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New Exclusion Rules to Take Effect Next Month

Earlier this month, the Health and Human Services Office of the Inspector General (HHS-OIG) finalized its long-awaited rules on civil monetary penalties that could make it easier for providers to be excluded from participating in the Medicare and Medicaid programs. The final rule, which was published in the Federal Register on January 12, was first […]

CMS Issues Sweeping New Rules For HHA Participation in Medicare/Medicaid

Home health agencies have six months to comply with sweeping new changes that will impact their ability to participate in the Medicare and Medicaid programs. Earlier this month, The Centers for Medicare and Medicaid, released its final rules relating to the conditions of participation (CoPs) that home health agencies must meet to participate in the […]

Why Labs Have a Lot to Lose Under CMS’ Clinical Laboratory Fee Schedule

Big changes are coming that will impact how Medicare will pay for clinical diagnostic laboratory tests (CDLTs). The changes, according to some in the industry, could result in a significant financial hit for labs across the country because they will result in substantial fee cuts. The changes, which take effect Jan. 1, 2018, were mandated […]

New Year: New Prescribing Laws Take Effect

Two new prescribing laws took effect this month that physicians, physician assistants and nurse practitioners should be familiar with. Effective Jan. 1, advanced registered nurse practitioners (ARNPs) and physician assistants (PAs) are allowed to prescribe, order, and administer controlled substances, subject to certain protocols. This came with the passage of HB 423, which was signed […]

DEA Reverses Stand on Renewal Notices

The Drug Enforcement Administration (DEA) recently announced important changes to its registration renewal process. Effective Jan. 1, the DEA will send a single renewal notice to registrants notifying them that their registration is set to expire. The notice will be sent 65 days in advance of the expiration date. However, no additional reminders will be […]

OIG’s New Safe Harbors, Civil Monetary Penalty Exceptions Set to Take Effect

On January 6, new safe harbors to the federal anti-kickback statute and amendments to the civil monetary penalty rules will take effect. The expansion of existing safe harbors, along with the addition of new ones, were issued by the Department of Health and Human Services Office of the Inspector General on Dec. 7, and are […]

Judge Orders HHS to Clear Medicare Claims Appeal Backlog by 2020

Four years, that’s how long a federal judge has given the Department of Health and Human Services (HHS) to clear through a huge backlog of Medicare claims appeals. The Dec. 5 ruling, from Judge James E. Boasberg grew out of a motion for summary judgment filed in October by the American Hospital Association. At issue […]

OIG Says Free Labeling of Test Tubes, Collection Containers Could Violate Anti-Kickback Laws

The Office of Inspector General (OIG) recently issued an advisory opinion suggesting that a laboratory’s proposal to label test tubes and specimen collection containers at no cost to dialysis facilities could constitute remuneration under the anti-kickback statute and result in potential sanctions. The opinion issued this month came at the request of an unnamed laboratory […]

Feds weigh in on competitive benefits of telemedicine

As telemedicine continues to grow in use and popularity, federal agencies are increasingly being asked to consider how it will affect competition in the healthcare arena. Recently, the Department of Justice offered its backing of a telemedicine bill winding its way through Michigan. Although the DOJ’s statement, in support of SB 753, was issued in […]

CMS: Ignorance not an excuse when it comes to liability

The Centers for Medicare & Medicaid Services (CMS) recently released a policy change that provides additional conditions for determining when a contractor must assume a physician, provider, or supplier should have known about a policy or rule. Currently, CMS requires its contractors to consider at least one of three conditions when assuming that a provider, […]