Ross Sallade

Apr 26, 2024 | natlawreview.com | Ross Sallade

In May 2023, the Centers for Medicare and Medicaid Services (“CMS”) proposed a series of rule changes intended to help promote the availability of home and community-based services (“HCBS”) for Medicaid beneficiaries. Chief among these proposals was a new rule that would require HCBS agencies to spend at least 80% of their Medicaid payments for homemaker, home health aide, and personal care services on direct care worker compensation (the “80/20 Rule”).

Dec 28, 2023 | mondaq.com | Michael Flood |Ross Sallade |Laura Pone |Eleanor Brown

The Centers for Medicare & Medicaid Services ("CMS") continued its efforts to increase oversight of the Medicare program by updating Medicare provider enrollment regulations and policies through recent regulatory and sub-regulatory actions. These efforts, which are described in detail below, include updates to Medicare's provider and supplier enrollment regulations at 42 C.F.R. §424, Subpart P and changes to the Form CMS-855A for the first time in twelve years.

Aug 11, 2023 | mondaq.com | Eleanor Brown |Ross Sallade

Recently the Centers for Medicare & Medicaid Services ("CMS") announced in a newly released MedLearn Matter (MLN7867599, July 2023) that effective as of July 13, 2021, any "new hospice agency" located in the states of Texas, California, Arizona and Nevada will be placed in a "provisional period of enhanced oversight" for up to a 12-month window in effort to eliminate or reduce fraud, waste and abuse.

Aug 9, 2023 | jdsupra.com | Eleanor Brown |Ross Sallade

Recently the Centers for Medicare & Medicaid Services (“CMS”) announced in a newly released MedLearn Matter (MLN7867599, July 2023) that effective as of July 13, 2021, any “new hospice agency” located in the states of Texas, California, Arizona and Nevada will be placed in a “provisional period of enhanced oversight” for up to a 12-month window in effort to eliminate or reduce fraud, waste and abuse.

Jul 13, 2023 | natlawreview.com | Ross Sallade

On July 10, the Centers for Medicare & Medicaid Services (“CMS”) issued a Proposed Rule that would extend the “36-Month Rule” to Hospice providers. The 36-Month Rule refers to 42 C.F.R. § 424.550(b), which currently prohibits a home health agency (“HHA”) from undergoing a change in majority ownership during the 36 months after the HHA’s initial enrollment in Medicare or within 36 months after the HHA’s most recent change in majority ownership.