Healthcarelawbrief.com
Proskauer's perspective on health care law and business
WEBThis year’s Health and Mental Hygiene Bill (“HMH Bill”) (part of the Governor’s FY 2025 Executive Budget, which proposes a $233 billion balanced budget), includes $35.5 billion to fund Medicaid, $4.8 billion to address serious mental illness and $6 billion in federal funding through the 1115 Waiver.
Actived: 5 days ago
New Federal Transparency Requirements Impacting Health …
WEBBeginning January 1, 2022, the Act requires providers (individual practitioners and facilities) to send the health plan a “good faith estimated amount” of scheduled services, including any expected ancillary services and the expected billing and diagnostic codes for all items and services to be provided. This notice then triggers the …
The Key Health Care Initiatives Proposed in Governor Hochul’s …
WEBThis year’s Health and Mental Hygiene Bill (“HMH Bill”) (part of the Governor’s FY 2025 Executive Budget, which proposes a $233 billion balanced budget), includes $35.5 billion to fund Medicaid, $4.8 billion to address serious mental illness and $6 billion in federal funding through the 1115 Waiver.. In addition to those provisions that …
2024 Final Rule: CMS Announces More Changes to Medicare …
WEBOn April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. Parts 417, 422, 423, 455, and 460. The Final Rule adopts a host of reforms aimed at improving health care access, quality, and equity for …
A New Era for Home-Based Patient Care Health Care Law Brief
WEBA New Era for Home-Based Patient Care. By Cyrus Abbassi on May 26, 2021. Among the numerous consequences of the Covid-19 Pandemic is a well-documented emphasis on the home. Work at home. Exercise at home. See your doctor or other health provider at home. Home-based health care beyond the traditional nursing care is yet …
HHS Publishes Roadmap of New Strategy for Cybersecurity in the
WEBThe U.S. Department of Health and Human Services (HHS) recently issued a strategy paper highlighting key aspects of its plan to revamp cybersecurity requirements in the healthcare industry. Citing a 93% increase in large data breaches in healthcare from 2018 to 2022 and a rapid increase in ransomware attacks against U.S. hospitals, HHS …
The Future of Health Care Reform is Top of
WEBMatt is an associate in the Corporate Department and a member of the Health Care Group. His practice focuses on providing regulatory compliance advice for the Firm’s health care clients, including service providers, health plans, …
“Tele-Triage”: The COVID-19 Crisis’s Transformation of Emergency …
WEBDuring the COVID-19 pandemic, health care providers have faced unique challenges in the delivery of health care. As COVID-19 began to spread across the United States, the CDC advised health care providers, especially in areas with widespread COVID-19 transmission, to offer care via telemedicine technologies where appropriate.
OIG Approves Cash Equivalents Paid to Patients Participating in
WEBContingency management (CM) is a form of intervention treatment program that incentivizes patients with substance use disorders to observe certain conditions—such as non-use of drugs or alcohol confirmed via urine drug screening or breathalyzer test, or even drug therapy adherence—in exchange for something of monetary value.
Hold the Phone: Audio-Only Telehealth Expanding in New York …
WEBThe COVID-19 pandemic has seen a wave of telehealth policy changes across the nation at both federal and state levels. Such changes have expanded access to health care and addressed underutilization in chronic disease management while minimizing the risk of exposure for individuals seeking care. One such policy change in …
The State of the Fertility Industry Health Care Law Brief
WEBDriving Factors. In 2019, there were 58.3 births for every 1,000 women ages 15 to 44 in the U.S., down from 59.1 in 2018. [1] This marked the fifth consecutive year in which the fertility rate declined. Many factors may be driving down the rate, including the lingering effects of the Great Recession, delays in marriage and an emphasis on career
Health Care Providers on Alert: Two Hospitals Penalized for …
WEBWe previously discussed the requirements of the Hospital Price Transparency Rule (“Rule”) on health care providers and health plans, as well as CMS’s proposal to increase penalties for a hospital’s failure to comply with the Rule. About a year and a half after the Rule became effective, CMS has now imposed its first set of civil …
OIG Publishes Favorable Advisory Opinion Related to the …
WEBIn an advisory opinion posted November 10, 2021 (), the Office of the Inspector General of the United States Department of Health and Human Services (OIG) appeared to soften a disturbing position that it had taken in 2012 regarding the employment safe harbor.The issue is the breadth of the employment safe harbor, which is also …
CMS releases guidance on Expanded Home Health Value-Based …
WEBMatt is an associate in the Corporate Department and a member of the Health Care Group. His practice focuses on providing regulatory compliance advice for the Firm’s health care clients, including service providers, health plans, …
Where Are We Now
WEBBeginning in February 2021, telehealth utilization has begun to decline, with utilization levels now appearing to have stabilized at 13 to 17% of total outpatient visits. A monthly telehealth tracker tracks the month-to-month change in telehealth claim lines, which represent individual telehealth-related services that appear on insurance claims
The Hospital Price Transparency Rule: Is it Worth the Cost of
WEBThis post is part one of two in a series on new transparency requirements impacting both health plans and health care providers.. In an effort to assist patients in understanding the cost of hospital services, the Hospital Price Transparency rule at 45 C.F.R. § 180.10 et. seq., effective January 1, 2021, requires all hospitals to make public …
Lessons from the COVID-19 Pandemic: Planning for Disaster …
WEBAlthough the COVID-19 pandemic is still active worldwide, health care industry leaders and regulators have already begun to think about how to implement post-pandemic changes to health care delivery based on lessons learned during the global emergency of the past year and a half.
Developments Regarding Commission-Based
WEBA recent Fourth Circuit decision, United States v.Mallory (988 F.3d 730), upheld damages and penalties for more than $100 million for violations of the Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)) (the “AKS”) and the False Claims Act (31 U.S.C. § 3729) by a blood testing laboratory and its contracted sales agents.The Court held that …
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