Articles and Blogs

The Centers for Medicare & Medicaid Services (“CMS”) recently finalized a rule (“Final Rule”) that expands its ability to impose a Provisional Period of Enhanced Oversight (“PPEO”) on providers, including post-acute providers, reactivating their Medicare enrollment. This regulation, authorized under Section 1866(j)(3)(A) of the Social Security Act (“Act”), is designed to strengthen Medicare program... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes regarding the role of the medical director and how mental disorders are diagnosed. On November 18, 2024, the Quality, Safety & Oversight Group at CMS issued... READ MORE

NATIONAL 5 key health topics to watch at RFK Jr.’s Senate confirmation hearings 6 more states sharpening PE regulation Change breach hit more than half of Americans, UnitedHealth says Epic hits back at Particle Health counterargument as it pushes to get antitrust case dismissed Health systems embark on culture makeovers Healthcare finance trends for... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing its emphasis on hospice quality of care and identifying fraud. On November 13, 2024, CMS issued a QSO Memo, “Ensuring Consistency in the Hospice Survey Process to Identify Quality of Care Concerns and Potential Fraud Referrals” (the “CMS Memo”), addressing the importance of consistency in... READ MORE

On January 10, 2025, Secretary Becerra of the U.S. Department of Health and Human Services (“HHS”) issued a determination titled “Determination That A Public Health Emergency Exists” (the “California PHE Determination”), that decided a public health emergency exists and has existed since January 7, 2025, in the State of California (“California Public Health Emergency”). Blanket Waivers... READ MORE

Effective January 1, 2025, Illinois enacted a law that contains several updates to Illinois’s change of ownership (“CHOW”) laws for nursing homes. Changes to Illinois’ CHOW Laws Illinois Public Act 103-0776 (“CHOW Law”) replaces Sections 3-112,  3-113 and 3-114 of the Illinois Nursing Home Care Act (the “Act”). The CHOW Law provides that nursing... READ MORE

On December 31, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released a memo titled “Long-Term Care (LTC) Facility Acute Respiratory Illness Reporting Requirements” (“Memo”) to state survey agency directors providing survey guidance related to requirements for long-term care reporting through the National Healthcare Safety Network (“NHSN”) as COVID-19 data reporting requirements ended... READ MORE

On November 21, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued revised guidance under QSO-25-09-ALL, updating Core Appendix Q of the State Operations Manual regarding findings of immediate jeopardy. These updates are intended to enhance transparency, standardize immediate jeopardy determinations and improve communication with providers, suppliers and laboratories. These revisions apply to... READ MORE

The following is our summary of significant nursing home legal and regulatory developments during 2024 of interest to nursing home providers and operators. 1. Staffing Mandate Rule. The “Minimum Staffing Standards for Long Term Care Facilities” final rule was published in the Federal Register on May 10, 2024, establishing a phased implementation of a... READ MORE

NATIONAL 5 PE moves ASC leaders are eyeing Academic health systems benefitting from for-profit selling spree Amazon’s top 10 healthcare moves in ’24 Amazon One Medical faces lawsuit over telehealth patient death Bipartisan bills in Congress would force insurance companies, PBMs to sell pharmacies CMS rolls out 5-year plan to ‘optimize’ care delivery CMS... READ MORE