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CMS Issues Proposed Rule Revising the Long-Term Care Facility Medicare and Medicaid Participation Requirements

By: Meghan M. Linvill McNab on September 9, 2015

On July 16, 2015, CMS issued a proposed rule revising the Long-Term Care Facility Medicare and Medicaid participation requirements. These proposed revisions would serve as a widespread update to the participation requirements which have not been comprehensively reviewed and updated since 1991,…

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CMS Clarifies Access to Documentation as a Condition of Payment

By: Thomas N. Hutchinson on September 9, 2015

Earlier this year, CMS published a Medicare notice titled Clarification of Ordering and Certifying Documentation Maintenance Requirements (Change Request 9112), which clarifies the term "access to documentation" in the Medicare Program Integrity Manual (Pub. 100-08, Chapter 15, Section 15.18).

Under…

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No "Privilege Against Self-Incrimination" (Fifth Amendment) for Corporate Documents in a Fraud and Abuse Investigation

By: Meghan M. Linvill McNab on June 17, 2015

In a federal grand jury investigation into illegal physician kickbacks paid by a laboratory, Circuit Court Judge Cohen, writing for the U.S. Court of Appeals for the Third Circuit, affirmed the U.S. District Court for the District of New Jersey’s order of contempt against a physician and his…

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CMS Proposes Medicaid Managed Care Revisions

By: Meghan M. Linvill McNab on June 17, 2015

 The Centers for Medicare & Medicaid Services (“CMS”) published its proposed rule to update its standards and requirements for Medicaid managed care plans.

CMS notes that laws passed since the Medicaid managed care regulations were promulgated in 2002 have changed Medicaid to such an extent that the…

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ACO Final Rule Released

By: Brian M. Heaton on June 17, 2015

On June 4, 2015, the Centers for Medicare and Medicaid Services (“CMS”) issued a Final Rule for the “Medicare Shared Savings Program: Accountable Care Organizations.” The Final Rule follows the December 2014 Proposed Rule and the review of more than 270 public comments. The Medicare Shared Savings…

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Changes to Advanced Practice Nurse and Physician Assistant Laws

May 5, 2015

Utilization of advanced practice nurses, such as nurse practitioners, and physician assistants has been increasing over the past few years. Laws with respect to these health care providers have also changed, both on a Federal and State level. On May 4th, Governor Mike Pence signed into Indiana law…

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