HHS OIG’s Mary Riordan Outlines New Compliance Priorities at …
Nov 7, 2024 · Looking forward, the OIG Work Plan for 2025 includes investigations in key areas affecting pharmaceutical compliance. Among these are: Medicare Part D coverage of weight-loss medications: The agency will examine drugs prescribed for both diabetes and weight loss, assessing if Medicare payments align with Part D requirements.; FDA Oversight: Future OIG audits will scrutinize the FDA’s role in ...
Bipartisan Legislation Introduced to Avoid Decreased Medicare ...
Dec 3, 2024 · Congressman Greg Murphy, MD, recently introduced the Medicare Patient Access and Practice Stabilization Act, which aims to support physicians and Medicare beneficiaries, in response to the CMS Proposed Rule that would decrease Medicare reimbursement for physician services by 2.8%, starting January 1, 2025.. Congressman Murphy and other sponsors of the legislation cite statistics from the AMA ...
Summary of Section 1557 of the Affordable Care Act ... - Policy
Jun 13, 2024 · The United States Department of Health and Human Services (HHS) has issued a final rule under Section 1557 of the Affordable Care Act (ACA) to strengthen nondiscrimination protections and advance civil rights in healthcare. The new rule is effective July 5, 2024 and applies to all healthcare providers who bill Medicare, Medicaid or see patients who are insured through a ACA exchange plan.
DEA and HHS Extend Telehealth Flexibilities for Controlled …
Jan 10, 2024 · The rule’s publication drew significant opposition from the provider stakeholder community, with the DEA receiving more than 38,000 comments in response, most of which scrutinized DEA’s perceived shortsightedness and burdensome requirements for typical prescribing relationships.
Biden Administration Rescinds Trump Administration Insulin …
Oct 26, 2021 · One of the final healthcare actions made by the Trump Administration has been rescinded by the Biden Administration. On December 23, 2020, the Trump Administration finalized a rule that directed the Department of Health and Human Services (HHS) to take action to require that federally qualified health centers (FQHCs) make insulin and injectable epinephrine available to certain patients at 340B ...
HHS Finalizes Information Blocking Rule – Policy & Medicine
Sep 19, 2024 · The Department of Health and Human Services (HHS) finalized a rule that sets penalties, including cuts to Medicare payments, for providers found guilty of blocking the free flow of electronic health data. The penalties are largely similar to HHS’ proposal last fall, including the potential to miss out on annual payment increases, earn lower quality scores and be suspended from a major value ...
Policy & Medicine – Legal, Regulatory, and Compliance Issues
Legal, Regulatory, and Compliance Issues. ASD Specialty Healthcare LLC, trading as Besse Medical, has reached a $1.67 million settlement to resolve allegations of violating the Anti-Kickback Statute and the False Claims Act, according to the U.S. Department of Justice (DOJ).
Supreme Court Rules in Favor of Protecting Vaccine Makers from …
Mar 3, 2011 · The United States Supreme Court reached a decision recently, concluding that federal law protects vaccine makers from product-liability lawsuits that are filed in state courts and seek damages for injuries or death attributed to a vaccine.In the 57-p
CMS Issues New Guidance on Independent Dispute Resolution …
Jun 6, 2022 · On April 14, 2022, the Centers for Medicare & Medicaid Services (CMS) issued new guidance on the Independent Dispute Resolution (IDR) process, created under the No Surprises Act (NSA) to provide a mechanism for payers and providers to resolve disputes as to appropriate payment amounts for certain out-of-network claims.
CMS Issues First Fines to Non-Compliant Hospitals Under Price ...
On June 7, 2022, the Centers for Medicare and Medicaid Services (CMS) issued the first fines with respect to the transparency rules that took effect in January 2021. Under the transparency rules, hospitals must disclose five types of charges for items and services in a patient-accessible online file, including negotiated rates with payers.