The Office of the Secretary of Family and Social Services finalized LSA Document #17-342, which is a rule amendment that impacts Indiana Medicaid home health service providers (“Final Rule”).[1] In general, the Final Rule seeks to align Indiana home…
In April 2018 the U.S. Department of Health and Human Services Office of Civil Rights (OCR) published guidance entitled “Risk Analyses v. Gap Analyses – What is the difference?” (the “Guidance”).[1] This Guidance is extremely helpful for both…
The Bipartisan Budget Act of 2018 (“BBA”) was signed into law February 9 and funds the federal government through March 23. Additionally, the legislation contains significant health care policy changes. Of important note are dramatic increases to…
On April 27, 2018, CMS announced four (4) new proposed rules to “advance administrative burden reduction, Medicare modernization, and the Meaningful Measures Initiative.” These proposed regulations apply to the following payment systems: (i) Skilled…
The Indiana Legislature recently made several significant and common sense changes to Indiana’s medical consent statute (I.C. 16-36-1-1 et. seq.) and added a new section to the Indiana Code about Physician Orders for Scope of Treatment (POST) forms…
In February 2018, the Center for Medicare and Medicaid Services (“CMS”) revised its MLN Booklet on Telehealth Services (the “Telehealth Booklet”).[1] Medicare continues to be fairly restrictive in terms of reimbursing telehealth services. While the…
On March 14, 2018, Governor Eric J. Holcomb signed into law a measure that provides for significant streamlining of the prior authorization requirements for health care services covered by commercial health insurance plans in Indiana that are not…
Governor Eric Holcomb is expected to sign legislation aimed at curbing Indiana’s growing opioid crisis, one of Governor Holcomb’s top agenda items for the 2018 legislative session. Senate Enrolled Act 221 (“SEA 221”) requires prescribers to have…
The Centers for Medicare and Medicaid Services (“CMS”) recently issued guidance (MLN Matters SE17033 – Revised) re-emphasizing that Medicare should not pay an acute care hospital for services furnished to a Medicare beneficiary, when the beneficiary…
CMS’ recent MLN Connects e-Newsletter reminds providers of their obligation to report changes in ownership to CMS and highlighted the 2016 Office of Inspector General (“OIG”) study that revealed providers may not be properly reporting changes in…
In a recent announcement by the U.S. Department of Health and Human Services (“HHS”), Office of Civil Rights (“OCR”), the OCR was clear to make a point that just because a business closes during an OCR investigation, does not mean that the business’…
A December 2017 Office of Inspector General (“OIG”) Advisory Opinion favors a gainsharing arrangement whereby a hospital will share with specific neurosurgeons a percentage of the hospital’s cost savings from spinal surgeries performed at the…
