On November 18, 2019, the Medicaid world was “rocked” when the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule titled “Medicaid Fiscal Accountability Rule” (“Proposed Rule”). While intending to strengthen the fiscal integrity and promote transparency of the Medicaid…
For years, many experts have predicted the disappearance of private medical practices in favor of hospital-employed arrangements. In fact, a 2019 Merritt Hawkins study found that 45% of final-year medical residents were open to hospital employment. This compares to just 36% in 2014 and 22% in 2008.…
The Department of Health and Human Services, Office of Inspector General (“OIG”) conducted an audit and published a new report (“Report”) that identifies inconsistencies and questionable extrapolation practices used by Medicare contractors to identify Medicare Part A and B overpayments. While the…
On August 25, 2020, CMS issued an Interim Final Rule (“New Rule”) revising regulations for numerous provider types in response to the COVID-19 public health emergency. With respect to Skilled Nursing Facilities for Medicare and Nursing Facilities for Medicaid (collectively, “Nursing Homes”), the New…
In a pair of press releases, the Office of Civil Rights (“OCR”) announced that it had resolved unrelated complaints relating to religious liberty in the context of overzealous Covid-19 precautions. The first case involved a hospital preventing a Catholic priest from visiting with a seriously…
Earlier this year, the U.S. Government Accountability Office (“GAO”) issued a Report to Congressional Requesters (“Report”) recognizing state views on administration challenges with the Medicaid program. The audit informing the Report lasted nearly two years and was conducted in response to a…
House Bill 1004 (“HB 1004”), signed into law earlier this year, imposes new patient billing requirements affecting health care providers and health care facilities beginning July 1, 2020. With few exceptions, HB 1004 requires health care providers and facilities to give a patient a good faith…
Late last week, the Department of Health and Human Services (“HHS”) updated its Frequently Asked Questions (“FAQ”) webpage to provide guidance on the tax treatment of payments received under the Public Health and Social Services Emergency Fund (the “Provider Relief Fund”). The new FAQ makes it…
As we previously reported, with case counts accumulating amongst the vulnerable patient population in nursing homes, the Indiana State Department of Health (“ISDH”) has mandated that all nursing home (“facility”) staff must undergo testing for COVID-19, free of charge, during the period of June 15,…
While the goal of any organization is to avoid investigation by government agencies altogether, the reality is that health care providers operate in a highly regulated industry resulting in greater risk of encountering an enforcement action at some point. Therefore, it is imperative to consider how…
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…
Nursing facilities have undoubtedly encountered unique challenges during the ongoing COVID-19 public health crisis. In an effort to protect the vulnerable population receiving care in these facilities, the Centers for Medicare and Medicaid Services (CMS) issued guidance on June 1, 2020 announcing…
