News & Analysis as of

Medicare Waivers

King & Spalding

Federal Judge Vacates Regulation Excluding Section 1115 Days From DSH Formula

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On August 15, 2024, the United States District Court for the Northern District of Texas vacated a Medicare regulation excluding from the Medicare DSH payment days attributable to inpatients covered by a section 1115 waiver...more

McDermott+

Telehealth: Regulatory Questions Amid Legislative Uncertainty

McDermott+ on

Where has the time gone? We have hit the one-year mark since the end of the COVID-19 public health emergency (PHE). Yes, you read that correctly. One year! One of the long-term consequences of the PHE was the shift in when...more

Holland & Hart LLP

Patient Inducements: Law and Limits

Holland & Hart LLP on

Although often well-intentioned, offering free or discounted items or services to patients (e.g., gifts, rewards, writing off copays, free screening exams, free supplies, etc.) may violate federal and state laws governing...more

King & Spalding

CMS Issues IPPS and LTCH PPS Final Rule for FY 2024

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On August 1, 2023, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule for FY 2024 (the Final Rule). In the Final Rule, CMS,...more

Baker Donelson

Making Sense of the Varying End Dates of Telehealth Waivers and Flexibilities When the PHE Ends on May 11th

Baker Donelson on

With the COVID-19 Public Health Emergency (PHE) ending on May 11th, providers and practitioners must carefully consider the dates when various telehealth waivers and flexibilities end. This requires understanding the...more

Pullman & Comley - Connecticut Health Law

The Status of 10 Key CMS Waivers Affecting Health Care Practitioners Following the Expiration of the COVID Public Health Emergency...

The Centers for Medicare & Medicaid Services (CMS) used its emergency waiver authority to relax many aspects of health care delivery during the federal Public Health Emergency for COVID-19 (PHE) to allow health care...more

Mintz - Health Care Viewpoints

The End of the Federal COVID-19 Public Health Emergency is Near: What to Expect as HHS Transitions beyond the Emergency Phase

With less than two weeks left until the end of the federal COVID-19 Public Health Emergency (PHE), which is set to expire on May 11, 2023, the Department of Health and Human Services (HHS) is preparing to transition certain...more

Robinson & Cole LLP

Health Law Diagnosis - CMS Issues Guidance for Providers on Waivers, Flexibilities and End of COVID-19 Public Health Emergency

Robinson & Cole LLP on

The Centers for Medicare & Medicaid Services (CMS) recently issued a Fact Sheet (Fact Sheet) providing guidance on the impact of the end of the federal COVID-19 Public Health Emergency (PHE) on certain regulatory waivers,...more

Ankura

COVID-19 Public Health Emergency – Compliance Considerations as We Prepare for the End of the PHE

Ankura on

On January 30, 2023, the Biden Administration announced plans to end the Public Health Emergency (PHE) on May 11, 2023. The PHE was enacted on January 27, 2020, to provide flexibility to healthcare providers and payors...more

Bricker Graydon LLP

What to expect now that we’re expecting: What the end of the public health emergency means for healthcare providers

Bricker Graydon LLP on

On January 30, 2023, President Biden announced that both the COVID-19 national emergency and the public health emergency (PHE) will end May 11, 2023. This announcement has left many healthcare providers considering how the...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - January 2023

As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more

King & Spalding

GAO Releases Report and Recommendations to CMS to Address Risks Posed by Provider Enrollment Waivers and Flexibilities Implemented...

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On December 19, 2022, the U.S. Government Accountability Office (GAO) released a report titled, “Medicare: CMS Needs to Address Risks Posed by Provider Enrollment Waivers and Flexibilities” (GAO-23-105494). The report...more

Venable LLP

Return to "Normalcy" - Bracing for the End of the Public Health Emergency

Venable LLP on

In January 2020, Alex M. Azar, II, then secretary of the U.S. Department of Health and Human Services (HHS), signed a nationwide declaration of a Public Health Emergency (PHE) that would largely shape the response of public...more

Sheppard Mullin Richter & Hampton LLP

Finding Our Way Out of the Pandemic Haze: What Telehealth Tools Are Medicare Providers Allowed to Keep, and Which Must They Leave...

During the COVID-19 pandemic, Medicare coverage expanded to include a vast arsenal of tools that help patients access medical services while keeping patients and practitioners safe. Many of these tools involve telehealth...more

Verrill

The PHE is Ending: Do You Know Where Your Waivers Are?

Verrill on

While the pandemic is not over, the COVID-19 public health emergency (PHE) is expected to expire soon, which means that a number of operational, safety, and billing standards that were waived at the beginning of the pandemic...more

Willcox & Savage

You've Heard of Medicare and ERISA Liens, but What About the Federal Medical Care Recovery Act? The Federal Law Controlling the...

Willcox & Savage on

Claims adjusters are frequently warned to identify and resolve Medicare and Employee Retirement Income Security Act (“ERISA”) liens before finalizing settlements in personal injury claims. But there is another federal law...more

Butler Snow LLP

Telehealth in a Post-Pandemic World

Butler Snow LLP on

As we enter the third year of the pandemic, life with COVID-19 has become the new “normal” for many Americans. While debate can be had about when a pandemic ends or becomes endemic, there is no dispute that more and more...more

Mintz - Health Care Viewpoints

Telehealth Update: Assessing PHE Flexibilities, Pending Legislation Entering Fall 2022

As we covered in a prior Telehealth Update, many of the flexibilities upon which telehealth providers have come to rely in recent years are tied to the federal Public Health Emergency related to the COVID-19 pandemic (the...more

King & Spalding

CMS Releases Fact Sheets to Advise Regarding Eventual End of Medicare COVID-19 Waivers

King & Spalding on

In response to the COVID-19 Public Health Emergency (PHE), CMS temporarily waived a significant number of Medicare, Medicaid and Children’s Health Insurance Program (CHIP) requirements and conditions of participation pursuant...more

Foley & Lardner LLP

Enhancing Oncology Model - Successor to Oncology Care Model: What’s New

Foley & Lardner LLP on

The Center for Medicare and Medicaid Innovation (CMMI) is launching a long awaited new oncology model, the Enhancing Oncology Model (EOM). EOM is a successor to the Oncology Care Model (OCM), which ended June 30, 2020 after a...more

Foley & Lardner LLP

Medicare Telehealth Services for 2023 – CMS Proposes Substantial Changes

Foley & Lardner LLP on

On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released its proposed 2023 Medicare Physician Fee Schedule (PFS) rule. The rule, if enacted as proposed, will: Create three new permanent telehealth...more

Foley & Lardner LLP

Is Hospital Care at Home Here to Stay?

Foley & Lardner LLP on

It has been almost two years since the Centers for Medicare & Medicaid Services (CMS) first issued blanket waivers of certain hospital conditions of participation allowing healthcare systems and hospitals to provide hospital...more

Foley & Lardner LLP

The Federal Telehealth Extension and Evaluation Act: What You Need to Know

Foley & Lardner LLP on

What is the Telehealth Extension and Evaluation Act? The Telehealth Extension and Evaluation Act would establish a two-year extension for certain COVID-19 emergency telehealth waivers. The legislation aims to extend the...more

Womble Bond Dickinson

Opportunity Economy: Telehealth in the Pandemic - and Beyond

Womble Bond Dickinson on

Takeaways: ..Telehealth greatly expanded during the COVID-19 pandemic, in large part due to regulatory waivers. Those regulatory waivers aren’t permanent, but lawmakers are evaluating ways to permanently expand some...more

Bradley Arant Boult Cummings LLP

What’s Next for Long Term Care? Waivers, Laws and Regulations and the Next Chapter of the COVID-19 Pandemic

For health care providers, particularly long term care providers, COVID-19 has brought unprecedented challenges. In response to those challenges, both the federal and state governments have responded over the course of the...more

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