Articles and Blogs

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 7, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule (“Final Rule”) that added a new condition of participation for home health agencies (“HHA”) to participate in Medicare under the “Medicare Program; Calendar Year (“CY”) 2025 Home Health Prospective Payment System (“HH PPS”) Rate Update” for the calendar... READ MORE

On November 5, 2024, 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”). CMS announced that regardless of when the SNF received its notice of revalidation letter from its MAC (i.e., October, November or... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing regulatory expectations regarding nursing home residents’ rights to vote. On September 26, 2024, CMS issued a QSO Memo, “Compliance with Residents’ Rights requirement related to Nursing Home Residents’ Right to Vote.” CMS reminds nursing homes of the regulatory expectations that residents of nursing homes... READ MORE

On October 3, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published an interim final rule that eliminated the low wage index hospital policy and related budget neutrality adjustments. This action was prompted by the D.C. Circuit Court of Appeals’ decision to vacate the policy in Bridgeport Hospital v Becerra (“Bridgeport“) concluding that the... READ MORE

On July 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued its calendar year 2025 Medicare Physician Fee Schedule (“MPFS”) proposed rule (“Proposed Rule”), to implement certain payment updates effective January 1, 2025. Several major proposals are summarized below and the fact sheet accompanying this Proposed Rule may be found here. Telehealth... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) will publish the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) in the Federal Register on August 28 with an effective date of October 1, 2024. Along with increasing IPPS payments for FY 2025, the Final Rule introduces a new alternative payment model, funds... READ MORE

On July 3, 2024, a federal court in Texas (“the Court”) issued a stay related to certain provisions of CMS’s Contract Year 2025 Medicare Advantage and Part D (“MAPD”) Final Rule (“2025 Final Rule”), which would change how agents and brokers are paid by Medicare Advantage (“MA”) and Part D plans. Specifically, the Court... READ MORE

On June 24, 2024, the Department of Health and Human Services (“HHS”) released a final rule implementing disincentives for health care providers who are found by the Office of Inspector General (“OIG”) to have engaged in information blocking practices as defined under the 21st Century Cures Act. This rule establishes a framework for the... READ MORE

On June 10, 2024, the Supreme Court of the United States (“Supreme Court”) agreed to consider an appeal on behalf of more than 200 hospitals* in Advocate Christ Medical Center, et al v. Becerra, challenging the manner in which the Centers for Medicare and Medicaid Services (“CMS”) calculates a hospital’s Disproportionate Share Hospital (“DSH”) payments.... READ MORE