-
1 month ago | 
mwe.com | Emily Cook |Sandra M. DiVarco |Monica Wallace |Caroline Reignley
Hospitals participating in the Medicare program must follow specific “provider-based rules” to receive payments from Medicare for hospital services. These rules are complex and often misunderstood. Certain persistent myths about these rules may result in hospitals receiving improper payments.
-
Jan 24, 2025 | 
jdsupra.com | Emily Cook |Sandra M. DiVarco |Caroline Reignley
Medicare reimbursement for hospital outpatient services has come under attack in recent years, with a focus on “site neutral” payment policies that would pay hospitals for outpatient services furnished in off-campus locations at the same rates paid for similar services furnished in physician offices or other non-hospital settings.
-
Sep 30, 2024 | 
mondaq.com | Caroline Reignley |Marshall Jackson |James Cannatti III |Lisa S. Mazur
On September 24, 2024, the Office of Inspector General (OIG) at
the US Department of Health and Human Services issued a report
recommending additional oversight of remote physiologic monitoring
(RPM) services furnished to Medicare beneficiaries. The full report
is available here.
Many of the issues highlighted by OIG are inherent to the
current RPM codes established by the American Medical Association
(AMA) but may not actually be problematic.
-
Sep 27, 2024 | 
natlawreview.com | Caroline Reignley
On September 24, 2024, the Office of Inspector General (OIG) at the US Department of Health and Human Services issued a report recommending additional oversight of remote physiologic monitoring (RPM) services furnished to Medicare beneficiaries. The full report is available here. Many of the issues highlighted by OIG are inherent to the current RPM codes established by the American Medical Association (AMA) but may not actually be problematic.
-
Aug 28, 2024 | 
mondaq.com | Tony Maida |Emily Cook |Monica Wallace |Caroline Reignley
In response to comments on the 2022 proposed changes to the
overpayments regulation, the Centers for Medicare & Medicaid
Services (CMS) proposed additional changes to the overpayment rule
to clarify that the obligation to report and return requires
quantification of the overpayment as part of identification. However, CMS proposed a strict time period for conducting reviews
of overpayment issues.
-
May 29, 2024 | 
lexology.com | Tony Maida |Emily Cook |Monica Wallace |Caroline Reignley |Marissa Daley |Jacob Weissman
APRIL REGULATORY UPDATE SUMMARYThis issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for April 2024.
-
Feb 28, 2024 | 
jdsupra.com | Callee Donovan |Caroline Reignley |Monica Wallace
The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare enrollment regulations applicable to hospices and home health agencies (HHAs), including increasing the level of screening that hospice providers are subject to and limiting a Medicare-enrolled hospice’s ability to change majority ownership to once every 36 months.
-
Dec 27, 2023 | 
lexology.com | Chelsea M. Rutherford |Caroline Reignley |Tony Maida |Monica Wallace |Danielle Scheer
On November 29, 2023, the Centers for Medicare & Medicaid Services (CMS) published the 2024 annual update to the designated health services (DHS) Code List. This annual update includes important changes for Medicare providers who rely on the Code List to ensure financial relationships with physicians remain in compliance with the federal physician self-referral law (the Stark Law). Of particular note, CMS has clarified that certain definitive drug testing codes will be considered DHS.
-
Dec 20, 2023 | 
jdsupra.com | Grayson Dimick |Caroline Reignley |Monica Wallace
The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare provider and supplier enrollment regulations, including adding marriage and family therapists (MFTs) and mental health counselors (MHCs) as supplier types eligible for enrollment. Other enrollment changes include increasing CMS’ authority to deny or revoke enrollments and deactivate providers’ billing privileges after six months of non-billing and creating a new “stay of enrollment” status.
-
Dec 19, 2023 | 
lexology.com | Monica Wallace |Caroline Reignley |Grayson Dimick
The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare provider and supplier enrollment regulations, including adding marriage and family therapists (MFTs) and mental health counselors (MHCs) as supplier types eligible for enrollment. Other enrollment changes include increasing CMS’ authority to deny or revoke enrollments and deactivate providers’ billing privileges after six months of non-billing and creating a new “stay of enrollment” status.
