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CMS Issues Revised Staff Vaccination Guidance

On October 26, 2022, CMS issued revised guidance on COVID-19 vaccination requirements for staff working for Medicare-certified and Medicaid-certified providers and suppliers. While the revised guidance was issued in separate...more

HHS Issues Guidance to Pharmacies Regarding Access to Reproductive Health Care

Following President Biden’s Executive Order on ensuring access to reproductive health care, on July 13, 2022, HHS issued guidance to U.S. retail pharmacies regarding their obligations under federal civil rights laws. This...more

HHS to End Telehealth HIPAA Flexibilities Upon PHE Expiration

On June 13, 2022, HHS OCR issued guidance on how covered health care providers and health plans can use remote communication technologies to provide audio-only telehealth services when conducted in a manner consistent with...more

CMS Issues Final Rule for Medicare Advantage and Part D Plans

On April 29, 2022, CMS issued its final rule for Medicare Advantage (MA) and Part D plans with updates including reduced out-of-pocket costs for prescription drugs and improved consumer protections. CMS published the final...more

CMS Seeks Feedback on FY 2023 SNF Prospective Payment System Proposed Rule

On April 11, 2022, CMS issued its FY 2023 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule updating Medicare payment policies and rates for SNFs. The proposed rule also includes proposals for the...more

Omnibus Spending Bill Passed by Congress Includes Healthcare Provisions

On March 10, 2022, the Senate passed a $1.5 trillion omnibus appropriations bill (the Omnibus Bill) to fund the federal government for fiscal year 2022 (FY 2022) that contained significant healthcare-related provisions...more

New York District Court Dismisses COVID-19 Fraud Related Whistleblower Suit Against Nursing Facility

On February 7, 2022, the Northern District of New York dismissed a qui tam complaint against a New York nursing facility operator, Kingston NH Operations LLC, which operates Ten Broeck Center (TBC). The relator, a former...more

CMS Approves CalAIM proposal to transform California’s Medi-Cal

On December 29, 2021, the California Department of Health Care Services (DHCS) announced CMS’s approval of its California Advancing and Innovating Medi-Cal (CalAIM) proposal. CalAIM’s launch on January 1, 2022 is part of a...more

Recent District Court Opinion Allows Commission Payments Under EKRA

On October 18, 2021, a U.S. District Court in Hawaii decided that providers subject to the federal Eliminating Kickbacks in Recovery Act (EKRA) are permitted to pay employees and independent contractors sales commissions for...more

CMS to Pay for COVID-19 Booster Shots

In a continued effort to ensure cost is not a barrier to vaccine access, on September 24, 2021, CMS announced that it will pay for Medicare beneficiaries’ COVID-19 booster doses without any cost sharing. Medicare...more

CMS to Develop Regulations Requiring Nursing Home Staff Vaccinations

On August 18, 2021, President Biden announced that CMS would develop an emergency regulation to require nursing home staff vaccinations. This announcement comes after months of incentives and giveaways to increase the...more

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