Articles and Blogs

As we previously discussed here (“EEOC Provides COVID-19 Guidance Via Webinar (Part I of II)”), here (“EEOC Provides COVID-19 Guidance Via Webinar (Part II)”) and here (“EEOC Updates COVID-19 Technical Assistance”), the Equal Employment Opportunity Commission (“EEOC”) has previously addressed several employment practice concerns throughout the ongoing COVID-19 pandemic. Earlier this fall, the EEOC released an…Read More

The Centers for Medicare & Medicaid Services (“CMS”) published an Interim Final Rule on November 27, 2020 that creates a new drug reimbursement model tying Medicare Part B drug reimbursement for certain drugs to price limits in place in other countries (“Most Favored Nation Model” or “MFN Model”). Scheduled to begin January 1, 2021, the…Read More

On November 20, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released a much anticipated final rule (“Final Rule”) aimed at modernizing and streamlining key regulations under the federal Stark Law. As anticipated, the Final Rule included some major changes to the Stark regulations that will drive physician contracting, compensation models and compliance strategies…Read More

On November 12, 2020, the United States Department of Health and Human Services (“HHS”), Department of Labor and Department of the Treasury jointly published a final rule requiring health care payors to publicly disclose certain price and cost-sharing information (the “Final Rule”). The Final Rule, which HHS refers to as the “Transparency in Coverage” rule,…Read More

On Wednesday, November 25, 2020, CMS announced additional flexibilities in the “Hospitals Without Walls” waiver initiative designed to permit even greater flexibility for hospitals to treat eligible patients in the patient’s home. It is critical to note that this is an individualized waiver program. Each hospital that wishes to provide care through the Acute Hospital…Read More

The Office of Inspector General (“OIG”) in its November Work Plan has put hospitals on notice that it is going to begin auditing short-stay inpatient claims for compliance with CMS’s Two-Midnight Rule. Short stay claims – claims for inpatient stays of less than two midnights – have caused hospitals and providers considerable confusion over the…Read More

Late this afternoon, the Centers for Medicare & Medicaid Services (“CMS”) and Office of Inspector General (“OIG”) released long-awaited and highly anticipated Stark and Anti-Kickback Statute final rules (“Final Rules”) aimed at modernizing and streamlining key fraud and abuse regulations under the federal Stark, Anti-Kickback and Civil Monetary Penalties Laws. As anticipated, the Final Rules…Read More

In health care, actions under the False Claims Act (“FCA”) typically allege conduct that is knowingly in violation of one or more of Medicare’s conditions of payment—part of an amorphous contract between a government agency and a provider—that results in a fraudulently obtained overpayment to the provider for services rendered. Last week, the Ninth Circuit…Read More