Articles Posted in Medicare/Medicaid

On March 24, 2020, the U.S. District Court for the District of Connecticut granted a class of Medicare beneficiaries the right to challenge their designation in hospitals as outpatients receiving observation services rather than as inpatients. In the case, Alexander v. Azar, the court ruled that the Department of Health and Human Services (HHS) violated […]

On April 26, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that its suspending its Advance Payment Program to Part B Suppliers, effective immediately. Additionally, CMS announced that it is reevaluating the amounts to be paid out under the Accelerated Payment Program. To date, CMS has paid out $40.4 billion in payments to […]

On April 15, 2020, the Department of Justice announced the following settlement agreements under the False Claims Act (FCA): The U.S. Attorney’s office for the Eastern District of Pennsylvania announced that a laboratory, pain clinic and two former executives agreed to pay $41 million dollars to resolve allegations under the FCA related to unnecessary Urine […]

The Center for Medicare & Medicaid Services (CMS) has announced that it is increasing payments under Medicare for high-throughput COVID-19 clinical diagnostic laboratory tests. Previously, Medicare Administrative Contractors were paying out $51 for these tests. Under the new payment policy, effective April 14, 2020, Medicare will pay $100 (nearly double the previous amount) for such […]

Today, the U.S. Department of Health and Human Services (“HHS”) announced that it would directly deposit $30 billion in funds into the accounts of providers/suppliers that billed Medicare fee-for-service claims last year.  This initial $30 billion is part of a $100 billion appropriation under the CARES Act that HHS will disburse through its grants from […]

On April 2, 2020, the Centers for Medicare and Medicaid Services (CMS), in consultation with the Centers for Disease Control and Prevention (CDC), issued critical guidance to nursing homes and state and local governments to mitigate the spread of COVID-19 in long-term care facilities. While CMS and the CDC have already taken action to address […]

In a Coronavirus Task Force press briefing on April 7, 2020, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma (the “Administrator”) announced that CMS will distribute $30 billion in grants from the Public Health and Social Service Emergency Fund (PHSSEF) to providers to help alleviate the burden that COVID-19 has caused to the […]

On March 28, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it is expanding its Accelerated and Advance Payment Program for healthcare providers and suppliers participating in Medicare. CMS is expanding the program to ensure that all Medicare-participating providers and suppliers have the resources necessary to combat COVID-19. Accelerated and/or advance payments […]

The Centers for Medicare and Medicaid Services (CMS) has issued a Frequently Asked Questions (FAQs) Sheet responding to eight (8) FAQs regarding provider burden relief for COVID-19. Below is an overview of the FAQs Sheet issued by CMS. Is CMS suspending most Medicare Fee-For-Service (FFS) medical review during the Public Health emergency (PHE) period for […]

On March 21, 2020, the New York Department of Health (DOH) published guidance in the New York State Medicaid Update March 2020 Special Edition Vol. 36, No. 5 (the “Guidance”) regarding the expansion of telehealth in response to COVID-19. The DOH’s Guidance expands telehealth to better protect Medicaid members from potential contact with sick individuals. […]

Contact Information