Medicare and Medicaid


Time to Prepare for Possible Medicaid Home Care Changes
July 9, 2020 | Wendy Hoey Sheinberg | Home Health | Legislation and Public Policy | Medicare and Medicaid
Community Medicaid Services will undergo a significant change on October 1, 2020, due to the passage of the New York State Budget Bill (“2020 Bill”). Although many of the changes in the 2020 Bill are subject to federal approval, this bulletin will offer an overview of what might be affected. You can take steps now …
Read More
VNSNY Agrees to $57 Million Settlement
June 29, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Home Health | Litigation | Medicare and Medicaid
The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits that were not actually provided. The lawsuit, originally filed in 2014 by a former executive of VNSNY, …
Read More
Drug Price Disclosure Rule Rejected Again
June 17, 2020 | Eric D. Fader | Legislation and Public Policy | Medicare and Medicaid | Pharmaceuticals
On June 16, the U.S. Court of Appeals for the District of Columbia Circuit upheld a ruling from a year ago that struck down a federal regulation requiring pharmaceutical companies to disclose wholesale prices of prescription drugs in television advertisements. The appeals court agreed with the lower court’s opinion that the rule exceeded the legal …
Read More
Navajo National Collaboration Could Greatly Boost Molina’s Flagging Fortunes in New Mexico
June 2, 2020 | Rivkin Rounds Staff | Medicare and Medicaid | Private Insurers | Telehealth
A recent article in Health Payer Specialist, “Navajo National Collaboration Could Greatly Boost Molina’s Flagging Fortunes in New Mexico,” discussed how Molina Healthcare, through the Navajo Managed Care Organization (MCO), is working to better the healthcare of the Navajo Nation while bolstering its own bottom line. Rivkin Radler’s Chris Kutner was quoted in the article. …
Read More
False Claims Act, Medical Necessity and Government Regulation of Medicine
May 14, 2020 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid
Rivkin Radler’s Geoffrey R. Kaiser authored an article for Law360 entitled “False Claims Act, Medical Necessity and Government Regulation of Medicine.” The full article can be found here. …
Read More
CMS Announces Further Rule Changes to Address Pandemic
May 4, 2020 | Eric D. Fader | ACOs | Behavioral Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Telehealth
On April 30, the Centers for Medicare & Medicaid Services (CMS) announced numerous regulatory waivers and rule changes to, among other things, expand Medicare beneficiaries’ access to coronavirus testing and telehealth services. CMS also made changes to address financial concerns that had been raised by many accountable care organizations (ACOs). The changes included adding behavioral …
Read More
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 …
Read More
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 …
Read More
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 …
Read More
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 …
Read More

Authors
show more

Get legal updates and news delivered to your inbox