Articles and Blogs

This latest installment of our series on HHS Provider Relief Funding focuses on the new Medicaid Targeted Distribution, the postponement of the July 10 reporting deadline and new and updated FAQs. Since our last Bulletin posted June 12, found here, HHS has posted 45 new or modified FAQs, including 20 dated June 25. Many... READ MORE

On March 25, 2020, the Senate passed the Coronavirus Aid, Relief, and Economic Security Act (H.R. 748) (“CARES Act” or “Act”). The CARES Act contains numerous provisions aimed at the response to the Coronavirus or COVID-19 pandemic, including $100 billion in reimbursement to hospitals and other health care entities for COVID-19-related expenses and lost... READ MORE

Surprise Billing Continues to Be Hot as More Committees Weigh In The House Ways & Means Committee plans to release its surprise billing legislation this week in preparation for a markup on February 12. The Ways and Means proposal will rely on arbitration for resolving out of network claims and will have to be... READ MORE

For the fifth time, Certified Community Behavioral Health Clinics (“CCBHCs”) have received a short-term funding extension with Congress’ last-minute passage of a temporary government-wide spending bill. Funding for CCBHCs in this extension runs through December 20, 2019. This measure was signed into law late on November 21, just in the nick of time as... READ MORE

On May 1, 2019, the Michigan Medical Service Administration of the Michigan Department of Health & Human Services (“MDHHS”) issued Bulletin MSA 19-10 (the “Bulletin”), which set forth new enrollment and billing requirements for nurse practitioners (“NPs”) and clinical nurse specialists (“CNSs”) participating in the Michigan Medicaid program. Under the new guidelines, effective June... READ MORE

Congressional Leaders Discuss Health Care Priorities Congress’ top leaders, Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Nancy Pelosi (D-CA), announced they are not embracing “Medicare for All” as a priority at the American Hospital Association’s annual Washington conference. Both leaders reinforced that each chamber will pursue largely separate health care agendas in... READ MORE

On June 12, 2018, the Wisconsin Court of Appeals (“Court”) affirmed a decision by a Wisconsin circuit court and held that a family planning clinic with multiple locations in Wisconsin (“Provider”) was not required to repay the Wisconsin Department of Health Services (“DHS”) a total of $185,074.80 related to Medicaid fee-for-service claims submitted for... READ MORE

On July 30, 1965, President Lyndon B. Johnson signed into law what we now know as the Medicare and Medicaid programs.  They came into being after a long political gestation period that can be traced back to President Theodore Roosevelt’s proposals for a national health insurance system in 1912 and President Harry Truman’s 1948 bid... READ MORE

“Incident to” billing is a significant False Claims Act risk for Medicare and Medicaid providers. A new proposed rule will change how physicians and physician practices are supposed to bill for services provided in their offices. CMS Proposal to Limit Incident to Billing This week CMS released the proposed Medicare Physician Fee Schedule Rule... READ MORE

Health care providers and practitioners in most states are well aware that most Medicaid and CHIP enrollees are members of managed care organizations (“MCOs”). As states have increasingly contracted with and relied on MCOs for their growing Medicaid and CHIP populations, including enrollees who need and use long-term care services, the Centers for Medicare... READ MORE