As part of its 2022 Inpatient Prospective Payment System (IPPS) Proposed Rule for Acute Care Hospitals, the Centers for Medicare and Medicaid (CMS) is proposing an increase for Medicare fee-for-service payment rates to acute care hospitals by 2.8 percent, or $3.4 billion in Fiscal Year (FY) 2022.[[1]] Hospitals hoping to receive the payment increase must successfully participate in the Hospital Inpatient Quality Reporting Program and be meaningful electronic health record users ...
On Dec. 14, 2021, the Centers for Medicare and Medicaid Services (CMS) unexpectedly issued a letter to U.S. Senator Ron Widen (D-OR)[1] indicating that CMS plans to use its “administrative authority to issue proposed rulemaking” addressing price concessions and direct and indirect remuneration (DIR) fees that pharmacy benefit managers (PBMs) have increasingly charged to specialty and retail pharmacy providers in Medicare and other pharmacy benefit programs in recent years ...
At the end of 2022, the Centers for Medicare and Medicaid (“CMS”) issued a proposed rule that would amend the standard imposed on Medicare providers to report and return overpayments. If finalized, the proposed rule would replace the 60-day overpayment rule’s current “reasonable diligence” standard with the False Claims Act “knowingly” standard ...
On Nov. 20, 2020, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS) issued two final rules, which implement changes to the Physician-Self Referral Law (Stark Law) and the Anti-Kickback Statute (AKS) regulations (respectively the OIG Final Rule and the CMS Rule, collectively the Final Rules). This alert is a part of the Dinsmore Health Care practice group’s ongoing summary of the Final Rules ...
In a letter to state Medicaid directors on Nov.13, 2018, the Secretary of the U.S. Department of Health and Human Services, Alexander Azar, announced a new demonstration opportunity that will allow states to provide improved care for adults with a serious mental illness (SMI) and children with serious emotional disturbance (SED) ...
On April 27, 2021, the Center for Medicare & Medicaid Services (CMS) announced revised guidance for Interim Final Rule, CMS-3401-IFC related to Long-Term Care Facility Testing Requirements and the COVID-19 Focused Survey Tool. CMS published the initial interim final rule with comment period on Aug. 25, 2020 ...
On April 27, 2021, the Center for Medicare & Medicaid Services (CMS) announced revised guidance for Nursing Home Visitation. CMS issued its initial guidance in March 2020, via memorandum QSO-20-14-NH. Under this memorandum, all visitation by visitors and non-essential health care personnel was restricted, except for situations involving compassionate care, such as end-of-life ...
Recently, the Centers for Medicare & Medicaid Services (CMS) announced it is rescinding the audit determinations for providers notified in January 2021 that had failed to qualify for the “mid-build” exception. CMS took this action due to questions raised by these providers regarding the audit process ...
On April 8, 2021, the Center for Medicare & Medicaid Services (“CMS”) announced a proposed rate increase of 1.3 percent for skilled nursing providers in fiscal year 2022. It is estimated this will result in approximately $444 million increase in payments to skilled nursing facilities (SNF) under Medicare Part A for the fiscal year. This increased payment rate does not incorporate the SNF Value-Based Program (VBP) reductions that CMS estimates to be $184 ...
The Centers for Medicare & Medicaid Services (CMS) announced during a March 19, 2020 teleconference for physicians and teaching hospitals that it does not have the authority to postpone the statutory timeline for the Physician Payments Sunshine Act (Sunshine Act) ...
The Centers for Medicare and Medicaid Services (CMS) announced on March 13, 2020 enhanced penalties for infection control survey non-compliance amid the COVID-19 pandemic.[1] On June 1, 2020, CMS announced significant changes related to nursing home surveys. The new changes require states to complete 100 percent of their Focused Infection Control nursing home surveys by July 31, 2020 ...
On Feb. 24, 2022, the Centers for Medicare and Medicaid Services (CMS) announced the redesign of its Global and Professional Direct Contracting (GPDC) accountable care organization (ACO) into one that focuses on health equity. The redesigned model, Realizing Equity, Access, and Community Health (REACH), was modified to reflect the Biden administration’s policy priorities as well as stakeholder feedback and participant experience ...
EPA continues to make progress in its effort to repeal and replace the Clean Power Plan (CPP). EPA held public hearings on November 28-29, 2017, in Charleston, West Virginia to take testimony on its October 10, 2017, proposal to repeal the rule. EPA is accepting comments on the proposal to repeal the rule through January 16, 2018. EPA announced it will hold three additional public comment sessions due to the “overwhelming response” to the West Virginia hearing ...
A recent Tenth Circuit decision shines light on a new avenue to challenge cannabis businesses, even in states where medical and recreational marijuana is legal. Although the potential federal criminal threat to cannabis businesses in states that have legalized medical or recreational cannabis has been relatively well-discussed, the potential civil threat has received little attention. In Safe Streets Alliance v. Hickenlooper, 859 F.3d 865 (10th Cir ...
Cincinnati, Ohio has joined a small but growing list of states and municipalities that ban discrimination on the basis of natural hair styles. On Oct. 9, 2019, the Cincinnati City Council voted 7-1 to add a hair-bias ban to the city’s existing non-discrimination law ...
The federal government has announced a new policy that will grant a path to work authorization and legal status for the undocumented spouses of U.S. citizens. The policy, which is known as “parole in place” or “PIP,” is expected to be similar to the existing PIP program in effect for family members of U.S. military personnel ...
For those of us in the HUD-insured multifamily finance space who make our living trying to shrink the time period between firm commitment and closing, Chapter 19 of the new Multifamily Accelerated Processing (MAP) Guide was a must-read when it was published at the end of 2020 ...
In March of 2021, Dinsmore published a client alert titled “Chapter 19 of HUD’s New MAP Guide – Initial Takeaways for Lenders and Borrowers.” In that article, we offered our observations about new requirements in the MAP Guide and predicted how those requirements might impact the loan closing process ...
The events of this spring had many school districts looking forward to summer break. Unfortunately, it’s not quite resting time yet. On May 6, 2020, the U.S. Department of Education Secretary Betsy DeVos released new rules, which apply to colleges as well as K-12 schools and mark the first time the department has promulgated regulations under Title IX addressing how schools must handle sexual assault cases involving students ...
On June 16, 2020, Governor Mike DeWine signed into law House Bill 81. Its impact is significant for employers in the context of workers’ compensation. Governor DeWine touted the amendment that provided workers’ compensation coverage for medical diagnostic services to investigate whether a detention facility employee’s exposure to another’s blood or bodily fluids resulted in an injury or occupational disease ...
Effective Oct. 17, 2019, hospital outpatient departments (HOPDs) and other facilities which previously were exempt from the Ambulatory Surgical Facility (ASF) licensure requirement may now meet the criteria of an ASF. Governor Mike DeWine’s budget bill contained provisions which modified the definition of an ASF and will expand the number of facilities subject to regulation under Ohio law as an ASF ...
Effective Oct. 15, 2020[1], the Committee on Foreign Investment in the United States’ (CFIUS) mandatory filing requirement will shift from a critical technology[2], industry-specific focus to one focused on export controls. It will focus on whether the U.S. regulatory authorization would be required to export the target U.S. business’ critical technology to the foreign person party to the transaction, including certain parties in the foreign person’s ownership chain ...
On Thursday, May 13, 2021, the Centers for Disease Control (CDC) announced new guidance stating it is safe for fully vaccinated people to not wear masks or physically distance in any non-health care setting.1 Per this guidance, fully vaccinated people can now resume most activities without wearing a mask or physically distancing ...
On April 13, 2020, the Centers for Disease Control and Prevention (“CDC”) issued guidelines on safety practices for critical workers who may have had exposure to a person with suspected or confirmed COVID-19 ...
On Oct. 21, 2020, the Centers for Disease Control and Prevention (CDC) released a new definition for “close contact.” The new definition was expanded to account for the cumulative amount of exposure one might have had with a person infected with COVID-19. Under the new definition, close contact is defined as being “within six feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period beginning two days before illness onset ...
