Articles: 1-10 of 439

2023 Payment Rule’s Nondiscrimination Provisions and Anticipation of New Section 1557 Rules

USA - May 17 2022 On January 5, 2022, we discussed the Notice of Benefit and Payment Parameters for 2023 proposed rule released by the Centers for Medicare & Medicaid…

CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors

USA - May 16 2022 On April 29, 2022, the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes…

Medicaid and Health Equity: CalAIM’s Bold Experiment

USA - May 16 2022 More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In…

HHS OIG Report On Prior Authorizations Under Medicare Advantage

USA - May 5 2022 Last month, the U.S. Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials…

The Biden Administration’s and HHS’s Plan to Advance Health Care Equity

USA - April 27 2022 President Biden issued Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government…

Less is More: Brevity is the Soul of Wit

USA - April 14 2022 Last month, a three-judge panel in the Ninth Circuit reversed the Northern District of California’s ruling in Wit v. United Behavioral Health.In Wit…

Alert to Providers: Another Shot to Comply with Provider Relief Fund Reporting Requirements

USA - April 12 2022 As of April 11, 2022, the Health Resources & Services Administration (“HRSA”) is now offering providers who missed the original Provider Relief Fund…

Fifth Circuit Upholds ACA Risk Adjustment Program

USA - March 25 2022 Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA)…

HHS OIG Signs Off on Substance Use Recovery Incentive Program

USA - March 24 2022 On March 2, 2022, the Department of Health and Human Services (“HHS”) Office of the Inspector General (the “OIG”) issued a new Advisory Opinion (“AO…

OIG Advisory Opinion Alert: Yet Another Favorable Decision for Medical Device Manufacturers

USA - March 17 2022 On Thursday, March 16, the Office of the Inspector General for the Department of Health and Human Services (“OIG”) issued OIG Advisory Opinion (“AO”)…