Articles and Blogs

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

On December 13, 2024, the Centers for Medicare & Medicaid Services (“CMS”) continued revisions to its “Guidance for SNF Attachment on Form CMS-855A” (“Guidance”). The Guidance is CMS’s subregulatory advice and FAQs to skilled nursing facilities on the completion and submission of the new Form CMS-855A SNF Disclosures Attachment (“SNF Attachment”) for every skilled... READ MORE

On December 2, 2024, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) issued a proposed rule (“Proposed Rule”) that amended the regulations relating to exclusion authorities under the authority of OIG. The Proposed Rule would codify changes made by the Medicaid Services Investment and Accountability Act... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) provided additional details and information related to CMS provider enrollment site visits. On November 4, 2024, CMS issued a Quality and Safety Special Alert memo (“QSSAM”), “Clarification of CMS’ Provider Enrollment Visits (all providers and suppliers) and Specific Disclosure Requirements for SNFs and NFs.” CMS provides... READ MORE

On November 20, 2024, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (“Nursing Facility ICPG”) for nursing home members of the health care compliance community. Motivating factors for issuing the Nursing Facility ICPG included long-standing issues such... READ MORE

On October 7, 2024, the United States Supreme Court denied review of a Second Circuit decision limiting the “willfulness” requirement for liability under the federal Anti-Kickback Statute (“AKS”) to knowledge that one’s actions are unlawful. The Second Circuit rejected the argument made by the plaintiff relators in U.S. ex rel. Hart v. McKesson (“Hart“)... READ MORE

NATIONAL Amazon’s push into telehealth knocks shares of Hims & Hers America’s Rural Hospital Crisis Has Been Looming for Decades AMA lawsuit targets collusion in health care pricing CMS Unveils Major Changes for Nursing Home Surveys for 2025 DEA, HHS issue another extension for telehealth controlled substance prescribing Donald Trump taps TV personality Dr.... READ MORE

The Office of Inspector General (“OIG”) of the U.S. Department of Health and Human Services found that most skilled nursing facilities (“nursing homes”) in Massachusetts that it surveyed are not correctly complying with life safety requirements or emergency preparedness requirements. OIG recently issued a report on its audits of life safety requirements or emergency... READ MORE