News & Analysis as of

Opioid Medicaid Medicare

Foley & Lardner LLP

Substance Use Disorder Treatment Services: 2025 Physician Fee Schedule Proposed Rule Would Expand Access and Medicare Coverage

Foley & Lardner LLP on

On July 10, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule Proposed Rule (Proposed Rule) for the calendar year 2025. The Proposed Rule would implement certain provisions of the...more

Hendershot Cowart P.C.

A Pharmacist's Guide To Prescription Drug Fraud Investigations

Hendershot Cowart P.C. on

Prescription drug fraud has long been a focus for government regulators, but it has taken on new significance in the wake of America’s opioid crisis. The U.S. Department of Justice (DOJ), Department of Health and Human...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

Harris Beach PLLC

Continued: Summary of Fraud and Abuse Enforcement Yields Insight for Health Care Compliance and Risk Assessment

Harris Beach PLLC on

The following is a summary of the federal Health and Human Services agency’s Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are based...more

Fox Rothschild LLP

Enhanced Scrutiny of Opioid Prescriptions Poses Legal Risks for Medical Professionals

Fox Rothschild LLP on

The U.S. Department of Justice recently charged multiple physicians and health care professionals for opioid-related crimes in a crackdown with a clear message to individuals in the industry: If you are involved with...more

Mintz - Health Care Viewpoints

False Claims Act Settlements and Judgments Exceed $5.6 Billion in Fiscal Year 2021

The Department of Justice announced in a February 1, 2022 press release (Press Release) that it obtained more than $5.6 billion in settlements and judgments from civil cases involving fraud and false claims in the fiscal year...more

Womble Bond Dickinson

Opportunity Economy: Telehealth in the Pandemic - and Beyond

Womble Bond Dickinson on

Takeaways: ..Telehealth greatly expanded during the COVID-19 pandemic, in large part due to regulatory waivers. Those regulatory waivers aren’t permanent, but lawmakers are evaluating ways to permanently expand some...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 32. News Briefs: September 2021

Report on Medicare Compliance 30, no. 32 (September 13, 2021) - Saint Francis Medical Center in Missouri agreed to pay $1.625 million in a civil settlement of allegations it violated the Controlled Substances Act, the...more

King & Spalding

OIG Releases Semiannual Report to Congress

King & Spalding on

On May 28, 2021, OIG released its Semiannual Report to Congress (the Report). The Report describes OIG’s work during the 6-month semiannual reporting period of October 1, 2020, through March 31, 2021 (the Semiannual Reporting...more

Foley & Lardner LLP

COVID-19 Compounds Opioid Crisis and Treatment Gaps for Vulnerable Americans: Will a Biden Administration and New Congress Expand...

Foley & Lardner LLP on

Payment misalignment in Medicare FFS for Substance Use Disorder (SUD) treatment as the subject of potential legislative and/or regulatory reforms - New opportunities for investor-backed behavioral health platforms in...more

ArentFox Schiff

Investigations Newsletter: HHS Announces Final Rules Amending Stark Law Regulations and Anti-Kickback Statute

ArentFox Schiff on

HHS Announces Final Rules Amending Stark Law Regulations and Anti-Kickback Statute - On November 20, 2020, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services (HHS) published...more

Akin Gump Strauss Hauer & Feld LLP

President-Elect Biden’s Potential Executive Actions: A Health Care & Life Sciences Perspective

President-elect Biden’s agenda and approach for his first 100 days in office will depend to a large degree on which party controls the United States Senate. Many of the incoming President’s major campaign promises—such as...more

Epstein Becker & Green

Opioids, Sober Homes and “Telefraud”: an Overview of the DOJ 2020 Healthcare Fraud Takedown

Epstein Becker & Green on

In September 2020, the U.S. Department of Justice (“DOJ”) and the U.S. Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) announced its annual healthcare-related “takedown.” The takedown,...more

Troutman Pepper

The “New” Enforcers: How States and Localities Are Changing the Landscape of Regulatory Authority

Troutman Pepper on

Over the last decade, observers have noted that states have begun to play a greater role as regulatory enforcers – a trend that increased with the federal regulatory roll-back that began with the advent of the Trump...more

McGuireWoods Consulting

Washington Healthcare Update - August 2020 #2

This week in Washington: Senate stays in session this week as negotiations on the COVID-19 package continue, but is not expecting votes; House remains in district work period....more

Health Care Compliance Association (HCCA)

[Event] 2020 Clinical Practice Compliance Conference - October 26th - 28th, Atlanta, GA

Our annual Clinical Practice Compliance Conference provides information about the latest government initiatives related to physicians and clinics, and physician integrity trends. Unite with your colleagues to discuss...more

Chambliss, Bahner & Stophel, P.C.

Medicare Now Covers Outpatient Treatment for Opioid Addiction

Recognizing the huge problems caused by opioid addiction in the United States, Medicare is adding a new outpatient opioid treatment benefit, paying for methadone and related treatment in certain facilities. Under a new...more

Manatt, Phelps & Phillips, LLP

Using Medicaid to Advance Evidence-Based Treatment of Substance Use Disorders: A Toolkit for State Medicaid Leaders

In 2019, the number of drug overdose deaths in the United States declined, suggesting that the efforts of state and local governments, providers and other stakeholders to stem the crisis of drug-related deaths are beginning...more

Health Care Compliance Association (HCCA)

[Event] Clinical Practice Compliance Conference - October 27th-29th, Nashville, TN

Our annual Clinical Practice Compliance Conference provides information about the latest government initiatives related to physicians and clinics. Unite with your colleagues to discuss strategies for facing compliance issues...more

McGuireWoods Consulting

Washington Healthcare Update - August 2019 #1

Congress - House - House Passes Short-Term Funding Extension for Medicaid Pilot Program - On July 30, the House passed a bill to keep a $1 billion Medicaid pilot providing mental health and addiction services running...more

McGuireWoods Consulting

Washington Healthcare Update June 2019 #3

This week in Washington: Senate to hold hearing on the enforcement of antitrust laws, while the House plans to cover a number of health care bills that reauthorize a variety of health programs for Americans. The House may...more

Manatt, Phelps & Phillips, LLP

InCK and MOM Support Improved Care Delivery for Children

On February 8, 2019, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) released the funding announcements for the Integrated Care for Kids Model (InCK Model) and...more

Manatt, Phelps & Phillips, LLP

Sharing Information on Plan Members With Opioid Use Disorder

Editor’s Note: People eligible for both Medicare and Medicaid experience co-occurring substance use disorders (SUDs) and chronic pain at rates that are two to six times higher than Medicare-only beneficiaries or Medicaid-only...more

Holland & Hart - Health Law Blog

What Healthcare Providers Need to Know About EKRA

In October 2018, the President signed the SUPPORT for Patients and Communities Act, a portion of which is known as the “Eliminating Kickbacks in Recovery Act of 2018” or “EKRA.” EKRA, aimed at the ongoing opioid crisis, is...more

Baker Donelson

President Trump's Budget: Key Takeaways for Health Care

Baker Donelson on

President Trump's fiscal year 2020 (FY20) budget proposal for the Department of Health and Human Services (HHS) reflects the Trump Administration's priorities to repeal and replace the Affordable Care Act (ACA), implement...more

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