OIG Posts FAQs on Enforcement During Pandemic
April 29, 2020 | Geoffrey R. Kaiser | Behavioral Health | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Telehealth
On April 24, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) published responses to certain frequently asked questions and further explained its application of administrative enforcement authorities to arrangements directly connected to the COVID-19 pandemic. OIG stated that it is accepting inquiries regarding application of its administrative …
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Supreme Court Rules in Favor of Health Insurers Under ACA Program
April 29, 2020 | Mark J. Wagner Jr. | Affordable Care Act | Litigation | Private Insurers
On April 27, the U.S. Supreme Court ruled in favor of commercial health insurers that were seeking $12 billion under the Affordable Care Act’s risk corridor program, acknowledging that the ACA “obligated the government to pay the full amount of risk corridor payments.” The ACA established the risk corridor program to mitigate the risks assumed …
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CMS Updates Status of Provider Assistance Programs
April 28, 2020 | Margarita Christoforou | Legislation and Public Policy | Medicare and Medicaid
On April 26, the Centers for Medicare and Medicaid Services (CMS) announced that it will no longer accept new applications from physician practices, medical equipment suppliers, and other providers for its Advance Payment Program. CMS will continue to accept applications from hospitals for loans under its Accelerated Payment Program but will be reevaluating the amounts …
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Healthcare Providers Receive ‘Helicopter Money’ with Strings Attached
April 28, 2020 | Robert H. Iseman | Legislation and Public Policy | Medicare and Medicaid
In 1969, noted economist Milton Friedman coined the term “helicopter money” to describe the monetary policy of injecting liquidity into the market, much like dropping money to people from helicopters, as an alternative to quantitative easing. The CARES Act, popularly referred to as the Provider Relief Fund is a “helicopter” that dropped a lot of …
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DOH Confirms that Pandemic Payments Will Not Affect Medicaid Eligibility
April 27, 2020 | Wendy Hoey Sheinberg | Legislation and Public Policy | Medicare and Medicaid
The New York State Department of Health has issued a General Information System (GIS) message clarifying the impact of COVID-19 related payments on Medicaid eligibility determinations. The GIS confirms that pursuant to sections 2104 and 2201 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 certain pandemic-related payments will not impact Medicaid …
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Little COVID-19 Relief for Facilities and Providers Subject to Justice Center Actions
April 24, 2020 | Cassandra Rivais DiNova | John F. Queenan | Behavioral Health | Hospitals | Legislation and Public Policy
Although Executive Order 202.10 gave health care providers some immunity for COVID-19 related care, this immunity does not extend to actions by the Justice Center for the Protection of People with Special Needs (“Justice Center”). A provider or facility could be prosecuted for allegations of abuse or neglect by the Justice Center for actions taken during this …
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How Will Trump’s Immigration Ban Affect You
April 23, 2020 | Henry M. Mascia | Employer/Employee | Legislation and Public Policy
After a teaser on Twitter and a verbal preview during a press conference, President Trump has signed an executive order preventing certain foreign nationals from receiving an immigrant visa for the next 60 days. The purpose of the order is protecting United States workers from competition from foreign workers. In reality, however, the order will …
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OCR Pushes Back Against Discriminatory State Triaging Guidelines
April 22, 2020 | Carol A. Hyde | Cassandra Rivais DiNova | Hospitals | Legislation and Public Policy | Litigation
Two recent decisions of the Department of Health and Human Services Office for Civil Rights (OCR) illustrate that age and disability status cannot be used as blanket criteria for denying access to health care services, even during a pandemic. This should serve as a warning to healthcare providers about the risks in making triage decisions …
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DOJ Charges California Physician with COVID-19 Fraud
April 21, 2020 | Marc S. Ullman | FDA | Fraud and Abuse | Litigation | Pharmaceuticals
On April 16, the United States Attorney’s Office for the Southern District of California charged Dr. Jennings Ryan Staley, a licensed physician and the operator of Skinny Beach Med Spa in San Diego, with mail fraud in connection with his offer to sell “COVID-19 treatment packs” to patients and the general public. Emails sent by Dr. Staley …
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CMS Pays Out $51B Under Accelerated and Advance Payment Program
April 20, 2020 | Eric D. Fader | Legislation and Public Policy | Medicare and Medicaid
On April 7, the Centers for Medicare & Medicaid Services announced that it had paid out over $34 billion under the Medicare Accelerated and Advance Payment Program to healthcare providers affected by the coronavirus public health emergency. Two days later, the figure had grown to $51 billion. CMS announced an expansion of the program on …
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