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Search OptionsHealth CareCMS's New Federal Prior Authorization Rule: An Eventual Step In the Right Direction
CMS published a final rule, effective January 1, 2026, implementing additional processes to advance interoperability as well as to improve prior authorization processes. The changes to prior authorization will require: (1) Medicare Advantage, Medicaid Fee-for-Service (“FFS”) and Medicaid Managed… Navigating Digital Privacy in Healthcare: Understanding Web Tracking and HIPAA Concerns (Podcast)
In this episode of the Krieg DeVault Podcast… The OIG’s New Unified Compliance Resource Tool: You’ve Been “Voluntold” to Comply
The United States Office of Inspector General (“OIG”) published a unified compliance resource tool on November 6, 2023. While the General Compliance Program Guidance (“GCPG”) does not provide new substantive content, it does provide a single source of information relating to some of the greatest… Lawsuit Challenges HHS Guidance on the Use of Web Tracking Technologies
On November 2, 2023, parties including the American Hospital Association (“AHA”) sued the U.S. Department of Health and Human Services (“HHS”) Office of Civil Rights (“OCR”) in a federal court in Texas. In their complaint they challenge the enforcement of an OCR guidance bulletin (the, “Bulletin”),… Expansion of Medicare Coverage for Behavioral Health Services
As part of CMS’ annual Medicare OPPS and ASC Final Rule, it finalized new Medicare coverage of intensive outpatient program (“IOP”) services performed in hospital outpatient departments, CMHCs, FQHCs, and RHCs. Coverage begins January 1, 2024. This new coverage is intended to address the gap… President Biden Issues Executive Order on Artificial Intelligence
On October 30, President Biden issued his Executive Order on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence, along with a companion Fact Sheet issued by the White House. The Executive Order establishes the federal government’s priorities with respect to Artificial… A Time to Change
On August 2, 2023, CMS published the fiscal year 2024 Inpatient Psychiatric Facilities Prospective Payment System (“IPF PPS”) Final Rule. One of the included regulatory changes was to the permitted timing for a hospital to convert a rehabilitation or psychiatric unit from “non-excluded” to… SURPRISE! Federal Alternative Dispute Resolution Grinds to a Halt
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… Inquiring Minds Want to Know - Limit Access to PHI to Prevent Snooping
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… Rapid Modernization: Major Changes Coming to the Professional Licensing Agency
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… A Direct Proposal: New Proposed Medicaid Rules for State Directed Payments
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… HOLD ON A MINUTE! INDIANA LEGISLATURE CHANGES THE RULES FOR EMERGENCY DETENTIONS
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… |
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