News & Analysis as of

Chronic Care Managment (CCM)

Foley & Lardner LLP

New HCPCS for Advanced Primary Care Management

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The Center for Medicare & Medicaid Services (CMS) issued the display copy of the final Calendar Year 2025 Physician Fee Schedule on November 1, 2024, which included three new Healthcare Common Procedure Coding System (HCPCS)...more

King & Spalding

OIG Report Concludes That CMS Needs to Strengthen its Oversight of Remote Patient Monitoring

King & Spalding on

On September 24, 2024, OIG released a report recommending that CMS exercise additional oversight of remote patient monitoring (RPM) services provided to Medicare beneficiaries. Medicare reimburses RPM for any chronic or acute...more

ArentFox Schiff

Investigations Newsletter: Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme

ArentFox Schiff on

Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme - The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...more

King & Spalding

CMS Finalizes Rule Regarding Marketing Changes, Beneficiary Protections, and Coverage for Medicare Parts C and D

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On April 4, 2024, CMS published a final rule implementing certain policy changes to the Medicare Advantage (MA) Program (Medicare Part C) and the Medicare Prescription Drug Benefit Program (Medicare Part D). According to the...more

Sheppard Mullin Richter & Hampton LLP

CMS Issues CY2025 Medicare Advantage and Part D Final Rule

On April 4, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued the contract year 2025 (CY2025) Medicare Advantage and Part D final rule (the “Final Rule”). In addition to finalizing its CY2025 proposed rule,...more

McDermott+

McDermottPlus Check-Up: April 12, 2024

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Senate Finance Health Subcommittee Holds Roundtable on Substance Use Disorder Care. Panelists and members discussed how to improve treatment in federal health programs. House Energy & Commerce Health Subcommittee Holds...more

Sheppard Mullin Richter & Hampton LLP

Day 1 Notes from the 42nd Annual J.P. Morgan Healthcare Conference

At the first day of the J.P. Morgan Healthcare Conference, “[T]he answer to the ultimate question of life, the universe and everything is 42.” Recognize that famous line? No, it’s not something from ChatGPT, it’s Douglas...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - January 19th, Charlotte, NC

Looking for compliance education and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance education on a wide variety of current and emerging topics...more

Mintz

Fighting for Access to Lifesaving HIV Medicine

Mintz on

Even with breakthrough medication that transformed the human immunodeficiency virus (HIV) from a near-certain fatal disease to a manageable but chronic illness, many with HIV still endure debilitating effects. For about...more

King & Spalding

CMS Proposes Changes to the Medicare Advantage and Part D Programs Aimed at Improving Beneficiary Protections, Access to Care, and...

King & Spalding on

On November 6, 2023, CMS released a pre-publication version of a proposed rule (Proposed Rule) that is set to publish in the Federal Register on November 15, 2023, and that would amend the regulations governing Medicare...more

Foley & Lardner LLP

Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM): A Deep Dive into Proposed Medicare Changes

Foley & Lardner LLP on

On July 13, the Centers for Medicare & Medicaid Services (CMS) released its annual Proposed Rule updating the Medicare Physician Fee Schedule (PFS) for calendar year (CY) 2024, which includes various proposed changes related...more

King & Spalding

OIG Audit Alleges that CMS Made $1.9 Million in Overpayments for Chronic Care Management Services During 2017 and 2018

King & Spalding on

In a report issued by OIG in August of 2021, OIG alleged that for Chronic Care Management (CCM) services, “providers billed for and received overpayments totaling $1,918,278, and beneficiaries were required to pay a total of...more

McDermott Will & Emery

Leaders Moving 2020 Forward with Sean Duffy of Omada Health

This year has presented everyone, including business leaders, with intense challenges. From the devastation of the coronavirus pandemic to the call to address long-standing racial disparities that have come to the forefront...more

Rivkin Radler LLP

Wearables Brands Fight for Healthcare Space

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Manufacturers of activity trackers and smartwatches have been fighting over the “serious” healthcare market for several years. Companies such as Apple (previously discussed here), Fitbit (previously discussed here), and...more

Akerman LLP - Health Law Rx

As COVID-19 Spreads, Florida Pharmacists’ Scope of Practice Expands

Florida has been contemplating ways to increase patient access to care, especially in light of the COVID-19 pandemic and the anticipated increase in cases. Recognizing the accessibility of pharmacies, Florida is now...more

Downs Rachlin Martin PLLC

Vermont Health Care Update 01-13-2020 - An analysis from DRM's Health Law Team

DVHA presents budget adjustment proposal - The House Health Care Committee heard from Department of Vermont Health Access Commissioner Cory Gustafson on Tuesday on his department’s 2020 budget adjustment. ...more

Snell & Wilmer

Preventive Care Can Now Be Covered for Specified Chronic Conditions Before HDHP Deductible

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On July 17, 2019 the IRS released Notice 2019-45 resolving a preventive care problem that has been plaguing many high deductible health plans (“HDHPs.”). The Affordable Care Act’s free preventive care mandate appears to be...more

Burr & Forman

IRS Expands Preventive Care Benefits Under High Deductible Health Plans

Burr & Forman on

On July 17, 2019, the Internal Revenue Service (the “IRS”) released Notice 2019-45 which expands the list of permissible preventive care benefits for high deductible health plan (“HDHP”) purposes. Among other requirements, an...more

McDermott Will & Emery

IRS Expands Scope of Preventive Care under Health Savings Account Rules

McDermott Will & Emery on

A new IRS notice will allow many with chronic health conditions who participate in high-deductible health plans (HDHPs) with health savings accounts (HSAs) to receive necessary care that may otherwise be out of financial...more

Farrell Fritz, P.C.

Marijuana Regulation in New York – A Look Forward to 2019

Farrell Fritz, P.C. on

The Compassionate Care Act has expanded and changed each year since Governor Andrew M. Cuomo signed it into law in 2014 and 2018 was no different....more

Foley & Lardner LLP

Medicare Remote Patient Monitoring Reimbursement FAQs: Everything You Need to Know About Chronic Care Remote Physiologic...

Foley & Lardner LLP on

Remote Patient Monitoring (RPM) is the next big thing in medical care; patients just don’t know it yet. And, it seems, neither do many physicians. On Thursday, CMS published the final rule on its new RPM codes, officially...more

McDermott Will & Emery

Telehealth and the Changing Regulatory Landscape: Opportunities and Challenges in the Digital Health Ecosystem

What if you didn’t have to take time out of your day to see a physician in person when you needed a prescription? What if a diagnosis could be delivered over video chat? What if your psychiatrist was available at the press of...more

Mintz - Health Care Viewpoints

February 5, 2018 Continuing Resolution: Health Care Provisions

Late Monday night (February 5, 2018), the House of Representatives released a continuing resolution to keep the government funded and running until March 23, 2018. This CR includes many health care related provisions,...more

Sheppard Mullin Richter & Hampton LLP

Notes on Day 2 of the JP Morgan Healthcare Conference

San Francisco (Tuesday, January 9, 2018): Day 2 of the 2018 JP Morgan Healthcare Conference provided concrete examples of the trends that have been discussed in recent years – the impact of shifting healthcare delivery...more

McDermott Will & Emery

Virtual Care Advancement | Outlook on CHRONIC Care Act and Other Federal Legislation

McDermott Will & Emery on

The Senate’s unanimous passage of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 (S.870) on September 26th is an encouraging step forward for modernizing telehealth...more

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