Policy & Regulation News

DOJ Alleges Methodist Violated False Claims Act, Anti-Kickback Laws

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The US Department of Justice (DOJ) has filed a lawsuit against Methodist Le Bonheur Healthcare and Methodist Healthcare Memphis Hospitals, alleging that the health systems violated the False Claims Act...

CMS Releases Skilled Nursing Facility PPS Proposed Rule for FY23

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CMS has released its proposed Skilled Nursing Facility (SNF) Prospective Payment System (PPS) rule for fiscal year 2023, which includes a reduction in Medicare payments for SNFs. The proposed payment...

Biden Admin Announces Plans to Alleviate Medical Debt Burden

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The Biden-Harris administration has announced a series of reforms that aim to alleviate medical debt burden and increase consumer protections for Americans. One in three adults across the country has...

AHA, AMA Ask Court to Vacate IDR Provisions in Surprise Billing Rule

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The American Hospital Association (AHA) and the American Medical Association (AMA) have asked the US District Court for the District of Columbia to vacate the independent dispute resolution (IDR)...

Change Healthcare, UnitedHealth Extend Healthcare Merger Deadline

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Change Healthcare and UnitedHealth Group’s diversified health services company, Optum, have announced that they will extend their healthcare merger agreement to December 31, 2022. UnitedHealth...

CMS Proposes 2.7% Payment Boost for Inpatient Psychiatric Facilities

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CMS has issued a proposed Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) rule for FY 2023, which introduced an update to IPF Medicare payments and included comment requests on...

CMS Releases FY23 Inpatient Rehabilitation Facility PPS Proposed Rule

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CMS has released its proposed Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) rule for FY 2023, which included an increase in IRF payment rates and updates on the IRF Quality...

CMS Increases Hospice Payment Rate in Proposed Rule for FY 2023

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CMS has introduced a proposed rule for fiscal year 2023 that includes an increase in hospice payments and an aggregate cap on negative wage index changes. Under the rule, hospices would see a 2.7...

AHA Asks DOJ, FTC for Minor Hospital Merger Guideline Revisions

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The American Hospital Association (AHA) has asked the US Department of Justice (DOJ) and the Federal Trade Commission (FTC) to revise hospital merger guidelines to better account for the benefits...

Hospital Groups Urge HHS to Renew COVID-19 Public Health Emergency

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The American Hospital Association (AHA) and eight other hospital groups have urged HHS to renew the COVID-19 public health emergency (PHE), which is currently set to expire on April 15, 2022. In a...

Federal Appeals Court Blocks New Jersey Hospital Merger

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A federal appeals court has blocked the proposed hospital merger between New Jersey-based Hackensack Meridian Health and Englewood Health, stating that the merger would hurt competition and increase...

HHS Announces $413M in Provider Relief Fund Phase 4 Payments

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Through the Health Resources and Services Administration (HRSA), HHS has announced another series of Provider Relief Fund Phase 4 payments totaling $413 million for healthcare providers that have been...

Senate Voted to Repeal COVID-19 Healthcare Worker Vaccine Mandate

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The Senate has approved a resolution that seeks to repeal the COVID-19 healthcare worker vaccine mandate. The House of Representatives has not made such a vote, meaning as of now the vaccine mandate...

HHS to Distribute $560M in Phase 4 COVID-19 Provider Relief Funds

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HHS is distributing another $560 million in Provider Relief Fund Phase 4 payments to over 4,100 healthcare providers that have been affected by the COVID-19 pandemic. Provider Relief Funds have been...

Texas Federal Judge Rules Against HHS in Surprise Billing Lawsuit

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4/26/2022 update: This article has been updated to include the decision from HHS to appeal the ruling. A federal judge in Texas has ruled in favor of the Texas Medical Association (TMA) in a surprise...

DOJ Files Lawsuit to Block UnitedHealth, Change Healthcare Merger

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The Department of Justice (DOJ) has filed a civil lawsuit to block the merger between UnitedHealth Group and Change Healthcare. The complaint states that the proposed $13 billion transaction in which...

FAH Urges HHS to Extend COVID-19 Public Health Emergency, Waivers

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The Federation of American Hospitals (FAH) has urged the Department of Health and Human Services (HHS) to extend the COVID-19 public health emergency (PHE) beyond the current April 2022 expiration...

AHA to Congress: Hospitals Need More Resources Amid Financial Struggles

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The American Hospital Association (AHA) and seven other hospital organizations have penned a letter urging Congress to provide additional resources to help hospitals address ongoing operational and...

Telehealth, EHR Use Increases False Claims Act Violations, Fraud

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Healthcare digitization, including increased use of telehealth and EHR has led to a higher volume of healthcare fraud and False Claims Act (FCA) cases, according to lawyers from Hogan Lovells. The...

States Try Again to Block Vaccine Mandate for Healthcare Workers

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Louisiana Attorney General Jeff Landry and 15 other state attorney generals have filed a complaint against HHS and CMS to block the COVID-19 vaccine mandate for healthcare workers. CMS first issued...