Perspectives on Regulatory Compliance
60 total results. Page 1 of 3.
Beware of Your Medicare Advantage Capitated Arrangements – False Claims Act Exposure Lurks in Your Diagnosis Coding
After announcing in December that it would intervene in a qui tam action under the False Claims Act against Sutter Health and Palo Alto Medical Foundation (PAMF), the US Department of Justice filed its complaint-in-intervention in the Northern District of California on March 4, 2019.
In Los Angeles alone, the LA City Attorney's Office has in recent years initiated numerous lawsuits against hospitals and nursing facilities for homeless patient “dumping” – a practice generally described as discharging homeless persons without regard to their safety or ability to find shelter.
Lowell C. Brown, Debra Albin-Riley, Douglas A. Grimm, FACHE, Thomas E. Jeffry, Jr., D. Jacques Smith, Jennifer C. Terry, Sarah G. Benator, Susanna Hathaway Murphy, Diane B. Roldán
We are very pleased to announce that our Health Care attorneys will be hosting two Medical Staff Leaders and the Law Conferences in 2019.
WASHINGTON — Arent Fox LLP is pleased to announce that Health Care Co-Leader Stephanie Trunk has been selected to the LMG Life Sciences Award List in the “Healthcare Pricing & Reimbursement” category.
CY 2019 Medicare Physician Fee Schedule and Part B Proposed Rule Signals Payment Reduction for New Part B Drugs
The Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019 Proposed Rule (the Proposed Rule) is scheduled to be published in the Federal Register on July 27, 2018.
The ABA Young Lawyers Division Health Law Committee and ABA Health Law Section is hosting a networking reception followed by a roundtable discussion with senior government attorneys from CMS, DOJ, and OIG.
In-house counsel for health industry organizations face unique challenges – but those challenges can be met.
The Centers for Medicare and Medicaid (CMS) is overhauling the Electronic Health Records (EHR) Medicare and Medicaid program for hospitals.
Linda Baumann Discusses New Compliance Risks for Hospitals Related to Medical Devices for Bloomberg Law
Arent Fox Health Care Partner Linda Baumann discussed the potential compliance risks facing hospitals in connection with recalled medical devices for Bloomberg Law in an article titled, “Gaps in Hospital Recalled Device Reporting a ‘Wake-Up Call.’”
On December 28, 2017, the Centers for Medicare and Medicaid Services (CMS) issued Survey and Certification Memorandum Number 18-10-ALL to the State Survey Agencies clarifying its position regarding texting health care information by providers.
In recent months, a number of bills have been introduced or passed in Congress that would ease federal health care programs’ restrictions on telehealth. Currently, Medicare has strict limitations on telehealth.
The Department of Health and Human Services Office of Inspector General recently published its 2017 Work Plan, which furnishes key guidance to providers and suppliers and others doing business in the health care industry on the agency’s enforcement priorities for the upcoming year.
It’s About Time: The California Board of Registered Nursing Proposes the First Updates to Nurse Practitioner Regulations in 30 Years
Earlier this month, the California Board of Registered Nursing (BRN) proposed significant changes to regulations affecting nurse practitioners (NP) practicing in the state.
Rising prescription drug costs have been big news this year, and states are beginning to respond.
In March 2012, the Centers for Medicare & Medicaid Services (CMS) enhanced its Medicare enrollment screening for new and existing enrollees to the Medicare program. Providers not meeting CMS’s enhanced enrollment screening risk denial, revocation, or deactivation of Medicare billing privileges.
Guidance to Pharma from CMS: How to Calculate the New Inflation-Based Additional Rebate for Generic Drugs
The Program Notice provides some guidance on how generic drug manufacturers are to calculate the new Additional Discount on generic drugs that will become part of the rebate due state Medicaid programs under the Medicaid Drug Rebate Program.
The Move to Value-Based Payment Continues: CMS Announces Initiative to Transform Primary Care Delivery and Payment
On April 11, 2016, the Centers for Medicare and Medicaid Services (CMS) announced its Comprehensive Primary Care Plus (CPC+) initiative.
If finalized, the Proposed Rule would represent the most dramatic change in Part B Drug reimbursement since the enactment of the Medicare Modernization Act.
Together We Stand(ard): CMS and AHIP Announce Standardization of Quality Measures for Physicians and ACOs
As pay-for-performance programs continue to expand in both scale and scope across the US health care system, the amount of administrative and clinical resources necessary to participate in these programs has correspondingly grown.
Linda A. Baumann, Lowell C. Brown, Douglas A. Grimm, FACHE, Sarah G. Benator, Susanna Hathaway Murphy
The Centers for Medicare and Medicaid Services (CMS) intend to strengthen provider and supplier enrollment screening – meaning, scrutinizing providers and suppliers more closely during enrollment – according to a February 22, 2016 post on its blog.
CMS’s Long-Awaited Final 60-Day Repayment Rule Provides Guidance and Eases Some Requirements for Health Care Providers and Suppliers
On Friday, February 12, 2016, the Centers for Medicare and Medicaid Services (CMS) released the long-awaited Final Rule and regulations, providing much needed guidance to providers and suppliers on how to meet the Affordable Care Act’s (ACA’s) 60-day overpayment mandate.
CMS has finalized surveyor worksheets for assessing a hospital’s compliance Quality Assessment and Performance Improvement (QAPI).
On January 21, 2016, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited Final Rule implementing changes to the Medicaid Drug Rebate Program (MDRP) under the Affordable Care Act (ACA).
In an important development, the Centers for Medicare and Medicaid Services (CMS) has issued additional final regulations implementing the Stark Law as part of the Physician Fee Schedule for calendar year 2016 (see 80 Fed. Reg. 70,886 (Nov. 16, 2015)).