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Articles Posted in Medicare/Medicaid

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CMS Issues Guidance to Mitigate the Spread of COVID-19 in Long-Term Care Facilities

On April 2, 2020, the Centers for Medicare and Medicaid Services (CMS), in consultation with the Centers for Disease Control and Prevention (CDC), issued critical guidance to nursing homes and state and local governments to mitigate the spread of COVID-19 in long-term care facilities. While CMS and the CDC have…

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CMS to Distribute $30 Billion in Grants Under the CARES Act to Providers to Alleviate the Burden Imposed by COVID-19

In a Coronavirus Task Force press briefing on April 7, 2020, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma (the “Administrator”) announced that CMS will distribute $30 billion in grants from the Public Health and Social Service Emergency Fund (PHSSEF) to providers to help alleviate the burden that…

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CMS Expands the Accelerated and Advance Payments Program during COVID-19 Emergency

On March 28, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it is expanding its Accelerated and Advance Payment Program for healthcare providers and suppliers participating in Medicare. CMS is expanding the program to ensure that all Medicare-participating providers and suppliers have the resources necessary to combat…

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CMS Responds to FAQs Regarding COVID-19 Provider Burden Relief

The Centers for Medicare and Medicaid Services (CMS) has issued a Frequently Asked Questions (FAQs) Sheet responding to eight (8) FAQs regarding provider burden relief for COVID-19. Below is an overview of the FAQs Sheet issued by CMS. Is CMS suspending most Medicare Fee-For-Service (FFS) medical review during the Public…

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N.Y. Department of Health Expands Telehealth Policy for Medicaid During COVID-19 Pandemic

On March 21, 2020, the New York Department of Health (DOH) published guidance in the New York State Medicaid Update March 2020 Special Edition Vol. 36, No. 5 (the “Guidance”) regarding the expansion of telehealth in response to COVID-19. The DOH’s Guidance expands telehealth to better protect Medicaid members from…

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Stark, AKS, and CMP Reforms on the Horizon with New HHS Proposed Rules

“We serve patients poorly when government regulations gather dust in the attic: they become even more stale and liable to wreak havoc throughout the health care system. Administrative costs are driving up the cost of health care in America – to the tune of hundreds of billions of dollars. The…

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CMS Issues New Rule to Strengthen the Ability to Stop Fraud

By Adrienne Dresevic, Esq. and Carey Kalmowitz, Esq. of The Health Law Partners, P.C. The Centers for Medicare & Medicaid Services (CMS) issued a final rule that strengthens the agency’s ability to stop fraud by barring unscrupulous providers out of federal health insurance programs. This rule is unlike past rules…

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Ashland Physician and Substance Abuse Treatment Center Agree to Pay $1.4 Million to Resolve Civil Claims

An Ashland, KY addiction treatment specialist, Dr. Rose O. Uradu, and her substance abuse treatment center, Ultimate Care Medical Services, LLC d/b/a Ultimate Treatment Center, have agreed to pay $1.4 million to resolve civil allegations that they violated the Controlled Substances Act, and defrauded the Medicare and Kentucky Medicaid programs.…

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2020 OPPS Proposed Rule: Further Price Transparency Requirements for Hospitals

In the recently released CY 2020 Outpatient Prospective Payment System (OPPS) proposed rule, the Centers for Medicare & Medicaid Services (CMS) introduced policies that, if finalized, would require hospitals to post a list of standard charges for items and services provided. This proposed rule updates the requirements set forth in…

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Patient Recruiter Found Guilty in $1.3 Million Medicare Kickback Scheme

On July 30, 2019, a federal jury in Detroit, Michigan, found a patient recruiter guilty for his role in a scheme involving approximately $1.3 million in fraudulent Medicare claims for home health care that were procured through the payment of illegal kickbacks. Following a six-day trial, Dominic Trumbo, 45, of…