Articles and Blogs

Hospitals across the country have been receiving emails from the Department of Health and Human Services (“HHS”) requesting hospitals to submit certain information about the number of COVID-19 patients admitted to the hospital through a portal established by an HHS vendor, TeleTracking. HHS stated that submitting this data will inform the decisionmaking on future... READ MORE

On January 8, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released an Informational Bulletin titled “Best Practices for Avoiding 340B Duplicate Discounts in Medicaid” (“Bulletin”). The Bulletin outlines best practices that CMS encourages state Medicaid agencies to consider to avoid the situation where a manufacturer provides both a Medicaid drug rebate and... READ MORE

In 2014, Congress enacted the Protecting Access to Medicare Act (“PAMA”), changing the landscape of Medicare reimbursement for lab services. PAMA required the Centers for Medicare & Medicaid Services (“CMS”) to establish a single, national Clinical Laboratory Fee Schedule (“CLFS”) based on current charges in the private health care market. Below, we provide background... 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

In the near future, Regional Home Health Intermediaries (RHHIs) and Parts A and B Medicare Administrative Contractors (A/B MACs) will be contacting home health agencies (HHAs) that have previously submitted claims for ordered or referred services using a group name and national provider identifier (NPI).  HHAs will be informed they should begin submitting such... READ MORE

The Centers for Medicare & Medicaid Services (CMS) just released a final rule requiring all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has posted a listing of providers who have already been sent a request to revalidate their Medicare enrollment information.  The listing contains the name and National Provider Identifier (“NPI”) of each provider, as well as the date the letter was sent.  Providers on the list, but... READ MORE