On November 16, 2020, OIG issued a significant Special Fraud Alert that warns about certain “inherent” fraud and abuse risks raised by speaker programs sponsored by pharmaceutical and medical device companies. OIG expressed...more
CMS and OIG released highly anticipated final changes to the rules implementing the Stark Law, the safe harbors issued under the Anti-Kickback Statute (AKS) and the beneficiary inducements provision in the civil monetary...more
12/1/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Cybersecurity ,
Digital Health ,
DMEPOS ,
Electronic Health Record Incentives ,
Fair Market Value ,
Final Rules ,
OIG ,
Proposed Rules ,
Remuneration ,
Risk Assessment ,
Safe Harbors ,
Stark Law ,
Value-Based Care
On October 28, 2020, CMS released an interim final rule with comment period (IFC) that implements several CARES Act requirements to prepare for the availability of a COVID-19 vaccine. Among other changes, the IFC establishes...more
11/10/2020
/ ACIP ,
CARES Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Emergency Use Authorization (EUA) ,
Food and Drug Administration (FDA) ,
Inpatient Prospective Payment System (IPPS) ,
Interim Final Rules (IFR) ,
Medicare ,
Medicare Part B ,
Outpatient Prospective Payment System (OPPS) ,
Public Health Emergency ,
Public Health Service (PHS) ,
Vaccinations
On September 1, 2020, CMS published a proposed rule that would define “reasonable and necessary” for purposes of coverage under Part A and Part B of the Medicare program, and that would establish a new expedited Medicare...more
On May 11, 2020, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for FY 2021 (the Proposed Rule), which will affect...more
As the number of coronavirus cases across the country continue to rise, CMS has issued several coronavirus-specific memorandums to healthcare providers and laboratories. In the past two weeks, CMS has issued disease-specific...more
3/20/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Diagnostic Tests ,
Emergency Rooms ,
EMTALA ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Medicare Part C ,
Medicare Part D
On July 15, 2019, CMS released new resources, which are available here, that are intended to support states as they apply for waivers under Section 1332 of the Affordable Care Act. These materials follow guidance issued by...more