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Medicaid › Self-Referral

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | January 2024 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for January 2024. We discuss several US Department of Health and Human Services (HHS) agency actions, including the new Innovation in...more

Mintz - Health Care Viewpoints

OIG Issues Unfavorable Advisory Opinion on Common Arrangements between Physician Practices and Health Care Providers

Mintz - Health Care Viewpoints on

On August 15, 2023, the Office of Inspector General for the Department of Health and Human Services (OIG) issued a negative Advisory Opinion regarding a turnkey physician-owned entity (Newco) operated by an existing provider...more

Foley & Lardner LLP

Stark Law Changes Coming to Physician Compensation Models in 2022

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Medical groups that have division-based or service-level approaches to physician compensation should spend their summer evaluating their models in light of Stark Law revisions that go into effect on January 1, 2022. The...more

Foley Hoag LLP - Medicaid and the Law

A Deeper Dive into CMS’ Multiple Best Prices Policy

Foley Hoag LLP - Medicaid and the Law on

As my colleague Tom wrote about in a recent post, the Centers for Medicare & Medicaid Services (CMS) has finally responded to a growing chorus of stakeholders that government price reporting requirements, particularly...more

Manatt, Phelps & Phillips, LLP

[Webinar] Unpacking the Anti-Kickback and Stark Reforms: Promoting Value-Based Care and Easing Regulatory Compliance - January...

Manatt, Phelps & Phillips, LLP on

A New Manatt Webinar Guides You Through New Reforms Promoting Value-Based Care and Easing Regulatory Compliance—the Most Significant Changes to the Federal Fraud and Abuse Landscape in the Last Decade. On November 20,...more

Manatt, Phelps & Phillips, LLP

[Webinar] 1135 Waivers in Action: Flexibilities, Limits and Next Steps for States and - April 21st, 1:00 pm - 2:00 pm ET

Manatt, Phelps & Phillips, LLP on

On March 30, the Centers for Medicare & Medicaid Services (CMS) swept aside dozens of federal healthcare requirements using its emergency waiver authority under Section 1135 of the Social Security Act. The waivers—addressing...more

Spilman Thomas & Battle, PLLC

Stark Blanket Waivers Issued During COVID-19 National Emergency

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On March 30, 2020, the Secretary of the Department of Health and Human Services ("Secretary") announced a blanket waiver ("Waiver") of sanctions for violations of Section 1877 of the Social Security Act, also known as the...more

Bricker Graydon LLP

CMS proposes to change the way group practices can pay profit shares to physicians under Stark Law

Bricker Graydon LLP on

Part of the Centers for Medicare and Medicaid Services’ (CMS) proposed changes to the regulations interpreting the Physician Self-Referral Law (the “Stark Law”), released on October 9, 2019, include changes to the special...more

Akerman LLP - Health Law Rx

Possible Changes to Stark Law in 2019

Akerman LLP - Health Law Rx on

Last summer The Centers for Medicare and Medicaid Services (CMS) solicited input on potential amendments to the federal Physician Self-Referral Law (the Stark Law)....more

Holland & Knight LLP

Healthcare Law Update: September 2018

Holland & Knight LLP on

Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

Robinson+Cole Health Law Diagnosis

CMS issues Request for Information on the burdens the Stark Law may Impose on Care Coordination

Robinson+Cole Health Law Diagnosis on

The Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) seeking input from the public on the burden the Stark Law may impose on patient care and recommendations on how to address any undue...more

McDermott Will & Emery

CMS Seeks Comments on Stark Law Reforms Needed to Reduce Obstacles to Innovation

McDermott Will & Emery on

On June 25, 2018, the Centers for Medicare and Medicaid Services (CMS) published a request for information, seeking input from the public on how to address any undue regulatory impact and burden of the physician self-referral...more

King & Spalding

Hospital, Cardiology Group Settle False Claims Act Allegations for $20.75 Million

King & Spalding on

As reported previously, Hamot Medical Center (“Hamot”) and Medicor Associates, Inc. (“Medicor”) entered into a preliminary settlement agreement under which they agreed to pay $20.75 million to resolve kickback allegations...more

Husch Blackwell LLP

Colorado Mini-Stark Bill Indefinitely Postponed; FSED Bill Amended

Husch Blackwell LLP on

On February 14, 2018, the Colorado Senate State, Veterans, & Military Affairs Committee unanimously voted to indefinitely postpone consideration of SB18-115, which proposed to extend the prohibition on self-referrals that...more

Husch Blackwell LLP

CO Senate Proposes Bills Expanding Self-Referral Prohibition And Affecting Freestanding ERs

Husch Blackwell LLP on

Bill Would Extend Colorado Mini-Stark Law to Services Reimbursed by Private Payors On January 29, 2018, Colorado State Senator Irene Aguilar introduced SB 18-115, titled “Apply Stark Laws to Medical Referrals Outside...more

Manatt, Phelps & Phillips, LLP

Health Update - April 2017

Manatt, Phelps & Phillips, LLP on

CMS Issues Self-Referral Disclosure Protocol for Stark Law Violations - On March 28, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a new voluntary self-referral disclosure protocol (SRDP) for disclosing...more

McDermott Will & Emery

CMS Revises the Self-Referral Disclosure Protocol Requiring the Use of Prescribed Forms for Disclosure of Stark Law Violations

McDermott Will & Emery on

The Centers for Medicare and Medicaid Services (CMS) recently posted revisions to the Voluntary Self-Referral Disclosure Protocol (SRDP). In an attempt to streamline the self-disclosure process, CMS requires the use of new...more

The Volkov Law Group

Compliance Reminder — DOJ Announces Largest Healthcare Fraud Takedown

The Volkov Law Group on

On Wednesday, June 22, 2016, the DOJ announced the largest nationwide heath care fraud takedown in history, which resulted in criminal and civil charges against 301 individuals for alleged participation in health care fraud...more

Carlton Fields

2016 Stark Law Updates

Carlton Fields on

Centers for Medicare and Medicaid Services (CMS) issued the 2016 Medicare Fee Schedule (the "Schedule") in an effort to facilitate compliance with the Physician Self-Referral Law (the "Stark Law"). Generally, absent an...more

Saul Ewing Arnstein & Lehr LLP

CMS and OIG Issue Final ACO Waivers

Saul Ewing Arnstein & Lehr LLP on

On Thursday, October 29, 2015, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of Inspector General (“OIG”) jointly issued a rule (the “Final Rule”) to finalize five (5) waivers of certain fraud and abuse...more

Buchalter

Removing the Barriers to Coordinated Care: the Stark Law

Buchalter on

August 10, 2015 was the 22nd anniversary of the expansion of the Medicare self-referral prohibition to include 10 “designated health services” in addition to clinical laboratory tests. This law is the so-called Stark Law....more

Saul Ewing Arnstein & Lehr LLP

Proposed 2016 Medicare Physician Fee Schedule Includes Changes to Stark Regulations

Saul Ewing Arnstein & Lehr LLP on

The Centers for Medicare & Medicaid Services ("CMS") recently released the proposed 2016 Medicare Physician Fee Schedule (the "Proposed Rule"), which includes a number of proposed revisions to the regulations under the...more

Benesch

CMS Proposed Stark Law Revisions

Benesch on

On July 15, 2015, the Centers for Medicare and Medicaid Services (“CMS”) published proposed revisions to the regulations implementing the physician self-referral law, or Stark Law. The Stark Law is a key regulatory...more

BakerHostetler

Proposed Rule Aims to Refine Stark Regulations and Clarify “Incident To”

BakerHostetler on

On July 15, 2015, the Centers for Medicare and Medicaid Services (CMS) published the calendar year (CY) 2016 Physician Fee Schedule Proposed Rule. In addition to updating several traditional Part B payment policies, the...more

King & Spalding

CMS Issues CY 2016 Medicare Physician Fee Schedule Proposed Rule

King & Spalding on

On July 8, 2015, CMS issued its annual proposed rule outlining payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) for CY 2016. In the proposed rule,...more

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