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Healthcare Centers for Medicare & Medicaid Services (CMS)

McDermott+

Medicare FFS Regs: Thrills and Chills Under the Trump and Biden Administrations

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Happy Halloween! In the health policy world, there are two things on everyone’s mind this spooky season: the upcoming election and the major calendar year (CY) 2025 Medicare fee-for-service (FFS) final regs that should be...more

Manatt, Phelps & Phillips, LLP

HHS OIG Scrutinizes Medicare Advantage Use of Health Risk Assessments

On October 24, the HHS Office of Inspector General (OIG) released a report titled “Medicare Advantage: Questionable Use of Health Risk Assessments Continues to Drive Up Payments to Plans by Billions.” In evaluating 2022 MA...more

Manatt, Phelps & Phillips, LLP

Groundbreaking Approvals for Medicaid and CHIP Coverage of Traditional Health Care

On October 16, CMS approved Section 1115 demonstration amendments in four states—Arizona, California, New Mexico, and Oregon—to authorize Medicaid and Children’s Health Insurance Program (CHIP) coverage of traditional...more

Alston & Bird

Health Care Week in Review: HHS Released Proposed Rules Enhancing Coverage of Preventive Services; OIG Released Report on...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | September 2024 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for September 2024. We discuss several enforcement actions pertaining to healthcare fraud, including alleged violations under the False...more

McDermott+

It’s the Final Countdown: Comparing the Last Regulatory Actions of the Biden and Trump Administrations

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The election is approaching fast, and no matter who wins, there will be a change in administration come January 20, 2025. Thus, the Biden Administration is in the midst of making its final mark on priority healthcare...more

Alston & Bird

Health Care Week in Review: HHS Announced Updates on Response to IV Fluid Shortage and 233 Members Call on House Leadership to...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Manatt, Phelps & Phillips, LLP

CMS Proposed 2026 Notice of Benefit and Payment Parameters Rule Focuses on Marketplace Oversight

On October 4, the Centers for Medicare & Medicaid Services (CMS) released the proposed Notice of Benefit and Payment Parameters (NBPP) for plan year 2026. This proposal begins the annual rulemaking cycle for the Marketplaces...more

Akerman LLP - Health Law Rx

Zafirov Decision Sets Stage for Appellate Showdown Over Constitutionality of FCA’s Qui Tam Provision

For the first time ever, a judge has ruled that the qui tam provision of the False Claims Act (FCA), which whistleblowers have used to recover $52 billion on behalf of the government since 1986, is unconstitutional....more

McDermott+

Regs Coming Through the End of the Year: Expect the Expected and the Unexpected

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There could be an all-you-can-eat buffet of regs (and eggs) from now until the end of the year! As you may recall, a July 2024 Regs & Eggs blog post highlighted the spring 2024 “unified agenda” that listed all the regs...more

Manatt, Phelps & Phillips, LLP

CMS Releases Final 2027 IRA Negotiation Guidance

On October 2, the Centers for Medicare & Medicaid Services (CMS) released final guidance outlining how the agency will implement the Inflation Reduction Act’s (IRA) Medicare Drug Price Negotiation Program (the “Program”) for...more

Manatt, Phelps & Phillips, LLP

CMS Releases Guidance on Health Coverage Requirements for Children and Youth Enrolled in Medicaid

On September 26, the Centers for Medicare and Medicaid Services (CMS) released comprehensive guidance to states that reinforces and clarifies federal Medicaid requirements regarding Early and Periodic Screening, Diagnostics,...more

McCarter & English, LLP

CMS Proposes Further Changes to Medicare Overpayment Rule

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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

Manatt, Phelps & Phillips, LLP

CMS Guidance on Expectations for State Compliance with Medicaid and CHIP Renewal Requirements

On September 20, the Centers for Medicare & Medicaid Services (CMS) issued guidance detailing the timeline and expectations for states to fully comply with federal Medicaid and Children’s Health Insurance Program (CHIP)...more

McDermott+

McDermott+ Check-Up (Special Regulatory Edition): October 11, 2024

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Congress Continues Election Recess. Members are on the campaign trail and are scheduled to return for the lame duck session on November 12, 2024. CMS Releases Proposed NBPP for 2026. The proposed Notice of Benefit and...more

McDermott+

CMMI’s Accountable Care Strategy: A Perspective

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McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. Click here to subscribe to future blog posts. October 10, 2024 – For several years, the Center for Medicare & Medicaid...more

Brownstein Hyatt Farber Schreck

Health Care Policy Positions: Expectations for a Harris or Trump White House

With less than one month until the presidential election, health care policy issues are at the forefront of voters’ minds, including issues around drug pricing, federal research funding and reproductive rights....more

Manatt, Phelps & Phillips, LLP

CMS Releases Guidance Outlining Expectations for State Compliance with Medicaid & CHIP Renewal Requirements

On September 20, 2024, the Centers for Medicare & Medicaid Services (CMS) issued guidance detailing the timeline and expectations for states to fully comply with federal Medicaid and Children’s Health Insurance Program (CHIP)...more

Arnall Golden Gregory LLP

New OIG Report Suggests Medicare Remote Patient Monitoring Services May Face Increased Government Scrutiny

On September 24, 2024, the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) posted a report entitled, “Additional Oversight of Remote Patient Monitoring in Medicare is Needed.”...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | August 2024 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for August 2024. We discuss several enforcement actions pertaining to healthcare fraud, including alleged violations under the False...more

Alston & Bird

Health Care Week in Review: HHS Released Final Guidance for the Second Cycle of Medicare Drug Price Negotiations; CMS Released...

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Ankura

Navigating the Fallout: Essential Insights for Healthcare Companies in Light of the Change Healthcare Cyber Breach

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The cyber breach at Change Healthcare in 2024 stands out as one of the most significant cyber-attacks in recent memory. Its repercussions extend far beyond immediate industry disruptions, resonating deeply in regulatory...more

Arnall Golden Gregory LLP

OIG Issues Unfavorable Opinion on MAO’s Proposed Gainshare Program

The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released an unfavorable advisory opinion, OIG Advisory Opinion No. 24-08 (the “Opinion”), to a Medicare Advantage Organization (“MAO”)....more

McDermott+

CMS Issues Guidance to States on Children’s Access to Medicaid Coverage

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Last week, the Center for Medicaid and CHIP Services within the Centers for Medicare & Medicaid Services (CMS) released what it calls “historic” guidance to states on best practices for adherence to early and periodic...more

DLA Piper

OIG Report Recommends Oversight for Remote Patient Monitoring in Medicare

DLA Piper on

On September 24, 2024, the Office of Inspector General (OIG) at the US Department of Health and Human Services (HHS) issued a report titled, “Additional Oversight of Remote Patient Monitoring in Medicare Is Needed” (the...more

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