News & Analysis as of

Healthcare Medicare 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

Rivkin Radler LLP

Federal Rules Limit “Junk” Health Plans

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On March 28, the U.S. Departments of Health and Human Services, Labor and the Treasury collectively issued final rules with respect to short-term and limited duration insurance (STLDI) plans in an effort to reduce healthcare...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

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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

Polsinelli on

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

King & Spalding

OIG Publishes Strategic Plan for Managed Care Oversight on New Featured Webpage

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On August 28, 2023, OIG released a new webpage on managed care oversight, which features the HHS-OIG Strategic Plan for Oversight of Managed Care for Medicare and Medicaid. OIG has designated oversight of managed care as a...more

Polsinelli

CMS Proposes Changes to Medicare Provider Enrollment Rules

Polsinelli on

The Centers for Medicare & Medicaid Services (“CMS”) published proposed changes to the Medicare Provider Enrollment requirements in the 2024 Medicare Physician Fee Schedule Proposed Rule (the “Proposed Rule”). If finalized,...more

Polsinelli

“36-Month Rule” Anticipated to Expand to Hospice

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On July 10, the Centers for Medicare & Medicaid Services (“CMS”) issued a Proposed Rule that would extend the “36-Month Rule” to Hospice providers. The 36-Month Rule refers to 42 C.F.R. § 424.550(b), which currently...more

Seyfarth Shaw LLP

NPDB Waives Query Fees from March through May 2020

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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)

Foley & Lardner LLP on

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

Seyfarth Shaw LLP on

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

King & Spalding

CMS Releases Tools to Support States’ Medicaid and CHIP Programs During the COVID-19 Outbreak

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On March 22, 2020, CMS announced a suite of four new tools intended to help states combat the coronavirus by allowing states to streamline enrollment into long-term care and home-based services and by expediting application...more

Seyfarth Shaw LLP

CMS Announces New Priorities for Facility Surveys and Inspections

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In light of findings from the COVID-19 outbreak at a nursing home in Kirkland, Washington, the Centers for Medicare and Medicaid Services (CMS) has announced that it will suspend all routine facility inspections and surveys...more

McDermott Will & Emery

CMS Dramatically Modifies and Expedites the Medicare Enrollment Process to Combat COVID-19

McDermott Will & Emery on

The Centers for Medicare and Medicaid Services is expediting Medicare enrollment applications and allowing certain categories of practitioners to temporarily enroll in Medicare Part B to increase the number of healthcare...more

McDermott Will & Emery

CMS Final Rule Strengthens Integrity of Medicare Provider Enrollment Process

McDermott Will & Emery on

On September 10, 2019, the US Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) expanding Medicare, Medicaid and Children’s Health Insurance Program...more

Verrill

CMS Cracking Down on Health Care Fraud and Abuse

Verrill on

To increase provider and supplier transparency and accountability, the Centers for Medicare & Medicaid Services (“CMS”) recently issued a final rule (“Final Rule”) with comment period that allows CMS greater ability to...more

Mintz - Health Care Viewpoints

As CMS Lifts HHA Medicare Provider Enrollment Moratorium, States Continue to Limit HHA Licenses

As of January 30, 2019, CMS lifted its temporary provider enrollment moratoria (“Enrollment Moratorium”) for home health agencies (“HHAs”) in Florida, Illinois, Michigan and Texas. The Enrollment Moratorium had prevented new...more

McDermott Will & Emery

Program Integrity Changes to the Medicare Provider Enrollment Process

McDermott Will & Emery on

On March 1, 2016, the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) entitled “Medicare, Medicaid, and Children’s Health Insurance...more

Akerman LLP - Health Law Rx

CMS Extends Enrollment Moratorium on Home Health Agencies

The Centers for Medicare and Medicaid Services (CMS) announced that it will once again extend the moratorium on the enrollment of new home health agencies, branch locations and subunits in certain metropolitan areas of...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - July 2015 #3

In quick succession, governors in Alaska and Utah announce Medicaid expansions this week; Iowa is transitioning its expansion away from the Marketplace to Medicaid managed care, for now; and, HHS extends its exception to...more

Baker Donelson

Medicare Enrollment Rules - Expanded Enforcement Finalized in Regulations

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On December 5, 2014, CMS published final regulations that expand the bases for CMS to deny enrollment or revoke billing privileges of an enrolled provider or supplier. These final regulations also change the method to...more

Buchalter

Got Medicare Billing Privileges? Are You Sure? Traps for the Unwary in Medicare Enrollment

Buchalter on

To receive payment for items and services furnished to Medicare beneficiaries, a health care professional or facility must have approved Medicare billing privileges, which requires enrollment in the Medicare program. Failure...more

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