Group Health Plans and Health Insurance Issuers Relating to Dependent...
This regulation outlines the requirements for dependent coverage of children until the attainment of 26 years of age by their parents' group health plans and health insurance issuers in the group and...
View ArticleGroup Health Plans and Health Insurance Issuers Relating to Coverage of...
This regulation outlines requirements for group health plans and health insurance coverage in the group and individual markets for two areas: (1) expansion of coverage of recommended preventive...
View ArticleInterim Final Rules for Group Health Plans and Health Insurance Issuers...
This regulation outlines the requirements for the following processes of group health plans and health insurance coverage in the group and individual market: (1) internal claims and appeals, and (2)...
View ArticleAlert: CMS's Stark Law Self-Referral Disclosure Protocol Raises Tough...
On September 23, 2010, the Center for Medicare and Medicaid Services (CMS) announced a disclosure protocol pertaining to Stark Law self-referrals in accordance with Section 6409 of the Patient...
View ArticleCMS Issued Stark Self-Disclosure Protocol
On September 23, 2010, the Center for Medicare and Medicaid Services (CMS) announced a disclosure protocol pertaining to Stark Law self-referrals in accordance with Section 6409 of the Patient...
View ArticleLabor Department Releases Set of FAQs On Grandfather Requirements Under PPACA
On October 29, the Labor Department released a set of frequently asked questions (FAQs) regarding the grandfather requirements under the ACA.
View ArticleNew Regulation Outlining Changes to Medicare Program
This regulation, issued on November 24, 2010, outlines several changes to the Medicare program regarding the following: (1) the hospital outpatient prospective payment system, (2) the ambulatory...
View ArticleAmendment to the Interim Final Rules for Group Health Plans and Health...
This regulation, issued on November 15, 2010, amends an earlier regulation published in June that outlined rules governing whether group health plans and health insurance coverage in both the...
View ArticleCMS Introduces New Center for Medicare and Medicaid Innovation
On November 16, 2010, the Centers for Medicare and Medicaid Services (CMS) announced the establishment of the Center for Medicare and Medicaid Innovation (CMMI), under the Patient Protection and...
View ArticleNew Medicare Primary Care Incentive Payment Program
On December 3, 2010, the Centers for Medicare and Medicare Services (CMS) announced its implementation of a primary care incentive payment program, which is scheduled to take effect in 2011. Under the...
View ArticleCMS Transmittal Released on Waiving Copayments and Deductibles for...
On December 21, 2010, CMS released Transmittal 2122 providing instructions for waiving coinsurance and deductibles for certain preventative services provided in Rural Health Clinics, as provided for in...
View ArticleMedicare and Medicaid Programs; Requirements for Long-Term Care Facilities;...
Issued by the U.S. Department of Health and Human Services (HHS)on February 18, 2011, this regulation implements section 6113 of the Patient Protection and Affordable Care Act (PPACA). The interim...
View Article12 Proposed Recommendations for Accreditation of Patient-Centered Medical Homes
On March 8, 2011, a coalition comprised of physicians representing the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American...
View ArticleCivil Money Penalties for Nursing Homes
On March 18, 2011, the U.S. Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) issued this regulation, implementing section 6111 of the Affordable...
View ArticleCMS Releases Long-Awaited Proposed Rule on Accountable Care Organizations
On March 31, 2011, the Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) unveiled the long-awaited federal rule on accountable care organizations. This proposed...
View ArticleExpansion of CMS Never Events: They’re Not Just For Medicare Or Just For...
Expansion of CMS Never Events: They’re Not Just For Medicare Or Just For Hospitals AnymoreIn 2005 when “Never Events” were proposed for hospitals through the Deficit Reduction Act, no one knew what...
View ArticleMedicaid Never Events May Affect Nursing Facilities
Effective July 1, 2011, the Affordable Care Act requires that Medicaid payments be withheld for certain Provider Preventable Conditions (PPCs) also known as “Never Events.” Requiring states to...
View ArticleIRS Issues Exempt Hospitals Notice To Guide Their Assessment of Community...
On July 7, 2011, the Internal Revenue Service (“IRS”) and the United States Treasury (“the Treasury”) issued guidance in Notice 2011-52 designed to help tax-exempt hospitals and health systems comply...
View ArticleSupport for ACOs Continues to Erode; ACO Alternatives Picking Up Steam
Like many of those reading this blog, I receive numerous e-mails each day containing summaries of health care-related news articles culled from sources across the country. Since the Centers for...
View ArticleOIG’s 2012 Work Plan For Nursing Facilities: Same Fraud, Different Enforcement
Recently, the United States Department of Health and Human Services Office of Inspector General (“OIG”) published its Work Plan for fiscal year 2012 (“Work Plan”) and delineated focus points for...
View Article2011 Uncertainty Brings Worry and Change
2010 brought significant changes in the law for the healthcare industry with the passage of the Patient Protection and Affordable Care Act (“PPACA”), the Provena decision regarding real estate tax...
View Article
