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Patients Centers for Medicare & Medicaid Services (CMS) Health Care Providers

McGuireWoods LLP

OIG Recommends Increased RPM Oversight

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On September 24, 2024, the Department of Health and Human Services Office of Inspector General (“OIG”) published a report (the “Report), reviewing and recommending increased oversight of remote patient monitoring (“RPM”)...more

Health Care Compliance Association (HCCA)

Privacy Briefs: November 2024

Change Healthcare Inc. has amended its initial breach report to the HHS Office for Civil Rights (OCR) to state that 100 million individuals were impacted by its mammoth ransomware attack and breach. However, as of Oct. 24,...more

Whiteford

New CMS EMTALA Portal Signals CMS Continued Focus on Enforcement Fight Against State Abortion Bans

Whiteford on

On May 21, the Centers for Medicare and Medicaid Services (CMS) announced a new option on CMS.gov to allow individuals to more easily file an Emergency Medical Treatment and Labor Act (EMTALA) complaint. Before launching the...more

McDermott Will & Emery

CMS Interoperability and Prior Authorization Rule Significantly Impacts Payers’ Approval and Denial Practices

McDermott Will & Emery on

On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the CMS Interoperability and Prior Authorization final rule (Final Rule) (fact sheet, CMS’ interoperability website), which aims to improve prior...more

Quarles & Brady LLP

HRSA Notice Provides Clarity on 340B Child Site Registration Requirements

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After months of relative uncertainty, the Health Resources and Services Administration (HRSA) published a Notice confirming the end to a COVID-19 pandemic-era flexibility that allowed unregistered child sites to utilize 340B...more

Foley Hoag LLP

United States v. Elizabeth Holmes and Ramesh Balwani

Foley Hoag LLP on

I. WHY THIS CASE MADE THE LIST - A highly publicized and long-running multi-agency action against the former Chief Executive Officer and the former Chief Operating Officer of Theranos Inc. resulted in criminal convictions...more

Nelson Mullins Riley & Scarborough LLP

Price Transparency – CMS Updates Enforcement Process

As many are aware, compliance with price transparency requirements continues to lag. Under the final rule, effective January 1, 2021, hospitals are required to provide clear, accessible pricing information online about the...more

McDermott Will & Emery

Health Equity Elevated to a Joint Commission National Patient Safety Goal

Starting July 1, 2023, The Joint Commission (TJC) will set health equity as a National Patient Safety Goal for certain TJC-accredited organizations and roll out a new Health Care Equity certification program to recognize and...more

Sheppard Mullin Richter & Hampton LLP

Finding Our Way Out of the Pandemic Haze: What Telehealth Tools Are Medicare Providers Allowed to Keep, and Which Must They Leave...

During the COVID-19 pandemic, Medicare coverage expanded to include a vast arsenal of tools that help patients access medical services while keeping patients and practitioners safe. Many of these tools involve telehealth...more

Sheppard Mullin Richter & Hampton LLP

DMHC Guidance Confirms that California Law, Not the Federal No Surprises Act, Governs Payment and Dispute Resolution Processes for...

Executive Summary - The California Department of Managed Health Care (“DMHC”) issued a recent guidance interpreting the application of the No Surprises Act (“NSA”)—a new federal law prohibiting out-of-network healthcare...more

Troutman Pepper Locke

Centers for Medicare and Medicaid ‎Innovation Announce New ‎‎“ACO REACH” Model to ‎Replace ‎Medicare Direct

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On February 24, 2022, the Centers for Medicare & Medicaid Services (CMS) announced that it had redesigned the Global and Professional Direct Contracting Model for 2023. The Center for Medicare and Medicaid Innovation...more

McDermott Will & Emery

CMS Announces Request for Applications for Participation In the ACO REACH Model

On February 24, 2022, the Centers for Medicare and Medicaid Services (CMS) Innovation Center announced a Request for Applications (RFA) for the Accountable Care Organization (ACO) Realizing Equity, Access, and Community...more

Sheppard Mullin Richter & Hampton LLP

“REACHing” For Health Equity: CMS Revamps The Professional Direct Contracting Model

On February 24, 2022, the Centers for Medicare & Medicaid Services (CMS) announced its redesign of the Global and Professional Direct Contracting Model (GPDC), which now will be called the Accountable Care Organization (ACO)...more

Sheppard Mullin Richter & Hampton LLP

Q&A: The No Surprises Act’s Protections for Uninsured (or Self-Pay) Individuals

In our November 9, 2021, blog post on the No Surprises Act (“NSA”), we discussed new consumer protections against surprise out-of-network bills. In addition to protecting insured consumers from balance billing, the NSA...more

Holland & Hart - Health Law Blog

Free COVID-19 Vaccines and Diagnostic Testing

Over a year after the declaration of a nationwide public health emergency due to the Coronavirus Disease 2019 (“COVID-19”) pandemic, providers are in a position to offer patients a variety of COVID-19 medical services,...more

Sheppard Mullin Richter & Hampton LLP

The Permanency for Audio-Only Telehealth Act: A Matter of Healthcare Equity?

In our December 7, 2020 Blog Post, “Permanent Expansion of Medicare Telehealth Services,” we discussed the 2021 Medicare Physician Fee Schedule Final Rule (the “Final Rule”) and the regulatory changes made therein by the...more

Baker Donelson

Regulatory Sprint: Understanding the Impact on the Stark Law, Anti-kickback Statute, and Value-based Arrangements

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The Department of Health and Human Services has released extensive and significant revised final rules governing the Physician Self-Referral Law (the Stark law) and the Medicare Anti-Kickback Statute (AKS) in furtherance of...more

Steptoe & Johnson PLLC

What to Expect: HHS Issues Final Rules on Stark, AKS & CMP Laws

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The U.S. Department of Health and Human Services (“HHS”) recently issued two corresponding final rules amending the implementing regulations of the Physician Self-Referral Law (“Stark Law”), the Anti-Kickback Statute (“AKS”),...more

Sheppard Mullin Richter & Hampton LLP

Permanent Expansion of Medicare Telehealth Services

On December 1, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released the annual Physician Fee Schedule final rule (“Final Rule”) which, among other things, aimed to further President Trump’s October 3, 2019...more

Butler Snow LLP

CMS and OIG Release Stark and AKS Final Rules to Support Reforms for Coordinated, Value-Based Care

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On November 20, 2020, the Centers for Medicare & Medicaid Services (“CMS”) and the Department of Health and Human Services Office of the Inspector General (“OIG”) released their highly-anticipated final rules to modernize and...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2020 Virtual Regional Healthcare Compliance Conference - Richmond, VA - December 11th, 8:25 am - 5:30 pm EST

Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more

Foley Hoag LLP - Medicaid and the Law

New Developments in HIPAA and Related Issues in Health Information Law

Halloween or HIPAA: Which is Scarier? HIPAA and the Pandemic - Telehealth: - On Friday, March 20, 2020, OCR announced it will “exercise its enforcement discretion and will not impose penalties for noncompliance with...more

Sheppard Mullin Richter & Hampton LLP

Maneuvers on the 340B Drug Pricing Program Battlefield: Duplicate Discounts and Contract Pharmacies

In a December 12, 2017 Advisory Board article, “The 340B drug pricing controversy, explained,” Scott Orwig wrote, “the 340B Drug Pricing Program is one of the most contentious issues in health care: Its critics say it ‘hurts...more

Butler Snow LLP

Ready or Not … Here Comes a Global Pandemic: A Legal and Practical Overview of the New Normal to Patient Healthcare – Telehealth

Butler Snow LLP on

What a time to be alive. Despite this phrase being a personal favorite, I would guess that most of us think of these six-words—or some variation thereof—on a daily basis. At the beginning of this year, most Americans likely...more

McDermott Will & Emery

CMS Continues to Refine Survey and Infection Control Guidance for Long-Term Care Facilities During the COVID-19 Pandemic

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Long-term care facilities, including nursing homes, (collectively, LTCF) have been a hot spot for the transmission of the novel coronavirus disease (COVID-19). In an effort to balance quality, transparency and infection...more

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