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Reporting Requirements Health Care Providers Medicaid

McCarter & English, LLP

New Jersey Regulatory Update Part I - January 2025

Below is Part I of our New Jersey Regulatory Update focusing on regulations that were finalized in 2024 by various New Jersey agencies that impact healthcare. The final regulations range from additional transparency...more

Dickinson Wright

Arizona’s New Behavioral Healthcare Laws – Part 2

Dickinson Wright on

In 2024, the Arizona legislature passed five new Arizona laws directly affecting behavioral health care in Arizona. These laws run the gamut between refining definitions, requiring peer specialist trainings, new requirements...more

Burr & Forman

Failure to Return Credit Balances (Especially to Medicare and Medicaid) Can Create Significant Liability

Burr & Forman on

Every health care provider has “credit balances,” which occur when a provider receives more money than it is owed for services rendered. Credit balances can be caused by a number of factors, including incorrect coding,...more

Nelson Mullins Riley & Scarborough LLP

Attention SNFs: Enhanced 855A Disclosure Requirements Have Arrived

Against the backdrop of increasing regulatory scrutiny of private equity ownership in the healthcare space, Medicare skilled nursing and Medicaid nursing facilities (“SNF”) and private equity companies looking to acquire SNFs...more

Arnall Golden Gregory LLP

CMS Issues Final Rule Mandating New Minimum Staffing Standards for Long-Term Care Facilities

On April 22, 2024, The Centers for Medicare & Medicaid Services (“CMS”) issued the “Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency...more

Venable LLP

Looming CTA Disclosure Requirements and Healthcare Providers

Venable LLP on

The Federal Corporate Transparency Act (the CTA), 31 U.S.C. §5336, will soon require certain entities to disclose to the U.S. Treasury's Financial Crimes Enforcement Network (FinCEN) certain pieces of identifying information...more

Goodwin

Government Continues to Explore Role of 340B Contract Pharmacies

Goodwin on

The 340B Drug Pricing Program (the “Program”) allows certain healthcare providers (“covered entities”) to purchase pharmaceuticals from drug manufacturers at discounted rates. Some covered entities do not have an internal...more

Harris Beach Murtha PLLC

New York Issues Technical Specifications Manual that Addresses Medicaid Payment Reporting

The New York Department of Health (DOH) announced March 8 that the 2022-2023 Value Based Payment (VBP) Reporting Requirements Technical Specifications Manual is available....more

Husch Blackwell LLP

Healthcare Providers To Receive $25.5 Billion In Relief Funds

Husch Blackwell LLP on

On September 10, the Biden-Harris Administration, in conjunction with the Department of Health and Human Services (HHS), announced that $25.5 billion in relief funds will be distributed to healthcare providers through the...more

Bricker Graydon LLP

Skilled nursing facility operator settles false claims case involving allegations that the company failed to report and return...

Bricker Graydon LLP on

On June 29, 2021, the Department of Justice (DOJ) announced a settlement with California skilled nursing facility operator Plum Healthcare Group LLC and facility Azalea Holdings LLC dba McKinley Park Care Center (Plum) to...more

Holland & Knight LLP

CMS Releases FY 2022 IPPS and LTCH Proposed Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on April 27, 2021, released the Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) Prospective Payment...more

Foley & Lardner LLP

Congress Requires New Medicaid Payment Reporting

Foley & Lardner LLP on

As part of the omnibus Federal appropriations bill enacted into law on December 27, 2020, Congress established new reporting requirements for states that make Medicaid supplemental payments. The new requirements follow on the...more

Arnall Golden Gregory LLP

HHS Continues to Release Limited Provider Relief Fund FAQs

While the release of Provider Relief Fund Frequently Asked Questions (FAQs) has dwindled in the last month, the Department of Health & Human Services (HHS) has continued to issue new FAQs on a more limited basis. On December...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 Managed Care Compliance Conference - February 1st - 3rd, 9:30 am - 3:45 pm CST

The first ever VIRTUAL Managed Care Compliance Conference will have the great speakers and content you have come to expect from the in-person event. Each year, we look forward to hosting compliance professionals at our...more

Jackson Walker

CMS Implements Stricter COVID-19 Testing Regulations on Nursing Homes

Jackson Walker on

As part of a broader Trump administration announcement made on August 25, 2020, the Centers for Medicare & Medicaid Services (CMS) issued sweeping oversight changes in the form of an Interim Final Rule with Comment Period...more

McGuireWoods LLP

CARES Act Healthcare Provider Relief Fund Update: New Distribution and Extended Deadlines

McGuireWoods LLP on

On July 31, 2020 and August 10, 2020, the U.S. Department of Health and Human Services (HHS) issued press releases announcing a second chance to apply for funding for certain Medicare providers and extended application...more

Baker Donelson

Update on HHS Provider Relief Fund Payments and Reporting Requirements

Baker Donelson on

On June 9, 2020, the Department of Health and Human Services (HHS) announced additional payments under the COVID-19 Provider Relief Fund to reimburse providers for health care related expenses and revenue losses attributable...more

Spilman Thomas & Battle, PLLC

COVID-19: Impacts and New Guidance for Skilled Nursing Facilities

The COVID-19 pandemic has had a disproportionate impact on skilled nursing and assisted living facilities. While the following CMS recommendations and guidelines identify nursing homes as the target recipients, they are...more

Holland & Knight LLP

Comments on CMS Proposed Rule on Medicaid Fiscal Accountability Due Feb. 1, 2020

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Nov. 18, 2019, published a proposed Medicaid Fiscal Accountability rule that would amend existing regulations related to 1) base and supplemental payments, 2)...more

King & Spalding

CMS Issues Proposed Rule Aimed at Increasing Transparency and Reducing Medicaid Program Spending

King & Spalding on

On November 18, 2019, CMS published the proposed Medicaid Fiscal Accountability Rule (the Proposed Rule) which, if finalized, would result in dramatic changes to the Medicaid program. Through the Proposed Rule, CMS aims to...more

Dorsey & Whitney LLP

New Disclosure Requirements to be Phased-In to CMS Enrollment and Revalidation Process

Dorsey & Whitney LLP on

On September 5, 2019, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) effective November 4, 2019, which increases disclosure requirements for the provider and supplier enrollment and...more

Foley & Lardner LLP

CMS Proposes Enhanced Scrutiny over Medicaid Supplemental Payments

Foley & Lardner LLP on

On November 18, 2019, the Centers for Medicare & Medicaid Services (CMS) proposed changes to federal Medicaid rules that, if implemented, would affect billions of dollars of Medicaid payments nationwide, creating new...more

Mintz - Health Care Viewpoints

CMS Finalizes Changes Expanding the Scope of the Open Payments Program

On November 15, 2019, the Centers for Medicare & Medicaid Services ("CMS") finalized changes to the Open Payments Program as part of the CY 2020 Physician Fee Schedule Final Rule. The Open Payments reporting requirements,...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

ArentFox Schiff

Guilt by Affiliation: New CMS Regulations Require Provider Disclosure of Past Association with “Bad Actors”

ArentFox Schiff on

On September 10, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a final rule with comment period, titled Program Integrity Enhancements to the Provider Enrollment Process (the “Final Rule”), which enhances...more

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