Medicare Compliance

Over One Third of Physicians Disagree with COVID Vaccine Mandate

by Sarai Rodriguez

The Adaptive Medical Partners (AMP) conducted survey of over 1,000 physicians and clinicians from their network to gather insight regarding the impact of the COVID-19 vaccine mandate for healthcare...

Geisinger to Pay $18M Settlement Over Medicare Billing Violations

by Sarai Rodriguez

The US Attorney’s Office for the Middle District of Pennsylvania announced that Geisinger Community Health Service (GCHS) reached an agreement to pay more than $18.5 million for...

CMS Issues COVID-19 Vaccine Mandate for Healthcare Workers

by Jacqueline LaPointe

CMS has issued the interim final rule with comment period requiring all healthcare workers to get a COVID-19 vaccine. The rule mandates vaccinations of eligible staff at healthcare facilities...

AHA Asks CMS to Retract Plans for Inpatient Rehab Facilities Review

by Victoria Bailey

The American Hospital Association (AHA) has asked CMS to withdraw the proposed review choice demonstration (RCD) that would implement program integrity audits at inpatient rehabilitation facilities...

CMS to Tie Vaccine Mandate to Medicaid, Medicare Participation

by Jacqueline LaPointe

A COVID-19 vaccine mandate for healthcare workers will be tied to Medicaid and Medicare Conditions of Participation (CoP), the Biden-Harris Administration recently announced. The announcement made via...

Leaked CMS Report Targets Medicare Noncompliance at CA Hospital

by Jill McKeon

A leaked CMS report put HCA Healthcare-owned Good Samaritan Hospital in California at risk of program termination by October if they fail to fix Medicare noncompliance issues that resulted in patient...

3 Hospital Price Transparency Strategies for Compliance, Patients

by Jacqueline LaPointe

Hospital price transparency goes beyond just compliance with federal regulations. Patients are also demanding more transparent pricing information from their providers in order to make more informed...

Large Hospitals Using Price Estimator Tools for Price Transparency Rule

by Jacqueline LaPointe

The majority of the top 100 hospitals by gross revenue are using a price estimator tool to comply with a landmark hospital price transparency rule from HHS, according to a recent study. The study...

OIG: Do Not Charge, Balance Bill Patients for COVID-19 Vaccines

by Jacqueline LaPointe

Healthcare providers should not charge or balance bill patients for getting the COVID-19 vaccine, the Office of Inspector General (OIG) at HHS recently warned. In an April 15th message, the federal...

CMS Resumes All Hospital Surveys As COVID-19 Cases Lessen

by Hannah Nelson

The Centers for Medicare & Medicaid Services has announced the immediate resumption of all hospital survey activities, including those related to Medicare compliance and patient safety. This...

OIG Asks Hospital for $23.6M Back After Medicare Billing Errors

by Jacqueline LaPointe

The Office of the Inspector General has identified $23.6 million in overpayments reimbursed to a Nevada-based hospital, resulting from years of Medicare billing errors. In a report released on April...

Major Hospitals Still Not Complying with Price Transparency Rule

by Jacqueline LaPointe

Many of the largest hospitals in the country are still not complying with a new price transparency rule that went into effect on Jan. 1, 2021, according to a new analysis. Nearly two-thirds of the 100...

Resource Constraints Trouble Hospital Price Transparency Compliance

by Jacqueline LaPointe

About 30 percent of hospitals are not complying with a hospital price transparency rule that went into effect on Jan. 1, 2021, according to a new analysis from Guidehouse. Researchers at the...

Biden Administration Inherits Slew of Medicare Regulatory Changes

by Jacqueline LaPointe

Nearly all Medicare providers have been impacted by at least one COVID-19 pandemic-related regulatory change, the Commonwealth Fund reports. Under the Trump administration, there were 244 Medicare...

Not All Hospitals Complying with New Price Transparency Rule

by Jacqueline LaPointe

Hospitals are struggling to comply with new price transparency requirements from CMS that took effect on Jan. 1, 2021. A new analysis from healthcare consulting firm ADVI found inconsistent and...

Providers Seek to Stop Hospital Price Transparency Enforcement

by Jacqueline LaPointe

Provider groups are calling on the court to prevent hospital price transparency enforcement in the 11th hour, citing the ongoing COVID-19 pandemic. The American Hospital Association, Association of...

CMS to Audit Some Hospitals for Price Transparency Compliance

by Jacqueline LaPointe

CMS is taking steps to ensure hospitals comply with a controversial price transparency rule taking effect on January 1, 2021. On that date, every hospital in the country is expected to provide...

CMS Releases Guidance on COVID-19 Data Reporting as Medicare CoP

by Jacqueline LaPointe

New guidance from CMS shares how the agency plans to implement a recent interim final rule that makes COVID-19 data reporting a condition of participation (CoP) in Medicare for hospitals. The guidance...

AHA: Reinstate June’s Provider Relief Fund Reporting Requirements

by Jacqueline LaPointe

The American Hospital Association (AHA) is urging HHS to reinstate Provider Relief Fund reporting requirements outlined in a June 19 FAQ rather than move forward with those detailed in a Sept. 19...

CMS Streamlines CLIA Certification to Expand COVID-19 Testing

by Jacqueline LaPointe

CMS is seeking to expand COVID-19 testing by streamlining Clinical Laboratory Improvement Amendments (CLIA) certification and compliance. In an announcement late last week, the agency provided a...