News & Analysis as of

Regulatory Oversight Centers for Medicare & Medicaid Services (CMS) Medicaid

DLA Piper

GAO Report Gives MA Organizations and Behavioral Health Providers Food for Thought on Prior Authorization

DLA Piper on

The US Government Accountability Office (GAO) recently released a report on the Centers for Medicare and Medicaid Services (CMS)’s oversight of prior authorization criteria for behavioral health services (BHS) by Medicare...more

King & Spalding

CMS Will Likely Stop Funding Certain State Medicaid Programs

King & Spalding on

CMS announced this month that it does not anticipate using federal funds to match state funds for designated state health programs (DSHP) and designated state investment programs (DSIP) under its section 1115 demonstration...more

Mintz - Health Care Viewpoints

HHS Restructuring and Workforce Reductions – Key Implications for the Health Care Industry

As spring arrived in the mid-Atlantic region, the Department of Health and Human Services (HHS) under Robert F. Kennedy, Jr. followed through with a previously announced Reduction in Force (RIF) that reduced the department’s...more

Stevens & Lee

U.S. HHS Announces Closure of Six Regional Locations of the Office of the General Counsel

Stevens & Lee on

On March 11, 2025, the U.S. Department of Health and Human Services (HHS) announced plans for a “reorganization of the Office of the General Counsel” (OGC) “[a]s part of the department’s ongoing efforts to advance the...more

Arnall Golden Gregory LLP

HHS to Close 6 of 10 Regional OGC Offices, With Potentially Significant Impacts on Providers and Suppliers

On Tuesday, March 11, 2025, the U.S. Department of Health and Human Services (“HHS”) announced plans to close six of the nation’s 10 regional offices for the HHS Office of the General Counsel (“OGC”). These closures, which...more

McDermott+

It’s Raining Regs: CMS Releases Major Laboratory-Developed Test Reg in Midst of Massive Reg Storm

McDermott+ on

Over the last several weeks, the Biden administration has released numerous final regulations in order to “beat the clock” before it ticks down to the Congressional Review Act (CRA) deadline. The CRA authorizes Congress to...more

ArentFox Schiff

Fast Five: Important Law and Policy Updates for US Health Care Transactions

ArentFox Schiff on

With the end of the first quarter of 2024, we highlight five developments, changes, or challenges that health systems, hospitals, nursing homes, clinics, physician practices, health insurers, and other health care providers,...more

Baker Donelson

OIG Reports Highlight State Challenges and Call for Increased Oversight to Improve the Provision of Medicaid Behavioral Health...

Baker Donelson on

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently issued two data briefs addressing challenges with the provision of behavioral health services to Medicaid enrollees, and calling for...more

Baker Donelson

A Flurry of Recent Activity Highlights Continued Interest in 340B Program Oversight

Baker Donelson on

Four separate government releases coming over a three-week period have once again highlighted the intense interest in the 340B drug pricing program, with a federal agency and two government watchdog groups issuing guidance...more

McDermott Will & Emery

2020 Starts Off with Two Government Publications Critical of 340B Program Oversight

McDermott Will & Emery on

Less than two weeks into the new year, the federal government has released two new publications addressing concerns related to 340B Program oversight by both state and federal agencies. After a relatively quiet 2019, 340B...more

ArentFox Schiff

CMS Proposes Increased Scrutiny of Medicaid Supplemental Payments and Related State Financing Arrangements

ArentFox Schiff on

In what is widely considered to signal intensified focus by the Federal government on Medicaid supplemental payments and related State Medicaid financing mechanisms, the Centers for Medicare & Medicaid Services (CMS) on...more

Baker Donelson

New PACE Rules Reduce Oversight, Increase Flexibility for Participating Organizations

Baker Donelson on

For the first time since 2006, CMS has issued updated rules affecting the Program for All-Inclusive Care for the Elderly, or PACE organizations. The final rule, published in the June 3, 2019 issue of the Federal Register,...more

Sheppard Mullin Richter & Hampton LLP

Recent Activity in Medicare Audit Programs: CMS Announces Increase in Audit Contractor Oversight

The Centers for Medicare and Medicaid Services (“CMS”) healthcare audit programs – including the Unified Program Integrity Contractors (“UPICs”) audit program, the Recovery Audit Contractor (“RAC”) program, the Comprehensive...more

Bricker Graydon LLP

CMS finalizes site-neutral payment for clinic visits but declines to finalize clinical families payment limitation

Bricker Graydon LLP on

In its final Calendar Year (CY) 2019 Outpatient Prospective Payment System (OPPS) Rule released November 2, 2018 (the Final Rule), the Centers for Medicare & Medicaid Services (CMS) finalized its proposal to make payments for...more

Baker Donelson

OIG October 2018 Work Plan Update

Baker Donelson on

The OIG added five new items to its Work Plan in the October 2018 update: (1) childcare provider compliance with criminal background check requirements; (2) early results from Opioid State Targeted Response Grants; (3)...more

Hogan Lovells

CMS proposes requiring drug prices in TV ads

Hogan Lovells on

On October 15, CMS released a proposed rule titled “Medicare and Medicaid Programs: Drug Pricing Transparency,” which would require direct-to-consumer (DTC) advertisements for prescription drugs covered by Medicare or...more

Mintz - Health Care Viewpoints

Federal Commission Recommends Streamlining Medicaid Waiver Authorities

In March, the Medicaid and CHIP Payment and Access Commission (MACPAC) released its biannual report to Congress. MACPAC is an independent congressional agency that advises Congress on issues relating to Medicaid. In its...more

Epstein Becker & Green

Medicaid Outlook: Policy and Regulatory Change in 2017

Epstein Becker & Green on

Perspectives on Health Care and Life Sciences - Medicaid has been a vital part of the American health care safety net for more than 50 years. Today, Medicaid, along with the State Children’s Health Insurance Program...more

Carlton Fields

The New “Price” of U.S. Health Care: The Future of Value-based Reimbursement Under President-elect Trump and Tom Price

Carlton Fields on

The total U.S. health care expenditure was $3.2 trillion in 2015, and is projected to grow to nearly $5.6 trillion by 2025. As our nation’s cost of care rises, both Democrats and Republicans recognize the overwhelming need to...more

Foley & Lardner LLP

New Report Highlights Period of Transformation for the Medicaid Program, Urges Greater Federal Oversight

Foley & Lardner LLP on

The U.S. Governmental Accountability Office (GAO) has issued a new report to Congress identifying key issues facing the Medicaid program and urging greater federal oversight. The report comes at a time of significant...more

20 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide