Efforts to draw attention to and, in some instances, dissuade private equity investment in healthcare have been on the rise. For example, in late 2023, the Centers for Medicare & Medicaid Services finalized a rule increasing...more
The Centers for Medicare & Medicaid Services (“CMS”) released a final rule on November 15, 2023 (published on November 17, 2023) (the “Rule”), requiring greater skilled nursing facility (“SNF”) ownership transparency. The...more
12/7/2023
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Change of Ownership ,
Corporate Transparency Act ,
Disclosure Requirements ,
Internal Revenue Code (IRC) ,
Medicare ,
Nursing Homes ,
Private Equity ,
Real Estate Investments ,
REIT ,
Skilled Nursing Facility ,
Social Security Act ,
Transparency
The Centers for Medicare & Medicaid Services (“CMS”) announced it is expanding access to behavioral health services for Medicare beneficiaries through intensive outpatient services coverage. In general, Medicare will cover...more
The Centers for Medicare & Medicaid Services (“CMS”) has finalized 2024 home health rules to include application of the home health “36-month rule” to hospice providers. The revised rule will forbid any change in majority...more
AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more
The Centers for Medicare & Medicaid Services (“CMS”) issued a Proposed Rule on July 10, 2023, that, if finalized, will revise the Medicare Provider Enrollment requirements to expand the current Home Health Agency (“HHA”)...more
Effective July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) announced a period of enhanced oversight for new hospices in Arizona, California, Nevada, and Texas. According to the Medicare Learning Network...more
In recent years, the Biden administration and Congress have pushed for greater transparency in skilled nursing facility ownership. In an effort focused on increased ownership disclosures specifically related to private equity...more
The nursing home industry has seen increased efforts by the federal government to enhance transparency, with a focus on ownership disclosures (both past and present ownership) of facilities enrolled in Medicare. The efforts...more
Continuing the theme of increased transparency of ownership of nursing homes included in the 2010 Affordable Care Act, the White House issued a Fact Sheet titled “Protecting Seniors and People with Disabilities by Improving...more
3/9/2022
/ Affordable Care Act ,
Assisted Living Facilities (ALFs) ,
Biden Administration ,
Business Ownership ,
Centers for Medicare & Medicaid Services (CMS) ,
Change in Ownership ,
Department of Health and Human Services (HHS) ,
Elder Care ,
Health and Safety ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Nursing Homes ,
Private Equity ,
REIT ,
Transparency
All Medicare providers must update their enrollment information to reflect changes in ownership (CHOWs) within 30 days after the CHOW. Providers must report CHOWs to the applicable Medicare Administrative Contractor (MAC)....more
A group of individuals with ties to the nursing home industry recently published a commentary in the journal Health Affairs and opined that complex ownership structures used by many nursing home operators make it difficult to...more
As long-term care facilities and other health care providers turn their attention and efforts to COVID-19 vaccination, many have inquired about the ability to use Provider Relief Funding (“Funding”) for vaccine-related costs....more
The Department of Health & Human Services (HHS) announced funding opportunities for (1) CHOW buyers that closed a transaction in 2019 or 2020 and (2) any provider that missed the June 3, 2020 deadline to apply for additional...more
As previously reported, the Department of Health & Human Services (HHS) issued Provider Relief Funds in multiple tranches. One of the largest tranches—$20 billion of the initial $50 billion general distribution—will be...more
Providers that recently acquired a Medicare provider through a change of ownership (CHOW) could face difficulties obtaining some or all of the provider relief funds as previously discussed. The first two tranches of payments...more
HHS Announces Allocation of Initial $100 Billion - The initial $30 billion disbursement from HHS to health care providers across the country was a part of a much larger $100 billion fund. HHS announced an outline of planned...more
This article is one in a series related to the Medicare Relief Fund. As noted in a previous article, the new Attestation Portal is available to providers that receive Medicare relief funding. In this article, we review the...more
As discussed in our previous article, healthcare providers that received Medicare relief funds must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The attestation is...more
Many Medicare providers awoke the morning of Friday April 10, 2020 to an influx of Medicare funds. The funds are a $30 billion portion of the $100 billion stimulus fund intended to provide relief to healthcare providers...more
As the single largest payor for health care in the United States, the Centers for Medicare & Medicaid Services (CMS) has recognized and acted on the need to move quickly in the fight against COVID-19....more
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on September 5, 2019, intended to address program integrity and vulnerability issues....more
On August 17, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a Memorandum to state survey agency directors regarding Medicare-approved End Stage Renal Disease (ESRD) facilities that provide dialysis...more
The Centers for Medicare & Medicaid Services (CMS) announced that it is seeking input on direct provider contracting (DPC) between “payers and primary care or multi-specialty groups to inform potential testing of a DPC model”...more
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on April 27, 2018 to overhaul the payment system for skilled nursing facilities (SNFs). Specifically, the rule would “update the payment rates used...more