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New Rules Centers for Medicare & Medicaid Services (CMS)

Akin Gump Strauss Hauer & Feld LLP

Akin Intelligence - November/December 2024

Welcome to the November-December edition of Akin Intelligence. As the end of 2024 approached, the European Union (EU) sustained progress on guidance and supporting materials for its AI Act and international AI Safety...more

Bass, Berry & Sims PLC

New CMS Policies Position the MSSP for Expansion and Increased Savings

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New policies tucked into the Centers for Medicare and Medicaid Services’ (CMS) 2025 Medicare Physician Fee Schedule Rule (Final Rule) will likely spur increased Accountable Care Organization (ACO) participation in the...more

Health Care Compliance Association (HCCA)

Early returns on MA plans’ two-midnight rule interpretations: A compliance nightmare

The Centers for Medicare and Medicaid Services (CMS) issued regulations applicable to Medicare Advantage (MA) plans—also commonly referred to as managed Medicare or Part C Medicare—in April 2023 (CMS 4201–F) that address,...more

Bass, Berry & Sims PLC

New Rule Curbs Impact of Suspect DME Claims on 2023 MSSP Financial Calculations

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Effective October 15, a new Final Rule issued by the Centers for Medicare & Medicaid Services (CMS) will allow the Medicare Shared Savings Program (MSSP) to adjust calendar year (CY) 2023 benchmark and expenditure...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, Issue 5, September 2024

Welcome to our fourth issue of The Health Record - our healthcare law insights e-newsletter. In this edition, we take a look at the Biden administration's proposed insurance rule regarding mental health and substance use...more

Polsinelli

New CMS Staffing Rules for Long Term Care Providers – What you need to know now

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On May 10, 2024, the Centers for Medicare and Medicaid Services (“CMS”) published a final rule implementing mandatory hours per resident day (“HPRD”) requirements for various levels of nursing staff for skilled nursing...more

Harris Beach Murtha PLLC

New Rule Improves Access to Medicaid, Other Federal Health Care

The federal government recently issued a new rule to make it easier for millions of eligible U.S. residents to enroll in and retain their Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health Program (BHP)...more

Foley Hoag LLP - Medicaid and the Law

CMS Issues Rule Implementing Medicaid Redetermination Policies

We’ve written recently about the process that states are undertaking to begin to wind down the Medicaid enrollment expansion that was necessitated by the enactment of the Families First Coronavirus Response Act in March of...more

McDermott+

Navigating the New IDR Batching Rules and Deadline Extensions

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If you have been following the implementation of the No Surprises Act independent dispute resolution (IDR) process, you have likely seen a bunch of new rules, guidance documents and deadline extensions come out recently and...more

Polsinelli

Ownership Transparency Continues for Skilled Nursing Facilities with Additional Required Disclosures

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On November 15, 2023, CMS finalized a proposed rule that will require Skilled Nursing Facilities (“SNFs”) to disclose the identity of an expanded array of ownership and control interests in SNFs beyond the information that is...more

Husch Blackwell LLP

I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules

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Audits that employ statistical extrapolation can turn a handful of claim denials into a liability of hundreds of thousands or millions of dollars. After years of relative quiet, the statisticians are back. The Centers for...more

McDermott Will & Schulte

Biden Administration and CMS Propose New Rule to Provide Greater Transparency for Nursing Home Ownership

Following the Biden administration’s efforts to promote nursing home safety, transparency, accountability and quality, the US Centers for Medicare & Medicaid Services (CMS) announced a proposed rule governing nursing home...more

Perkins Coie

New CMS Rule Requires Extrapolation of Medicare Advantage RADV Audit Findings

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The Centers for Medicare and Medicaid Services (CMS) published its final rule regarding the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program in early February 2023. Among other matters, the final rule...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - August 5th, Philadelphia, PA

Looking for compliance training and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance training, including updates on the latest news in regulatory...more

Health Care Compliance Association (HCCA)

Patient information access automated with the Cures Act

Compliance Today (May 2022) - United States healthcare professionals and patients stand upon the cusp of unprecedented, burdensome regulatory changes that will affect automation and how we manage access to patient...more

Littler

Mandatory Employee Vaccines – Coming to A State Near You? (UPDATED)

Littler on

While available vaccines have proven highly effective in controlling COVID-19 and its variants to date, the virus continues to spread, particularly among unvaccinated populations. In the face of flagging interest, officials...more

Foley & Lardner LLP

Medicare Telehealth and Substance Use Disorder Treatment FAQs: New CMS Reimbursement Requirements

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In the 12-month period starting in April 2021, over 100,000 people have died from drug overdoses, a 28.5% increase from the same period the year before. While the opioid crisis has been a declared public health emergency...more

Foley & Lardner LLP

Medicare Telehealth Mental Health FAQs: CMS and the New In-Person Exam Requirement

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The Centers for Medicare & Medicaid Services (CMS) has finalized its rule on in-person exam requirements for Medicare coverage of telehealth-based mental health services when the patient is located at home. The Frequently...more

Fisher Phillips

Medicare and Medicaid Participants Face Sweeping New Workplace Vaccination Rule: A 5-Step Survival Guide

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Note: This CMS Rule refenced in this Insight is separate and distinct from the OSHA ETS that was issued on November 4. Thus, although the CMS Rule could also be challenged in court, the November 6 court order blocking...more

Harris Beach Murtha PLLC

OSHA and CMS Publish Rules on Covid-19 Vaccination Mandates

The Occupational Safety and Health Agency (OSHA) and the Center for Medicare and Medicaid Services (CMS) published highly anticipated rules requiring covered employers to implement Covid-19 vaccination mandates for their...more

Bowditch & Dewey

New CMS Regulations Mandating Vaccination of Health Care Facility Staff

Bowditch & Dewey on

On November 5, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued an interim final rule requiring that a wide variety of providers and suppliers participating in the Medicare program ensure their staff are...more

Bowditch & Dewey

Biden Administration Announces New Vaccine Mandate for Employers

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On September 9, 2021, President Joe Biden announced sweeping COVID-19 vaccination and testing requirements applicable to both public and private employers nationwide. The following is an overview of the important upcoming...more

Fisher Phillips

The Top 18 Workplace Law Stories from August 2021

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It’s hard to keep up with all the recent changes to labor and employment law. While the law always seems to evolve at a rapid pace, there have been an unprecedented number of changes for the past few years—and this past month...more

Fisher Phillips

Hospitals Face Another Administrative Challenge: A New Obligation to Report and Track Employee Vaccination Rates

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In shrewd consideration of the healthcare industry’s unique acute care settings, states, localities, and individual hospitals across the nation have prioritized efforts to increase vaccination rates among healthcare workers....more

Steptoe & Johnson PLLC

What to Expect, Part III: Modified AKS Safe Harbor for Personal Services & Management Contracts

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The Office of Inspector General’s (“OIG”) new Anti-Kickback Statute (“AKS”) regulations modify the safe harbor for personal services and management contracts (42 CFR § 1001.952(d)) in a manner that allows providers...more

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