On September 7, 2017, the Health and Human Services Office of Inspector General (“OIG”) published Opinion 17-05 (“Opinion”) that allowed a retail pharmacy to include Medicare and Medicaid beneficiaries in the pharmacy’s discount benefit program. The…
The Joint Commission is enhancing provider Element of Performance (“EP”) protocols regarding patient medications in response to the nation’s ongoing opioid crisis. Specifically, the Joint Commission has revised its Medication Management (MM) EPs “to…
The Interim Study Committee on Public Health, Behavioral Health, and Human Services (“Committee”) met on September 28, 2017, to discuss the following topics: 1) Potential improvements to the INSPECT program; and 2) the shortage of health care…
Hurricanes Harvey and Irma have devastated our nation in recent weeks and significantly impacted health care facilities in the affected areas. To better address preparedness for disasters such as Hurricanes Harvey and Irma, the Centers for Medicare…
A July 21, 2017 letter from CMS approves Indiana’s State Plan Amendment (“SPA”) 17-0002, which “proposes to bring Indiana into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment.”[1] In review of…
A quick peek at CMS’ FY 2018 budget (and beyond) indicates that CMS is investing heavily in rules enforcement.[1] Encouraged by a Fraud Prevention System return on investment of $11.50 for every $1.00 spent[2], CMS sees enhanced enforcement as a…
As part of the August, 14, 2017 Inpatient Prospective Payment System (“IPPS”) Final Rule[1], the Centers for Medicare and Medicaid (“CMS”) revised the public notice requirements for Medicare provider agreement terminations.
Previously, a Rural…
After months of negotiations, Senate Majority Leader Mitch McConnell failed to find enough Republican support to advance some form of health care reform legislation late last week. Accordingly, the Patient Protection and Affordable Care Act (“ACA”)…
Without surprise, not many hospital providers joined in the celebration of EMTALA’s recent 30th anniversary. A lack of shared joy notwithstanding, EMTALA remains as rigorous, nuanced, and enforced as when it was first enacted as part of the 1986…
A June 12, 2017, OIG report indicates that, between 2001 and 2014, CMS paid $730 million in electronic healthcare record (“EHR”) incentive payments to eligible professionals (“EPs”) who did not comply with Federal requirements for “meaningful use”…
On June 30, 2017, CMS published a proposed rule with changes and policy updates to the Quality Payment Program (“QPP”) for calendar year 2018. The QPP, established under the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), includes…
Indiana’s seven day script law for new patients, Senate Enrolled Act (“SEA”) 226, went into effect on July 1, 2017.[1] Under SEA 226, the general rule is as follows: A prescriber may not issue more than a seven day supply of an opioid if the…
