Network (“MLN”) update that the deadline for submission of mandatory off-cycle Medicare revalidations for skilled...more

Polsinelli

CMS Spring Provider Enrollment Updates

Polsinelli on

Centers for Medicare & Medicaid Services (CMS) released several pieces of Medicare provider enrollment guidance this spring, both emphasizing current policy and requirements as well as providing guidance and clarification...more

Fox Rothschild LLP

UPDATE: SNFs Receive Even More Time to Complete Off-Cycle Revalidation

Fox Rothschild LLP on

In October, we broke down the required off-cycle Medicare revalidation of all Skilled Nursing Facilities (SNFs) in an Alert and related blog post. We were happy to announce in November that CMS extended the deadline for SNFs...more

McDermott Will & Emery

CMS Updates SNF Attachment Guidance Ahead of May 1 Enrollment Deadline

McDermott Will & Emery on

Skilled nursing facilities (SNFs) historically have been required to disclose ownership and managerial control information as part of their Medicare enrollment. However, these requirements were significantly expanded to...more

Arnall Golden Gregory LLP

AGG Talks: Cross-Border Business Podcast - Episode 27: U.S. Healthcare Reimbursement Guidance for Foreign Life Sciences Companies

In this episode, Mike Burke, AGG Corporate partner and co-chair of the firm’s International practice, is joined by Andrew Tsui, AGG Healthcare Litigation partner, to explore the intricacies of reimbursement in the U.S....more

Hogan Lovells

CMS Proposes Guidance on Use of Real World Data for Coverage with Evidence Development

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Real world data (RWD), which is data from actual patient treatments, provides valuable information on safety and effectiveness of innovative new health technologies, often at significantly lower cost than evidence generated...more

McGuireWoods LLP

Rethinking FDA’s Accelerated Approval Pathway: New Draft Guidances and Implications for Drug Companies

McGuireWoods LLP on

The U.S. Food and Drug Administration (FDA) recently issued two new guidance documents governing details of the Accelerated Approval Program, including a focus on product withdrawal and requirements for ongoing confirmatory...more

McCarter & English Blog: Government Contracts...

Antitrust Corporate Compliance Programs: Late 2024 Changes Mean Companies Should Revisit Their Programs Early in 2025

The US Department of Justice Antitrust Division (DOJ or Division) recently released a revised Evaluation of Corporate Compliance Programs in Criminal Antitrust Investigations (Guidance). The Guidance reflects how the Division...more

Lathrop GPM

OIG Issues New Nursing Facility Compliance Guidance, Comes on the Heels of Enhanced Medicare Enrollment Requirements for SNFs

Lathrop GPM on

The Office of Inspector General at the U.S. Department of Health and Human Services (OIG) recently followed up on a 2023 commitment to supplement its General Compliance Program Guidance (GCPG) by publishing its first...more

King & Spalding

OIG Issues Nursing Facility Compliance Guidance

King & Spalding on

On November 20, 2024, OIG released new compliance program guidelines for nursing facilities titled, “Nursing Facility Industry Segment-Specific Compliance Program Guidance” (the Nursing Facility ICPG or the Guidance). The...more

McDermott Will & Emery

CMS Issues Guidance on Usage of AI in Making Coverage Determinations

McDermott Will & Emery on

On February 6, 2024, the US Centers for Medicare & Medicaid Services (CMS) issued a letter to all Medicare Advantage (MA) organizations and Medicare-Medicaid plans. The letter covered frequently asked questions and answers...more

King & Spalding

OCR Provides Guidance Regarding Patient Visitation Rights

King & Spalding on

On January 25, 2024, HHS Office for Civil Rights (OCR) issued guidance and responses to frequently asked questions regarding nondiscrimination regulations related to patient visitation. Hospitals, long term care facilities,...more

McNees Wallace & Nurick LLC

The OIG Releases Updated General Compliance Program Guidance

As 2023 came to a close, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released an updated General Compliance Program Guidance (GCPG) manual, which serves as a reference guide for...more

Cornerstone Research

Potential Unintended Economic Impacts of the Inflation Reduction Act on the Pharmaceutical Industry

Cornerstone Research on

The Inflation Reduction Act (IRA) was signed into law in August 2022 with the goal of curbing inflation by, among other things, lowering prescription drug prices. Notable prescription drug provisions of the IRA include the...more

Foley Hoag LLP

CMMI Announces Medicare Dementia Care Model

Foley Hoag LLP on

The GUIDE Model is an eight-year model that will test an alternative payment for participants that delivers key supportive services to people with dementia, including comprehensive, person-centered assessments and care plans,...more

Holland & Knight LLP

CMS Proposes Transitional Coverage for Emerging Technologies

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The Centers for Medicare & Medicaid Services (CMS) recently issued a long-awaited Notice with Comment Period outlining a proposed Transitional Coverage for Emerging Technologies (TCET) pathway under Medicare that would be...more

McDermott+

CMS Releases Procedural Notice with Comment Period on Transitional Coverage for Emerging Technology

McDermott+ on

On June 22, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a procedural notice with comment period on Transitional Coverage for Emerging Technologies (TCET), a new pathway that uses existing national coverage...more

King & Spalding

OIG Issues Guidance for Ambulatory Surgery Center Safe Harbor’s “One-Third” Income Test

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In March, OIG published a new frequently asked questions (FAQ) page, General Questions Regarding Certain Fraud and Abuse Authorities. The FAQ page, located here, includes new guidance for ambulatory surgery center (ASC)...more

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