On December 30, 2024, the Massachusetts state legislature passed House Bill 4653 (the Act), which significantly enhances regulatory oversight in the Massachusetts health care market. As signed into law by Governor Maura Healy...more
1/10/2025
/ Compliance ,
Enforcement Actions ,
False Claims Act (FCA) ,
Healthcare ,
Infrastructure ,
Investors ,
New Legislation ,
Private Equity ,
Real Estate Transactions ,
REIT ,
State and Local Government ,
State Attorneys General
On November 20, 2024, the US Department of Health and Human Services, Office of Inspector General (OIG) issued its Industry Segment-Specific Compliance Program Guidance for Nursing Facilities (Nursing Facility ICPG)....more
1/9/2025
/ Anti-Kickback Statute ,
Assisted Living Facilities (ALFs) ,
Compliance ,
Department of Health and Human Services (HHS) ,
Enforcement ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
Risk Management ,
Skilled Nursing Facility
In November, we wrote about Massachusetts legislative and regulatory updates that impact both nursing homes and assisted living residences....more
12/24/2024
/ Assisted Living Facilities (ALFs) ,
Class Action ,
Consumer Protection Laws ,
Fees ,
Low-Income Issues ,
New Legislation ,
New Regulations ,
Nursing Homes ,
Policies and Procedures ,
Public Health ,
Tax Credits
How Massachusetts senior living providers need to be thinking about the recently enacted Long Term Care Reform Law and a recent Centers for Medicare & Medicaid Services audit of nursing homes....more
11/4/2024
/ Affordable Housing ,
Assisted Living Facilities (ALFs) ,
Audits ,
Enforcement ,
Legislative Agendas ,
Long-Term Care ,
Medicaid ,
Medicare ,
Operational Requirements ,
Regulatory Agenda ,
Training
Recent events have caused hospitals and health systems nationwide to contemplate more robust participation in the long term care (LTC) sector, whether through modified ownership, joint venturing, clinical affiliation, or...more
In this installment of our post-Dobbs risk assessment series for hospitals and academic medical centers, we consider the ongoing impact of Dobbs v. Jackson Women’s Health Organization on delivery of clinical services beyond...more
Throughout 2021 and 2022, states have been seeking to include or have successfully included medical respite to Medicaid 1115 waivers. These experimental Medicaid-reimbursed programs are reviewed and approved by the Secretary...more
An outcome of the COVID-19 pandemic has been the attractiveness of innovative care alternatives, for patients and providers alike. One model that has become increasingly popular in the United States (and which is already...more
Over 2500 hospitals across the country historically have relied upon Disproportionate Share Hospital (DSH) Medicaid payments for financial stability. These DSH payments, made in large measure to hospitals with high Medicaid...more
3/31/2023
/ Affordable Care Act ,
American Hospital Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
DSH ,
Financial Distress ,
Funding ,
Hospice ,
Hospitals ,
MACPAC ,
Medicaid ,
Proposed Rules ,
Provider Payments
In the landmark case of Dobbs v. Jackson Women’s Health Organization, the US Supreme Court overturned its prior rulings in Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey, which had recognized a...more
On February 15, 2023, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule which would require greater disclosures of the ownership and management of Medicare and Medicaid nursing homes. Specifically,...more
With the new year underway, the ArentFox Schiff Health Care team highlights 10 of the most pressing legal issues facing the industry in 2023.
End of the COVID-19 Public Health Emergency. After being in effect for more than...more
2/17/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Dobbs v. Jackson Women’s Health Organization ,
False Claims Act (FCA) ,
Federal Trade Commission (FTC) ,
Healthcare ,
HIPAA Privacy Rule ,
Inflation Reduction Act (IRA) ,
No Surprises Act (NSA) ,
Popular ,
Proposed Rules ,
Public Health Emergency ,
Reproductive Healthcare Issues ,
Roe v Wade ,
SCOTUS ,
Telehealth
On January 18, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a Memorandum to all state survey agency directors addressing erroneous schizophrenia coding and increased transparency of Nursing Home Care...more
The Biden Administration has embraced an aggressive and multi-part agenda designed to improve the safety and quality of care nationally in skilled nursing facilities (SNFs). The Biden Administration’s nursing home agenda...more
12/16/2022
/ Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Compliance ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Medicaid ,
Medicare ,
OIG ,
Quality of Care Standards ,
Skilled Nursing Facility
Since the US Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization (Dobbs) in June 2022, the impact of the Court’s decision continues to ripple across the health care delivery system. In this multi-part series,...more
12/9/2022
/ Abortion ,
Centers for Medicare & Medicaid Services (CMS) ,
Dobbs v. Jackson Women’s Health Organization ,
EMTALA ,
Environmental Social & Governance (ESG) ,
Hospitals ,
Planned Parenthood of Southeastern Pennsylvania v Casey ,
Reproductive Healthcare Issues ,
Risk Assessment ,
Roe v Wade ,
SCOTUS
Click the link below for our complete analysis of recent updates to the Stark Law and Anti-Kickback Statute and their impact on health care providers.
...more
3/3/2021
/ 21st Century Cures Act ,
Anti-Kickback Statute ,
Bonuses ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Commercially Reasonable Efforts ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Fair Market Value ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Medicare Part D ,
OIG ,
Pharmacy Benefit Manager (PBM) ,
Profit Sharing ,
Safe Harbors ,
Stark Law ,
Value-Based Care
OIG and CMS, through a coordinated effort, have issued sweeping and much-anticipated final changes to the Anti-kickback and Stark rules. These changes are generally industry-friendly.
Introduction -
On November 20,...more
12/9/2020
/ ACOs ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
DMEPOS ,
New Rules ,
OIG ,
Safe Harbors ,
Stark Law ,
Value-Based Care
Across the country, health care providers have struggled during the COVID-19 pandemic in the face of declining revenue and increased expenses.
This financial stress has adversely affected almost all entities within the...more
As these extraordinary actions are being implemented or contemplated in various parts of the United States, they raise understandable questions about the extent of domestic legal authority to take these steps.
Range of...more
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
11/26/2019
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
DSH ,
Health Care Providers ,
Mandatory Reporting Laws ,
Medicaid ,
Proposed Rules ,
Regulatory Oversight ,
State Medicaid Programs ,
State Regulators ,
Supplemental Payments