Articles and Blogs

In December 2024, the Centers for Medicare & Medicaid Services (“CMS”) made many 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 (“SNFs”) on the completion and submission of the new Form CMS-855A SNF Disclosures Attachment (“SNF Attachment”) for every... READ MORE

On March 7, 2025, the Centers for Medicare & Medicaid Services (“CMS”) posted a memo dated March 10, 2025, that gives nursing homes and surveyors more time to prepare for implementation of new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes. On November 18, 2024, the... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to assess and cite violations of the regulations on resident discharge and transfer. On November 18, 2024, the Quality, Safety & Oversight Group at CMS issued a memorandum entitled “REVISED: Revised Long-Term Care (LTC) Surveyor Guidance: Significant... READ MORE

According to a statement released on the Center for Medicare and Medicaid Services (“CMS”) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program. Hospice Special Focus Facility Program (“SFP”) The Consolidated Appropriations Act of 2021 called for... READ MORE

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

As of February 14, 2025, hospitals[1] will be required to provide notice to patients who are admitted as inpatients but who are later reclassified as outpatients receiving observation services (referred to as “change in patient status”). These patients who receive a change in patient status may request an expedited determination from the Centers for... 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

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

The United States Department of Justice (“DOJ”) recently settled part of a qui tam lawsuit under the False Claims Act for alleged violations of the Medicare “14-Day Rule” for $388,667. From March 2012 to November 2023, a laboratory and health system allegedly delayed submitting physician orders for certain laboratory testing until 14 days after patients’ hospital... 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