A recent federal court decision has the potential to significantly impact the future of False Claims Act (FCA) lawsuits initiated by whistleblowers and to upend the FCA. In United States of America ex rel. Clarissa Zafirov v....more
The Centers for Medicare & Medicaid Services (CMS) recently published a proposed rule, 89 FR 61596, that revives portions of a 2022 proposal to amend the Medicare Overpayment Rule. The 2024 proposed rule comes after...more
Certified registered nurse anesthetists (CRNAs) in Washington, DC can now practice without a collaborating physician following the DC legislature’s recent passing of Bill B25-0545, also known as the Health Occupations...more
The Centers for Medicare & Medicaid Services (CMS), the Office of the National Coordinator for Health Information Technology (ONC), and thr Department of Health and Human Services (HHS) published 89 FR 51238 (the Final Rule),...more
The Centers for Medicare & Medicaid Services (CMS) has adopted an age-friendly quality hospital measure in its most recent final rule addressing prospective payment systems, policy changes, and quality program requirements...more
Two New Jersey healthcare facilities that violated the New Jersey Patient Safety Act, N.J.S.A. §§ 26:2H-12.23 to -12.25, (PSA), must provide plaintiff patients with internal reports and documents relating to adverse events,...more
The Master List for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) comes from a November 2019 final rule that created the list to serve as a library of items that have been identified as potential...more
On July 31, 2024, the Department of Health and Human Services (HHS) final rule, 89 FR 54662, establishing disincentives for certain healthcare providers that have committed information blocking, will become effective. This...more
Through its recent decision in Loper Bright Enterprises v. Raimondo, No. 22-451 (S. Ct. June 28, 2024), the US Supreme Court overturned the landmark decision in Chevron U.S.A. Inc. v. Natural Resources Defense Council, Inc.,...more
7/18/2024
/ Administrative Procedure Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Federal Bans ,
Federal Trade Commission (FTC) ,
Government Agencies ,
Healthcare ,
Loper Bright Enterprises v Raimondo ,
SCOTUS ,
Statutory Interpretation
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
6/12/2024
/ Bias ,
Dentists ,
EMTs ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Home Health Care ,
Medicaid ,
Medical Devices ,
Medical Equipment ,
Mental Health ,
Out-of-State Employees ,
Per Diem ,
Prior Authorization ,
Reimbursements ,
Reproductive Healthcare Issues ,
Skilled Nursing Facility ,
Training ,
Transparency
Every year, the New Jersey legislature passes statutes that impact healthcare beyond rate increases under the Medicaid program. Last year was no different, and the discussion below highlights some of those statutes, such as...more
6/6/2024
/ Acute Facilities ,
Centers for Medicare & Medicaid Services (CMS) ,
Cost-Sharing ,
Drug Pricing ,
False Claims Act (FCA) ,
Healthcare ,
Hospitals ,
Licensees ,
Medical License ,
Mental Health ,
New Jersey ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Supply Chain ,
Telehealth
In an informational bulletin, the Centers for Medicare & Medicaid Services (CMS) announced it will further extend waivers for “unwinding” under Section 1902(e)(14)(A) of the Social Security Act until June 30, 2025. The...more
The U.S. Food and Drug Administration (FDA) published a final rule amending its regulations to include in vitro diagnostic products (IVDs) as devices, even those manufactured in a laboratory, and issuing policy to phase out...more
Part II of our New Jersey Regulatory Update further identifies proposed and adopted regulations that may impact healthcare providers, from additional financial transparency rules impacting facilities to rules attempting to...more
5/10/2024
/ Child Care ,
Dental Practice ,
Department of Health and Human Services (HHS) ,
Disabilities ,
Financial Transactions ,
Health Care Providers ,
Healthcare ,
Healthcare Facilities ,
Hospitals ,
Inpatient Rehab Facilities ,
Long Term Care Facilities ,
Medicaid ,
New Jersey ,
Pharmaceutical Industry ,
Pharmacist ,
Recordkeeping Requirements ,
Regulatory Standards ,
State Health Departments ,
Transparency
It is that time of year for our regulatory update. Parts I and II will discuss proposed and adopted rules from the second half of last year to the first quarter of this year that impact healthcare providers in New Jersey,...more
5/8/2024
/ Abortion ,
Background Checks ,
Certifications ,
Continuing Education ,
Coronavirus/COVID-19 ,
Disabilities ,
Donations ,
Executive Orders ,
Healthcare ,
License Renewals ,
Long Term Care Facilities ,
Medicaid ,
Mental Health ,
New Jersey ,
Office of Consumer Affairs ,
Physicians ,
Prescription Drugs ,
Regulatory Standards ,
State Health Departments
The Third Circuit Court of Appeals held in a recent precedential case that the court must compel arbitration between Government Employees Insurance Company (Geico) and several medical practices, which Geico had sued for fraud...more
The Federal Trade Commission (FTC) approved a sweeping ban on non-compete agreements by employers on April 23, 2024, in a 3-2 vote. The final rule provides that it is “an unfair method of competition” and thus a violation of...more
The contentious “Nursing Home Minimum Staffing Rule,” which sets minimum staffing requirements for federally funded long-term care facilities throughout the U.S., was finalized on April 22, 2024. The rule was initially...more
On April 22, 2024, the Department of Health and Human Services (HHS) announced a Final Rule titled HIPAA Privacy Rule to Support Reproductive Health Care Privacy. The Final Rule strengthens the Health Insurance Portability...more
On April 4, 2024, a final rule published on February 2, 2024 (the Final Rule) went into effect that concerns medication for the treatment of opioid use disorder. The Final Rule, published by the Substance Abuse and Mental...more
New guidance released by the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) on April 1, 2024, clarified that hospitals will not be eligible for Medicare or Medicaid...more
4/11/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Conditions of Participation (CoP) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Final Rules ,
Healthcare ,
Hospitals ,
Informed Consent ,
Medical Examinations ,
Nurses ,
Pharmaceutical Industry ,
Physicians ,
Teaching Hospitals ,
Vaccinations
On March 18, 2024, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services updated its bulletin on the Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates. The...more
For the past month or longer, many providers have reported a significant impact on their revenue cycle due to the cyberattack on Change Healthcare, LLC. In light of that impact, the Centers for Medicare & Medicaid Services...more