Congress Adds AKS and Stark Law Exceptions for Certain Wellness Programs
As a part of the Consolidated Appropriations Act, 2023 (CAA), Congress passed new exceptions to the Physician Self-Referral Law (Stark Law) and the federal Anti-Kickback Statute (AKS) allowing certain...
View ArticleHealthcare Regulatory Check-Up | April 2023
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for April 2023. We discuss several criminal and civil enforcement actions related to the...
View ArticleSuperValu: It’s Not Super Bad! A Practical Look at the Supreme Court’s Recent...
Two separate lawsuits alleging False Claims Act (FCA) violations by retail drug pharmacies made their way to the Supreme Court of the United States this term. The lawsuits decided whether the...
View ArticleHealthcare Regulatory Check-Up Newsletter - May 2023 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for May 2023. We discuss several criminal and civil enforcement actions that involve violations of...
View ArticleTop Takeaways | 2023 Physician Practice Management & ASC Symposium 2023 |...
In this session, McDermott Will & Emery Partners Denise Burke, Tony Maida and Monica Wallace discussed top issues and enforcement trends that physician practice management companies (PPMs) and...
View ArticleHealthcare Regulatory Check-up Newsletter | June 2023 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for June 2023. We discuss several civil enforcement actions involving false claims, the Anti-Kickback...
View ArticleHospitals: Check Your Addresses or Face Medicare Claims Returns!
Following an implementation delay during the COVID-19 public health emergency (PHE), on August 1, 2023, the Centers for Medicare and Medicaid Services (CMS) initiated Medicare hospital claims edits...
View ArticleHealthcare Regulatory Check-up Newsletter | July 2023 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for July 2023. We discuss several criminal and civil enforcement actions that involve violations of...
View ArticleHealthcare Regulatory Check-Up - August 2023
AUGUST REGULATORY UPDATE SUMMARY - This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for August 2023. We discuss several criminal and civil enforcement...
View Article[Hybrid Event] Healthcare Litigation, Compliance and Investigations Forum...
McDermott’s Healthcare Litigation, Compliance and Investigations Forum is back when you need it the most. Heightened regulatory scrutiny and enforcement activity pose legal, financial and reputational...
View ArticleOIG Pathology Lab: Don't Pay for Services You Don't Need
In September, the US Department of Health and Human Services Office of Inspector General (OIG) issued an unfavorable advisory opinion to a pathology laboratory concerning a proposed services...
View ArticleOIG Issues General Compliance Program Guidance Updates
On November 6, 2023, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) published the General Compliance Program Guidance (GCPG) as a revised reference guide for the...
View ArticleHealthcare Regulatory Check-up Newsletter | October 2023 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for October 2023. We discuss several enforcement actions that involve violations of the False Claims...
View ArticlePrivate Equity and REITs, Take Note! CMS Finalizes Nursing Facility Ownership...
On November 17, 2023, the US Department of Health and Human Services (HHS) published a final rule requiring nursing facilities participating in Medicaid and skilled nursing facilities participating in...
View ArticlePrivate Investors and Digital Health Attracting OIG Attention: General...
On November 6, 2023, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) published the General Compliance Program Guidance (GCPG) as a revised reference guide for the...
View ArticleMedicare Provider and Supplier Enrollment Requirements: Program Integrity...
The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare provider and supplier enrollment regulations, including adding marriage and family therapists...
View ArticleStark Law Changes for 2024: CMS Updates Designated Health Services Code List
On November 29, 2023, the Centers for Medicare & Medicaid Services (CMS) published the 2024 annual update to the designated health services (DHS) Code List. This annual update includes important...
View ArticleHealthcare Regulatory Check-Up Newsletter | November 2023 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for November 2023. We discuss several US Department of Health and Human Services (HHS) agency actions, including...
View ArticleHealthcare Regulatory Check-Up Newsletter | December 2023 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for December 2023. We discuss several civil and criminal enforcement actions that involve alleged...
View ArticleHealthcare Regulatory Check-Up Newsletter | January 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for January 2024. We discuss several US Department of Health and Human Services (HHS) agency actions, including...
View ArticleCMS Finalizes Important Changes to Medicare Enrollment Requirements for...
The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare enrollment regulations applicable to hospices and home health agencies (HHAs), including increasing...
View ArticleDOJ and OIG Actions: 2023 Enforcement Trends Recap
This report reviews notable areas for government enforcement actions during 2023 that were discussed in our monthly Healthcare Regulatory Check-Up reports. In the past year, we saw the relevant federal...
View ArticleHealthcare Regulatory Check-up Newsletter - March 2024
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for March 2024. We summarize a US Court of Appeals for the Second Circuit decision interpreting the intent...
View ArticleCMS Advises Preparatory Steps for Anticipated PrEP Coverage Transition to...
On April 15, the Centers for Medicare & Medicaid Services (CMS) released a fact sheet on the potential national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) using antiretroviral...
View Article[Event] Physician Practice Management and ASC Symposium 2024 - May 15th -...
The Physician Practice Management (PPM) and ASC Symposium 2024 is the destination event for PPM and ASC industry leaders and health industry investors. Join us as we deliver actionable insights on the...
View ArticleHealthcare Regulatory Check-up Newsletter - April 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for April 2024. We discuss several US Department of Health and Human Services (HHS) agency actions, including the...
View ArticleHealthcare Regulatory Check-Up Newsletter | May 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for May 2024. We discuss several notable cases and enforcement resolutions, including the US Court of Appeals for...
View ArticleCMS Issues FAQs to Aid Pharmacies in Preparing for Medicare Part B Coverage...
As we previously advised, the Centers for Medicare & Medicaid Services (CMS) is preparing to issue a national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) using antiretroviral...
View ArticleHealthcare Regulatory Check-Up Newsletter | June 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for June 2024. We discuss several US Department of Health and Human Services (HHS) agency actions, including...
View ArticleHealthcare Regulatory Check-up Newsletter | September 2023 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for September 2023. We discuss several criminal and civil enforcement actions that involve violations of the...
View ArticleHealthcare Regulatory Check-up Newsletter | February 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for February 2024. We discuss various regulatory developments, including guidance on the use of AI in coverage...
View ArticleHealthcare Regulatory Check-Up Newsletter | July 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for July 2024. We discuss several US Department of Health and Human Services (HHS) agency actions, including a...
View ArticleHealthcare Regulatory Check-Up Newsletter | August 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for August 2024. We discuss several enforcement actions pertaining to healthcare fraud, including alleged...
View ArticleHealthcare Regulatory Check-Up Newsletter | September 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for September 2024. We discuss several enforcement actions pertaining to healthcare fraud, including alleged...
View ArticleCMS Extends Remote Direct Supervision Flexibilities in CY 2025 Physician Fee...
On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year 2025 final rule for services reimbursed under the Medicare physician fee schedule. Among other...
View ArticleHealthcare Regulatory Check-Up Newsletter | October 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for October 2024. We discuss several enforcement actions pertaining to healthcare fraud, including alleged...
View ArticleNew Year Brings Material Changes to Medicare Overpayment Rule
The Centers for Medicare and Medicaid Services (CMS) finalized material changes to the overpayment rules for Medicare Parts A, B, C, and D effective January 1, 2025. These changes create new ambiguity...
View ArticleHealthcare Regulatory Check-Up Newsletter | November 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for November 2024. We discuss several US Department of Justice (DOJ) enforcement actions involving the False...
View ArticleCMS Updates Scope of Providers Subject to Provisional Period of Enhanced...
The Centers for Medicare & Medicaid Services’ (CMS) 2025 Home Health Prospective Payment System final rule (Final Rule) expanded the scope of providers subject to a provisional period of enhanced...
View ArticleNew Requirements for Illinois Dental Practices Using Third-Party Financing
Third-party financing services are frequently used by patients to finance out-of-pocket dental expenses. Effective January 1, 2025, dental practices in Illinois are prohibited from facilitating or...
View ArticleHospital Provider-Based Compliance: Top 10 Myths and Truths
Medicare reimbursement for hospital outpatient services has come under attack in recent years, with a focus on “site neutral” payment policies that would pay hospitals for outpatient services furnished...
View ArticleHealthcare Regulatory Check-Up Newsletter | December 2024 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for December 2024. We discuss several civil and criminal enforcement actions pertaining to healthcare fraud and...
View ArticleHHS OIG Releases Updated Nursing Facility Compliance Program Guidance:...
Nursing facilities and skilled nursing facilities that participate in the Medicare and Medicaid programs must comply with certain mandatory compliance program requirements of participation (ROPs)....
View ArticleHealthcare Regulatory Check-Up Newsletter | January 2025 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for January 2025. This month features long-awaited proposed and final rules regarding the Health Insurance...
View ArticleOIG Nursing Facility Compliance Program Guidance: Renewed Focus on Fraud and...
The US Department of Health and Human Services Office of Inspector General’s (OIG’s) release of Nursing Facility Industry Segment-Specific Compliance Program Guidance (ICPG) for the first time since...
View ArticleHealthcare Regulatory Check-Up Newsletter | February 2025 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for February 2025, including long-awaited proposed and final rules regarding the Health Insurance Portability and...
View ArticleCMS Updates SNF Attachment Guidance Ahead of May 1 Enrollment Deadline
Skilled nursing facilities (SNFs) historically have been required to disclose ownership and managerial control information as part of their Medicare enrollment. However, these requirements were...
View ArticleCMS Poised for Medicare, Medicaid Integrity Enforcement Actions
The Trump administration and 119th Congress are preparing to reduce federal expenditures by targeting Medicare and Medicaid fraud, waste, and abuse. Medicare enrollment revocations, Medicaid enrollment...
View ArticleHealthcare Regulatory Check-Up Newsletter | March 2025 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights key regulatory and enforcement activity for March 2025. This month features: - Noteworthy enforcement actions demonstrating that the...
View ArticleHealthcare Regulatory Check-Up Newsletter | April 2025 Recap
This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for April 2025, including Centers for Medicare & Medicaid Services (CMS) updates to Medicare Advantage (MA)...
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