News & Analysis as of

Health Care Providers Enrollment

Manatt, Phelps & Phillips, LLP

Demystifying Federal Authorities: State Considerations for Addressing Health-Related Social Needs in Medicaid

Introduction - Over the past several years, a growing body of literature has indicated that up to 50% of an individual’s health can be driven by the underlying social and economic factors affecting their lives, such as...more

Manatt, Phelps & Phillips, LLP

2024 Medicaid in Montana - How Medicaid Impacts Montana’s State Budget, Economy, and Health

Montana Medicaid provides health care coverage to nearly 300,000 Montanans, including low-income children, pregnant women, people with disabilities, and adults. We produce the Medicaid in Montana annual report to help...more

McDermott+

McDermottPlus Check-Up: January 5, 2024

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Congress Returns Next Week to Face Imminent Funding Deadlines. The Senate will return to session on January 8, and the House will return on January 9. Lawmakers face an immediate time crunch on FY 2024 appropriations, as the...more

McDermott Will & Emery

Medicare Provider and Supplier Enrollment Requirements: Program Integrity Changes for 2024

McDermott Will & Emery on

The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare provider and supplier enrollment regulations, including adding marriage and family therapists (MFTs) and mental health...more

Polsinelli

Medicare Continues its Updates to Provider Enrollment Policies as Part of Efforts to Enhance Program Integrity and Transparency

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The Centers for Medicare & Medicaid Services (“CMS”) continued its efforts to increase oversight of the Medicare program by updating Medicare provider enrollment regulations and policies through recent regulatory and...more

Husch Blackwell LLP

Behind the Curtain: Enhanced Provider Enrollment Oversight

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In the midst of consolidation and restructuring among hospices, the Centers for Medicare & Medicaid Services (CMS) is scrutinizing initial enrollments and changes in ownership and management. In this episode, Husch...more

Weintraub Tobin

California Medi-Cal Enrollment Appeals: An Uphill Battle but an Essential Tool

Weintraub Tobin on

In our practices, we are seeing an increasing number of denials or de facto denials of Medi-Cal provider enrollments. The consequences of a Medi-Cal enrollment denial can be quite serious. First, a provider may not receive...more

K&L Gates LLP

Health Care Triage: The End of Continuous Medicaid Enrollment—What Health Systems Should Know

K&L Gates LLP on

In this episode, Alexander Chu and Ashley Davis review the end of the continuous Medicaid enrollment condition as a result of the Consolidated Appropriations Act, 2023. They discuss potential impacts of the disenrollment...more

Manatt, Phelps & Phillips, LLP

[Webinar] Medicaid Coverage Opportunities for Justice-Involved Populations: CMS Guidance and States’ Approaches - July 13th, 3:00...

Individuals leaving incarceration have disproportionately higher rates of physical and behavioral health diagnoses and are at higher risk for injury and death compared with people who have not been incarcerated. Race...more

Manatt, Phelps & Phillips, LLP

[Webinar] Enhancing Access to Medicaid Family Planning Program Services: State-Level Best Practices - June 22nd, 3:00 pm - 4:00 pm...

Medicaid is the primary source of family planning coverage, accounting for 75% of public expenditures for family planning services in the United States. In order to expand the number of people who can access family planning...more

McDermott Will & Emery

CMS Streamlines Medicare Enrollment and Standardizes Nondiscrimination Language

In late January 2023, the Centers for Medicare and Medicaid Services (CMS) issued two updates relevant to provider and supplier organizations enrolled in Medicare: (1) a redesign to the Provider Enrollment, Chain and...more

King & Spalding

GAO Releases Report and Recommendations to CMS to Address Risks Posed by Provider Enrollment Waivers and Flexibilities Implemented...

King & Spalding on

On December 19, 2022, the U.S. Government Accountability Office (GAO) released a report titled, “Medicare: CMS Needs to Address Risks Posed by Provider Enrollment Waivers and Flexibilities” (GAO-23-105494). The report...more

Bass, Berry & Sims PLC

CY 2023 Medicare Physician Fee Schedule: Medicare Provider and Medicare Shared Savings Program

Bass, Berry & Sims PLC on

On November 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued CY 2023 Physician Fee Schedule Final Rule (Final Rule), implementing certain updates and policy changes for Medicare payments under the Physician...more

Manatt, Phelps & Phillips, LLP

[Webinar] The Role of State-Based Marketplaces in Advancing Health Equity - December 14th, 3:00 pm - 4:00 pm ET

Join Manatt for the Fourth of Our Imperatives Deep-Dive Sessions on the Topics You Voted Most Important to You. There are currently a record-breaking 12.2 million Americans enrolled in coverage through health care...more

Roetzel & Andress

Failing to Update Your Medicare Information Could Prove Costly

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The Centers for Medicare & Medicaid Services (CMS) requires Medicare providers and suppliers to keep their enrollment information up to date at all times. Changes in this information can affect claims processing, payment...more

McDermott Will & Emery

CMS Resumes Provider and Supplier Enrollment Activities Paused During Pandemic

McDermott Will & Emery on

The Centers for Medicare and Medicaid Services (CMS) has started phasing out certain program flexibilities granted during the COVID-19 public health emergency. Beginning in October 2021, CMS will resume several provider and...more

Manatt, Phelps & Phillips, LLP

Tracking Medicaid Enrollment Growth During COVID-19 Databook

As much of the nation’s economic activity ground to a halt at the beginning of the COVID-19 pandemic, millions of people lost jobs and many also lost their job-based healthcare coverage. Based on the experience in other...more

Manatt, Phelps & Phillips, LLP

Maintaining Medicaid and CHIP Coverage Amid Postal Delays and Housing Displacements

In light of recent postal delays and housing displacements caused by the COVID-19 pandemic, the related economic crisis and a wave of natural disasters across the country, state Medicaid and Children’s Health Insurance...more

Manatt, Phelps & Phillips, LLP

CMS Moves Toward Business as Usual With Provider Oversight and Claims Review in Medicare/Medicaid

The COVID-19 crisis is far from over, as evidenced by the 300,000 new U.S. cases reported over the past seven days. Recognizing this ongoing impact, federal and state officials have left in place many of the emergency...more

Manatt, Phelps & Phillips, LLP

[Webinar] Ensuring Children’s Access to Care Through Medicaid During COVID-19 - August 10th, 4:00 pm - 5:00 pm ET

How Can States Leverage Telehealth Policies and Implement Eligibility and Enrollment Strategies to Protect Children’s Access to Medicaid During COVID-19? Find Out at a New Webinar From Manatt Health, the American Academy of...more

Baker Donelson

CMS Revamps Medicare Provider Enrollment Policy Guidance

Baker Donelson on

On May 22, 2020, CMS rolled out Transmittal 10146, which completely reorganizes existing Chapter 15 of the Medicare Program Integrity Manual (MPIM), CMS 100-08. These changes, effective July 24, 2020, implement the recent...more

Seyfarth Shaw LLP

NPDB Waives Query Fees from March through May 2020

Seyfarth Shaw LLP on

To assist hospitals in credentialing physicians during the COVID-19 pandemic, the National Practitioner Data Bank (“NDPB”)—the federal clearinghouse for adverse action reports against physicians—has announced it is waiving...more

Foley & Lardner LLP

COVID-19: Resources for Oncology Providers (Medicaid, Grants, & Stark Law Waivers)

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The Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (HHS), the Office for Civil Rights (OCR), the Office of the Inspector General (OIG), and other Federal and State agencies and...more

Seyfarth Shaw LLP

HHS Issues Advisory Opinion on PREP Act: Immunity May Extend Beyond Actual Covered Persons and Approved Countermeasures

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With crisis comes uncertainty, and even the best-intentioned regulations can leave those combating the current COVID-19 public-health emergency out in the cold.  Many have asked whether the recent Declaration under the...more

Seyfarth Shaw LLP

Health CARES – How the CARES Act Impacts Health Care Providers

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Congress passed and the President signed the CARES Act on March 27, 2020. The Act impacts hospitals, post-acute providers and long term care facilities in numerous ways. The following is an outline of key provisions and their...more

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