The Centers for Medicare and Medicaid Services (“CMS”) recently suspended a key procedure for resolving payment disputes between out-of-network providers and health facilities against insurers under the No Surprises Act. The procedure is the Independent Dispute Resolution (“IDR”) process. It…
The U.S. Department of Health and Human Services, Office for Civil Rights (“OCR”) recently concluded its investigation into Yakima Valley Memorial Hospital (“Yakima”). The matter illustrates the need to limit access to private health information (“PHI”) to those members of the workforce with a need…
After the passage of transformative legislation and the announcement of groundbreaking new administrative processes, the Professional Licensing Agency (PLA) is poised to undergo a rapid modernization. This evolution will be much broader in scope and implemented at a faster pace than the norm for…
On May 3, 2023, the Centers for Medicare and Medicaid Services (“CMS”) published not one, but two, proposed rules for state Medicaid programs. Totaling nearly 300 pages, these rules are aimed at strengthening Medicaid and improving access to care, quality, health outcomes, and health equity issues…
The Indiana Legislature recently enacted and the Indiana Governor recently signed House Bill 1006 (the “Bill”). The changes in the bill are effective as of July 1, 2023. The legislation contains significant amendments to the Indiana law governing emergency mental health detentions. Currently, any…
The U.S. Department of Health and Human Services, Office for Civil Rights (“OCR”), recently concluded its investigation into MedEvolve, a business associate (“Business Associate”) of a covered health care entity. Business Associate self-reported a data breach to OCR that exposed the Protected…
Over the past three years, healthcare providers have adapted to specific regulatory requirements that were originally set to end when the federal public health emergency (“PHE”) expired. The PHE provided certain flexibilities and regulatory requirements over the past few years, that enabled health…
The Centers for Medicare and Medicaid Services (“CMS”) is making another concerted effort to enforce hospital cost transparency rules that have been in effect since January 1, 2021 (the “Rules”) as explained in our prior alert. Since that time, CMS struggled to enforce compliance with the Rule and…
Indiana continues down the path of instituting a managed care model for long term services and supports. The Indiana legislature recently enacted House Bill (HB) 1461 that provides sweeping regulatory relief to the provider industry. The legislation provides for implementation of the Family and…
The Indiana General Assembly recently passed Senate Enrolled Act (“SEA”) 71, which further narrows the use of noncompete agreements with respect to all employed physicians, but especially primary care physicians. The new law will take effect on July 1, 2023, after Governor Eric Holcomb’s expected…
Krieg DeVault Health Care Regulatory Lawyer, Brandon W. Shirley breaks down his recent alert on the proposed overpayment rule issued by the Centers for Medicare & Medicaid Services (CMS).
The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule that would eliminate the “reasonable diligence” requirement that Medicare Part A and Part B providers had to investigate and quantify Medicare repayments under 42 C.F.R. § 401.305. This reasonable diligence period,…
