Hospice Insights Podcast - Hospice Audit Updates: Hospices Fare Well in Federal Court
HHS OIG’s Nursing Facility: Industry Segment-Specific Compliance Program Guidance
Podcast - Innovations and Insights in the Palliative Care Space
Hospice Insights Podcast - Hospice Audit Updates: David Beats Goliath
False Claims Act Insights - Trump DOJ Sharpens Its Focus on Healthcare Fraud
UPIC Audits
AGG Talks: Home Health & Hospice Podcast - Episode 10: Anti-Kickback Compliance for Hospice and Skilled Nursing Providers
Healthcare Industry Segment-Specific Compliance Program Guidances (ICPGs)
Hospice Insights Podcast - One Size Doesn’t Fit All: Figuring Out What is Your Hospice+
AGG Talks: Cross-Border Business Podcast - Episode 27: U.S. Healthcare Reimbursement Guidance for Foreign Life Sciences Companies
AGG Talks: Home Health & Hospice Podcast - Episode 8: Hospice Special Focus Program: Pumping the Brakes
Hospice Insights Podcast - Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
Podcast — Drug Pricing: How the Demise of Chevron Deference and Other Litigation May Impact the Pharmaceutical Industry
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 187: South Carolina Hospitals and Healthcare Industry Trends with Thornton Kirby, SCHA President
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Medical Device Legal News with Sam Bernstein: Episode 19
Stakeholders in the Medicare value-based care world have without a doubt heard of the Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), and alternative payment models (APMs). While all these initiatives...more
On July 9, 2025, the U.S. Department of Justice (“DOJ”) announced it sent more than 20 subpoenas to physicians and clinics involved in providing gender-affirming care to minors, and that the subpoenas related to...more
Consistent with recent attention from Congress and rhetoric from the Trump administration, the Calendar Year 2026 Medicare Hospital Outpatient Prospective Payment System (OPPS) proposed rule (the Proposed Rule) includes...more
On July 16, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule for the Ambulatory Specialty Model (ASM), a mandatory, five-year alternative payment model for select specialists who regularly treat...more
Last week, the Centers for Medicare & Medicaid Services (CMS) issued two major regs: the calendar year (CY) 2026 Medicare Physician Fee Schedule (PFS) proposed rule and the CY 2026 Outpatient Prospective Payment System (OPPS)...more
The American Medical Association (AMA) CPT®* Editorial Panel will convene in Chicago, Illinois, from September 18 to 20, 2025. The meeting agenda includes proposals to create new current procedural terminology (CPT) codes and...more
The Center for Medicare and Medicaid Innovation ("CMMI") announced sweeping changes to the Kidney Care Choices Model ("KCC Model"), a key set of value-based programs....more
July 2, 2025 – There has been a lot of talk recently about the future of the Medicare Physician Fee Schedule (PFS) conversion factor (CF) – the standardized dollar amount used to convert relative value units (RVUs) into...more
On May 22, 2025, after a marathon markup session, the U.S. House of Representatives passed a bill containing significant proposed changes to the Medicaid program....more
“Kicking Off Accountable Care” served as the theme for this year’s America’s Physician Groups’ (“APG”) Spring Conference, a three-day event packed with compelling speakers and breakout sessions focused on the state of...more
In recent years, we have seen an emerging number of physicians and health care providers transitioning to concierge, direct-to-consumer practices. Many providers no longer want to deal with the hassles of billing insurance,...more
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for April 2025, including Centers for Medicare & Medicaid Services (CMS) updates to Medicare Advantage (MA) and other Medicare programs....more
Following the announcement that four Center for Medicare and Medicaid Innovation (CMMI or Innovation Center) models will end in 2025, the Centers for Medicare & Medicaid Services (CMS) has begun signaling what's next for the...more
The Center for Medicare and Medicaid Services ("CMS") has announced significant changes to its value-based payment model portfolio projected to save $750 million as part of a shift in the agency's refocused strategy toward...more
Through a recent stopgap funding bill, Congress has extended several telehealth-related flexibilities that are critical for Medicare beneficiaries and providers until September 30, 2025. As we previously reported, the...more
As Medicare physician reimbursement continues in 2025 to suffer from damaging shortfalls due to budget neutrality and lack of an inflation adjuster, steps are being taken in Congress to address the issue. On January 31, the...more
News Briefs - Trump Signs Executive Order to Improve Health Price Transparency - U.S. President Donald Trump signed an executive order aiming to improve price transparency on healthcare costs by directing federal agencies to...more
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for January 2025. This month features long-awaited proposed and final rules regarding the Health Insurance Portability and Accountability...more
While a physician practice management (PPM) structure allows for compliance with corporate practice of medicine laws and ease of administration, it often creates inadvertent health plan issues that should be navigated...more
Value-based care (VBC) is a healthcare delivery model that prioritizes patient outcomes over the volume of services provided. This approach aims to enhance the quality of care while controlling costs by incentivizing...more
Episode 13: The Future of Value-Based Care with Dr. Vishnukamal Golla In this episode of BRight Minds in Healthcare Delivery, host Eric Tower interviews Dr. Vishnukamal Golla, the medical director for value transformation at...more
CMS issued its Final Rule for the 2025 Medicare Physician Fee Schedule in November. Originally published in the Allegheny County Medical Society (ACMS) Bulletin - December 2024....more
Here we go again! For the second year in a row, we enter the new year without Congress enacting a doc fix or Advanced Alternative Payment Model (APM) bonus extension. While Congress did act last year on both counts (through...more
As the shift toward value-based care continues to transform the healthcare industry, hospitals and health systems are increasingly utilizing incentive-based physician compensation structures. Incentive-based compensation...more
School is out and it is summertime, which means only one thing in the health policy community: reg season! This is the time of the year when the Centers for Medicare & Medicaid Services (CMS) releases regulations that propose...more