On November 12, 2019, Seema Verma, Administrator for the Centers for Medicare and Medicaid Services (“CMS”) spoke to the National Association of Medicaid Directors. As part of that speech, Administrator Verma emphasized the need for transparency in Medicaid programs, particularly Medicaid…
CMS recently issued a final rule on discharge planning requirements for hospitals, critical access hospitals (“CAHs”), and home health agencies (“HHAs”). The new regulations focus on the exchange of patient information between healthcare facilities in the discharge process. The final rule allows…
Does your organization have a policy relating to verification of exclusion from Federal and State healthcare programs? If so, does your Policy comply with all applicable requirements? Requirements include the following:
The Civil Monetary Penalties (“CMP”) Law[1] which imposes monetary penalties…
In the age of increased access to online review platforms such as Google, Facebook, Healthgrades, and Vitals, healthcare providers face the difficult task of managing negative reviews. It can be tempting to respond to negative reviews in an effort to resolve problems. However, these platforms pose…
The Health and Human Services Office of Inspector General (“OIG”) recently published an Advisory Opinion (“AO 19-04”) concerning the use of online platforms for finding and booking physician appointments and physician marketing. While the OIG determined that the platform and payment structure…
Earlier this year, the Office of Civil Rights (“OCR”) at the U.S. Department of Health and Human Services (“HHS”) announced its Right of Access Initiative. The Right of Access Initiative promises to vigorously enforce the rights of patients to receive copies of their medical records without facing…
In a decision dated September 17, 2019, a Federal judge invalidated a 2018 Centers for Medicare and Medicaid Services (“CMS”) regulation that attempted to align Medicare Part B payments for Evaluation & Management (“E&M”) services in hospital outpatient departments (“OPD”) with the lower rates paid…
The Indiana Scheduled Prescription Collection and Tracking (“INSPECT”) program is an online tool that maintains a clearinghouse of patient information for health care professionals. The INSPECT database limits access to certain individuals and entities including the following: health care…
Health care, and its many statutory, regulatory and industry “yardsticks” are ever-changing and require regular attention. In order to stay close to the action, particularly with respect to matters concerning corporate compliance, there are at least three online sources to consider. The first is…
In a new rule effective November 4, 2019, the Centers for Medicare & Medicaid Services (“CMS”) expanded Federal and State authority to punish providers with a troubled history or for affiliating with “bad actors” (the “New Rule”). In announcing the New Rule, CMS Administrator Seema Verma…
On July 29th, CMS jointly released its Proposed Rules for the 2020 Medicare Physician Fee Schedule and 2020 Hospital Outpatient Prospective Payment System that would update Medicare payment policies aimed at increasing price transparency, improving quality, and reducing burdens on providers. Some…
The Centers for Medicare & Medicaid Services (CMS) published a Final Rule on July 18, 2019 that repealed a prior rule prohibiting Long-Term Care (LTC) facilities from using pre-dispute, binding arbitration agreements. LTC facilities that choose to utilize arbitration agreements must adhere to…
