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4 Aug 2023, 5:55 pm
United States Department of Health and Human Services, Case No. 6:23-cv-59-JDK (TMA IV), vacating certain portions of 45 C.F.R. [read post]
3 Aug 2023, 9:05 pm
” The Centers for Medicare and Medicaid Services issued a final rule that dictates how much money Medicare will pay to hospice providers. [read post]
16 Jul 2023, 10:41 pm
State of California, IHSS, legally uninsured, administered by York Risk Services Group, a Sedgwick Company, Defendants, 2023 Cal. [read post]
20 Jun 2023, 5:55 am
COVID-19 Vaccine Mandate Update (June 20, 2023): In response to the recent public health crises, the Centers for Medicare & Medicaid Services (CMS) first implemented a vaccine mandate for healthcare providers in late 2021. [read post]
15 Jun 2023, 9:26 pm
Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) over new measures in the Inflation Reduction Act (IRA). [read post]
8 Jun 2023, 4:30 am
[fn3] The panel also directed that the applicant should establish his competency to manage his affairs and to comply with the Center for Medicare and Medicaid Services (CMS) requirements for self-administration. [read post]
6 Jun 2023, 2:09 pm
Kandis represents relators in high stakes qui tam actions filed under the federal and state False Claims Acts relating to fraud on government healthcare payors such as Medicare, Medicaid, Department of Defense TRICARE, State Children’s Health Insurance Program, Veterans Health Administration, and the Indian Health Service program. [read post]
29 May 2023, 10:00 am
Medicare Advantage Plans are Aggressively Denying Claims – Administrative Appeals are Growing (May 25, 2023): According to the latest data released by the Centers for Medicare and Medicaid Services (CMS), beneficiaries participating in Medicare Advantage[1] plans now surpass those enrolled in original Medicare plans. [read post]
11 May 2023, 2:09 pm
In addition to ending the travel restrictions, the Biden Administration also announced that the COVID-19 vaccination requirements for federal employees and federal contractors will end May 11, and the Administration will start the process to end the vaccination requirement for head start educators and CMS (Centers for Medicare and Medicaid Services)-certified facilities. [read post]
8 May 2023, 12:28 am
Medicare Exclusion Risks: Employing Excluded Individuals Can Result in Significant Administrative, Civil and / or Criminal Liabilities (May 8, 2023): One of the most severe administrative sanctions available under the Social Security Act stems from the authority of the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS)[1] to “exclude” individuals and entities from participating in… [read post]
27 Apr 2023, 11:35 am
In part I, we discussed whether federal district courts could exercise jurisdiction under the federal-question statute over legal challenges to overpayment determinations made by the Centers for Medicare & Medicaid Services (CMS) under the agency’s controversial Risk Adjustment Data Validation (RADV) program for Medicare Advantage (MA) organizations. [read post]
21 Apr 2023, 11:48 am
Implications for Coverage, Costs, and Access (Kaiser Family Foundation)10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision (Kaiser Family Foundation)Health and Human Services COVID-19 Public Health Emergency pageHealth and Human Services COVID-19 Public Health Emergency Transition Roadmap Fact SheetCenters for Medicare & Medicaid Services CMS Waivers, Flexibilities, and the Transition Forward from the… [read post]
20 Apr 2023, 7:59 am
In part I, we discussed whether federal district courts could exercise jurisdiction under the federal-question statute over legal challenges to overpayment determinations made by the Centers for Medicare & Medicaid Services (CMS) under the agency’s controversial Risk Adjustment Data Validation (RADV) program for Medicare Advantage (MA) organizations. [read post]
14 Apr 2023, 9:05 pm
Furthermore, they recommend that the Centers for Medicare and Medicaid Services leverages underused community resources by establishing a demonstration program for funding community-initiated care. [read post]
13 Apr 2023, 8:41 am
The Medicare Act does not expressly provide for judicial review of overpayment determinations made by the Centers for Medicare & Medicaid Services (CMS) under the agency’s controversial Risk Adjustment Data Validation (RADV) program for Medicare Advantage (MA) organizations. [read post]
11 Apr 2023, 11:05 am
What is a Medicare Advantage Special Investigations Unit (SIU)? [read post]
7 Mar 2023, 7:56 am
On February 9, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued a fact sheet and its initial guidance documents addressing the Medicare Prescription Drug Inflation Rebate Program for Medicare Parts B and D (the “Inflation Rebates”)—a critical component of the sweeping prescription drug pricing changes enacted through the Inflation Reduction Act of 2022 (the “IRA”). [read post]
3 Mar 2023, 10:17 am
§1349. billing various healthcare benefit programs through claims administrators Humana, CIGNA and United Healthcare for $4.7 million for services never provided. [read post]
3 Mar 2023, 6:58 am
The case is being prosecuted by Assistant United States Attorneys Sara Miron Bloom and Kevin Love Hubbard. [read post]
1 Mar 2023, 9:29 am
See United States v. [read post]
