On August 12, 2024, OIG announced the results of an audit of payments made to hospitals for inpatient claims with the Medicare Severity Diagnosis-Related Groups (MS-DRGs) that require ninety-six hours of consecutive...more
On July 31, 2024, CMS published a final rule updating the Medicare rates and policies applicable to inpatient rehabilitation facilities (IRFs) under the IRF Prospective Payment System (PPS) and the IRF Quality Reporting...more
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
At last week’s America’s Physician Group Spring conference in San Diego, California, our team heard firsthand how physicians are leading efforts to integrate Artificial Intelligence (AI) applications in ambulatory and...more
I. Certificate of Need Program - A. Contested Case - AL2023-021, Affinity Hospital, LLC d/b/a Grandview Medical Center, Hoover, AL: Proposes to establish a Freestanding Emergency Department (FED) in the city of Hoover,...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
On March 29, 2024, CMS published its fiscal year (FY) 2025 prospective payment system (PPS) proposed rule for inpatient rehabilitation facilities (IRFs). Comments are due by 5 pm ET on May 28, 2024. In the IRF PPS proposed...more
I. Certificate of Need Program - A. Project Modification Request - AL2021-003, Crimson Village, LLC, Tuscaloosa County, AL: The project modification request is for the approval to relocate the specialty care assisted...more
Medicare’s open enrollment period is just a few weeks away, and it is not too early to start thinking about your coverage options. One benefit area that Medicare recipients often overlook is long term rehabilitation coverage....more
On July 27, 2023, CMS issued a final rule updating Medicare payments and policies under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the IRF Quality Reporting Program for FY 2024 (Final IRF...more
The House and Senate were both in session this week, with healthcare activity at the committee level. The House Ways and Means Committee held a markup focused on healthcare transparency and consolidation legislation. The...more
I. Certificate of Need Program A. A. AL2023-013, Birmingham Operations, LLC d/b/a Harmony at Birmingham, Trussville, AL: Proposes to construct and operate a thirty-two (32) bed Specialty Care Assisted Living Facility...more
Adult children in Pennsylvania with aging parents might be shocked to learn that they can be financially responsible for their parents’ nursing home bills. Pennsylvania, along with many other states, has filial support laws...more
On June 27, 2023, CMS hosted a Special Open Door Forum regarding its Review Choice Demonstration program for Inpatient Rehabilitation Facility Services (IRFs). CMS has stated that the Medicare IRF benefit continues to...more
The North Carolina Department of Health and Human Services Division of Health Service Regulation (DHSR) has published the draft 2024 State Medical Facilities Plan (SMFP), which was developed by the State Health Coordinating...more
I. Certificate of Need Program - A. AL2023-011, Metro Treatment of Alabama, L.P. d/b/a Birmingham Metro Treatment Center, Birmingham, AL: Proposes to relocate Birmingham Metro Treatment Center, an existing outpatient...more
I. Certificate of Need Program - A. Contested Case: AL2022-022, St. Vincent’s Birmingham, Pelham, AL: Proposes to develop a multi-specialty building to include a freestanding emergency department (FED), imaging center,...more
On April 4, 2023, CMS issued proposed rules for Fiscal Year (FY) 2024 to update Medicare payment policies for skilled nursing facilities (SNFs) and inpatient psychiatric facilities (IPFs). CMS notes these rules are intended...more
On April 3-4, Centers for Medicare & Medicaid Services (CMS) issued a number of proposed rules that would materially impact reimbursement rates for skilled nursing facilities (SNFs), inpatient psychiatric facilities (IPFs)...more
I. Certificate of Need Program - A. AL2022-033, North Alabama Specialty Hospital, LLC, Huntsville, AL: Proposes to add sixteen (16) long term acute care (LTAC) beds to its existing thirty-one (31) bed LTAC hospital in...more
This month, OIG updated its work plan to include a new Inpatient Rehabilitation Facility (IRF) Nationwide Audit. In explaining the new workstream, OIG cited high IRF error rates in other reviews and plans to determine whether...more
I. Certificate of Need Program - A. AL2022-020, Infirmary ASC - Saraland, LLC, Mobile, AL: Proposes to construct and operate a freestanding multi-specialty Ambulatory Surgery Center (ASC) consisting of four (4) operating...more
On July 27, 2022, CMS issued final rules for FY 2023 in its yearly update to Medicare payment policies and rates under the Inpatient Rehabilitation Facilities (IRFs) prospective payment system (PPS) and the Inpatient...more
The Biden administration recently released three final rules that provide for an aggregate $1.19 billion increase in Medicare payments in fiscal year 2023 for hospices, rehabilitation facilities, and psychiatric facilities. ...more
I. Certificate of Need Program - A. AL2022-005, Saad Enterprises, Inc. d/b/a Saad Hospice Services, Mobile, AL: Proposes to add ten (10) additional inpatient hospice beds to The Retreat, an existing inpatient hospice...more