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16 Feb 2023, 7:32 pm
As the September 1, 2023 deadline for Centers for Medicare & Medicaid Services (CMS) to publish the first 10 “selected drugs” subject to negotiation of “maximum fair prices” under Medicare Parts B and D fast approaches, CMS has recently specified information that manufacturers must submit in order for their drugs to qualify for the “Small Biotech Exception” to being included on the list. [read post]
16 Feb 2023, 9:00 am
., Board Certified by The Florida Bar in Health Law On January 27, 2023, a North Carolina doctor was found guilty of re-using "unsanitary" medical equipment meant for one-time use on unsuspecting patients during surgeries, the US Department of Justice (DOJ) announced. [read post]
15 Feb 2023, 4:25 pm
Whether this is from a private health insurance company or Medicaid/Medicare, audits mean a lot of paperwork, deadlines, and other bureaucratic complexities are in the future. [read post]
14 Feb 2023, 2:04 pm
On Monday, February 13, 2023, the Centers for Medicare & Medicaid Services (CMS), a part of the Department of Health and Human Services (HHS), submitted a proposed rule that goes beyond current data collections requirements by requiring nursing facilities to disclose additional information regarding ownership. [read post]
14 Feb 2023, 6:27 am
Legal Action Against a Nursing Home for Mistreatment The California Department of Social Services, California Department of Public Health, and Centers for Medicare and Medicaid Services (CMS) accept and investigate reports of nursing home abuse and neglect, but their primary function is to penalize the institution for rule violations. [read post]
13 Feb 2023, 11:31 am
The notice, posted on the website for the Centers for Medicare and Medicaid Services, instructed certified IDR entities to recall any payment determinations issued after February 6, 2023 (the date of the court’s decision) and to stop any further payment determinations until they receive further guidance from the departments. [read post]
10 Feb 2023, 9:05 pm
Heisler of the Congressional Research Service evaluate the eligibility criteria for immigrant populations for federal health care coverage programs, including Medicare and Medicaid. [read post]
10 Feb 2023, 1:24 pm
Malone [1] Department of Justice and FTC Antitrust Enforcement Policy Statements in the Health Care Area (Sept. 15, 1993). [2] Statements of Antitrust Enforcement Policy in Health Care (Aug. 1, 1996), § 8.C. [3] Id., § 8.C.1. [4] FTC Advisory Opinion re: Greater Rochester Independent Practice Association, Inc. [read post]
10 Feb 2023, 9:25 am
Department of Justice (DOJ) released its annual False Claims Act (FCA) enforcement statistics for fiscal year (FY) 2022, which ended on September 30, 2022.[1] While total recoveries exceeded $2.2 billion, this is a drop of more than 50 percent from the $5.7 billion recovered in FY 2021, marking the lowest annual reported recovery in 14 years. [read post]
9 Feb 2023, 9:16 pm
Additionally, the Department of Health and Human Services isn’t required to issue proposed rules for good manufacturing practices until December 29, 2024 at the latest, with the final rule due by December 29, 2025 at the latest. [read post]
9 Feb 2023, 1:15 pm
Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have taken initiative to “reduce the inappropriate use of antipsychotic medications and to bring greater transparency about nursing home citations to families. [read post]
9 Feb 2023, 8:37 am
According to the press release, health care-related recoveries from False Claims Act cases “restore funds to federal programs such as Medicare, Medicaid, and TRICARE, the health care program for service members and their families. [read post]
8 Feb 2023, 11:57 am
The Department of Justice (DOJ) Tuesday released a statement that it charged 23 Michigan residents, in two separate cases, for allegedly defrauding Medicare for $61.5 million. [read post]
8 Feb 2023, 10:04 am
Specifically, DOJ withdrew the following statements: Department of Justice and FTC Antitrust Enforcement Policy Statements in the Health Care Area (September 15, 1993); Statements of Antitrust Enforcement Policy in Health Care (August 1, 1996); and Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in Medicare Shared Savings Program (October 20, 2011). [read post]
8 Feb 2023, 7:59 am
Department of Health & Human Services (No. 6:22-cv-372), follows closely on the Requirements Related to Surprise Billing Final Rule issued in August 2022 (August Rule), which sought to address earlier criticisms of the independent dispute resolution process, and marks the second time that the rule has been vacated in part and sent back to the three agencies for another chance. [read post]
8 Feb 2023, 5:39 am
A little spice was added by the indulgence in the rhetoric of setting up of improbable targets followed by solemn pledges of defense (social security and medicare for example). [read post]
8 Feb 2023, 4:18 am
This is according to numbers released yesterday by the Commerce Department. [read post]
7 Feb 2023, 6:19 pm
These recoveries restore funds to federal programs such as Medicare, Medicaid, and TRICARE, the health care program for service members and their families. [read post]
7 Feb 2023, 12:00 pm
The Department of Health and Human Services (“HSS”) arguably did just that in promulgating its rule specifying the administrative dispute resolution (“ADR”) process[1] for conflicts between drug makers and certain health care providers. [read post]
6 Feb 2023, 10:38 am
On Friday, February 3, the Department of Justice, Antitrust Division (the “DOJ”) announced its withdrawal of three policy statements on health care antitrust enforcement: (1) The Department of Justice and Federal Trade Commission Antitrust Enforcement Policy Statements in the Healthcare Area (Sept. 15, 1993); (2) The Department of Justice and Federal Trade Commission Statements of Antitrust Enforcement Policy in Healthcare (Aug. 1, 1996); and (3) The… [read post]
