Articles and Blogs

CMS recently announced the Enhancing Oncology Model (“EOM”), which will build on the Oncology Care Model that ended on June 30, 2022. EOM is the next phase in the Biden Administration’s Cancer Moonshot initiative and will run from July 2023 through July 2028. EOM aims to improve care coordination, quality and health outcomes while holding…Read More

On June 29, 2022, the Office for Civil Rights (“OCR”) in the U.S. Department of Health & Human Services (“HHS”) released a notice and guidance on the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the protection of patient information relating to reproductive health care (the “Notice”). The Notice also describes example situations involving protected…Read More

The U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights released guidance detailing how health care providers subject to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) can use remote communication technologies to provide audio-only telehealth services when such communications are conducted in a manner that is consistent with the…Read More

Last week, CMS issued a proposal that would change how post-acute providers are paid for their services. The proposal drew negative feedback from trade associations. A number of prominent physician organizations issued a call to action urging payers and policy providers to increase funding and training offered to primary care providers so they can effectively…Read More

The Consolidated Appropriations Act, 2021 (the “Act”) signed into law on December 27, 2020, created a new Medicare provider type called a Rural Emergency Hospital (“REH”). Critical access hospitals (“CAHs”) and rural hospitals with 50 beds or fewer could transition to REH status starting January 1, 2023. On June 30, 2022, the Centers for Medicare…Read More

Last week, CMS announced a new hospital provider status for rural hospitals. A significant number of rural hospitals have closed over the past decade. CMS created the new provider status in an effort to preserve rural hospitals. In other news, South Carolina is exploring a minor modification to its Certificate of Need (“CON”) law after…Read More

In Becerra v. Empire Health Found., the Supreme Court upheld CMS’s decision to include Medicare exhaust and secondary payor days in the Medicare Fraction of the Disproportionate Share Hospital (“DSH”) statute. Although a loss for the hospitals in Empire, the ruling may support hospitals seeking to add SSI days to the numerator of the Medicare…Read More

Beginning July 1, 2022, the Departments of Health and Human Services, Labor and Treasury (the “Departments”) will begin enforcing the Transparency in Coverage Final Rule (“TiC Rule”) broadly requiring non-grandfathered health plans, including self-insured plans, to publish the price of nearly every health care service negotiated with providers. The TiC Rule continues federal efforts to…Read More