In August 2023, the Centers for Medicare & Medicaid Services (“CMS” or the “Agency”) announced a series of hospice program integrity initiatives it has already begun to take to combat its belief that “hospices are profiting from fraud at the expense of beneficiaries far too
There is little doubt that nursing home residents and staff have been disproportionately affected by the COVID-19 pandemic. Recent statistics released by CMS reveal that, as of May 24, 2020, over 25,000 nursing home residents and 400 staff have died from, and 60,000 residents and
President Theodore Roosevelt once reportedly said, “In any moment of decision, the best thing you can do is the right thing, the next best thing is the wrong thing, and the worst thing you can do is nothing.”1 During the COVID-19 pandemic, it has not
This article was originally published in the American Bar Association’s publication Health eSource, vol. 34, no.2, April 13, 2020. Proposed Opioid Settlement: Purdue Pharma In September 2019, Purdue Pharma (Purdue) announced its agreement in principle on a framework for a “landmark” opioid litigation settlement worth,
Medicare Advantage Organizations Generally, Medicare Advantage Organizations (MAOs) maintain provider networks and either limit an enrollee’s ability to obtain Medicare-covered services from out-of-network providers or charge enrollees more when they receive services from out-of-network providers. On March 10, 2020, CMS released guidance for MAOs (as
In response to the COVID-19 pandemic, hospitals face unique challenges under EMTALA and HIPAA regulations. This guidance outlines essential requirements for medical screening examinations, patient transfers, and the limited waiver of HIPAA sanctions. Discover how hospitals can adapt their protocols to ensure compliance while prioritizing
CMS’s Blanket Stark Waivers: As a result of the public health emergency caused by COVID-19, on March 30, 2020, CMS issued Blanket Waivers with respect to 18 categories of referrals and/or remuneration arrangements (see attached, below). The Waivers were designed to ensure that there are
This article was originally published in the American Bar Association’s publication Health eSource, vol., no.3, November 18, 2019. Introduction Every week – if not every day – it seems like one can pick up a newspaper or magazine and read a story related to the
Nursing Homes and Other Long-Term Care Facilities As many of you are likely already aware, a nursing home located in Washington State, Life Care Center of Kirkland (Life Care), was at the epicenter of the state’s COVID-19 outbreak and was the subject of a complaint
Telehealth: The Basics Medicare & Telehealth: The Way It Was and the Way It Is Now: Prior to the COVID-19 epidemic, CMS placed a number of restrictions on the use of telehealth in connection with the provision of services to Medicare beneficiaries. Many of these