Articles and Blogs

Effective July 1, 2025, Indiana Medicaid is no longer required to reimburse for services rendered during an Application for Emergency Detention (“AED”) without regard to medical necessity.   Background In 2023, Indiana overhauled its emergency detention framework through HEA 1006, which extended emergency detention to 14 business days, restructured procedures for initiating detentions and formally... READ MORE

On July 15, 2025, the Centers for Medicare & Medicaid Services (“CMS”) issued the CY 2026 Hospital Outpatient Prospective Payment System (“OPPS”) and Ambulatory Surgical Center (“ASC”) Payment System proposed rule. The rule, as drafted, proposes updating the payment rates of both OPPS hospital rates and ASC rates by 2.4%, calculated via the respective... READ MORE

NATIONAL Biden-era medical debt rule scrapped Changes are needed to stem primary care physician shortages CMS proposes 2026 Medicare rule: 6 notes CMS’ $7.8B hospital clawback plan ‘illegal and unwise’: AHA CMS proposes rule aligning Medicare physician payment with ‘Big Beautiful Bill,’ MACRA Hawley introduces bill to wipe hospitals’ Medicaid funding cuts, boost rural... READ MORE

New inflation data shows that the consumer price index (CPI) rose by 0.3% in June, bringing the annual inflation rate to 2.7%. Inflation has been slowly rising due to tariff concerns. Apparel and home furnishing prices have increased, while vehicle prices are down. Florida passed legislation phasing out the state’s sales tax on commercial... READ MORE

On July 17, 2025, the Centers for Medicare & Medicaid Services (“CMS”) extended the due date to complete and submit the new Form CMS-855A SNF Disclosures Attachment for every Skilled Nursing Facility (“SNF”).  In its Medicare Learning Network, 2025-07-17-MLNC, CMS formally announced that enrolled SNFs should collect data on ownership, managerial and related party information and... READ MORE

Health care continues to drive private equity (“PE”) activity, creating opportunities for investors and traditional health care providers. Transactions in the health care space are especially complicated, layering health care regulatory and reimbursement considerations on top of a complex securities, antitrust, privacy and security framework. Hall Render’s PE team of attorneys and advisors leverage... READ MORE

On July 14, 2025, the Centers for Medicare & Medicaid Services (“CMS”) released the CY 2026 Medicare Physician Fee Schedule (“PFS”) proposed rule. Several of the PFS proposals are related to telehealth, signaling a continued investment and interest in telehealth policies and use post the COVID-19 pandemic. The proposed rule does not address or... READ MORE

A recent Wisconsin Supreme Court (the “Court”) decision has shed some interpretive light on the scope of Wisconsin’s informed consent law. Under Wis. Stat. § 488.30, “[a]ny physician who treats a patient shall inform the patient about the availability of reasonable alternate medical modes of treatment and about the benefits and risks of these... READ MORE

The DOJ recently charged 324 defendants, including 96 licensed medical professionals, in a $14.6B national health care fraud takedown. The government seized over $245M in cash, luxury vehicles, cryptocurrency and other assets, while CMS reported preventing more than $4B in fraudulent payments by suspending or revoking the billing privileges of 205 providers. Intermountain Health... READ MORE

NATIONAL $14.6 billion Justice Department ‘takedown’ includes allegations of healthcare, narcotics fraud in assisted living 8 Hospitals Chosen for First Cohort of Rural Hospital Stabilization Program 3 recent updates to noncompete laws A ‘perfect storm’ strains rural hospitals AHA backs bill to expand physician residencies AHA supports legislation adding 14,000 residency slots to address... READ MORE