Proposed Revisions to the Anti-Kickback Statute: An Overview

On October 3, 2019, the Department of Health and Human Services, Office of Inspector General (HHS-OIG) issued its proposed amendments to specific provisions of the Anti-Kickback Statute (AKS), 42 CFR §§ 1001 and 1003. These proposed amendments modify existing safe harbors, add new safe harbors that provide new protections and codify existing statutory protections. Continue reading

Substantial Changes Proposed to the Stark Law and Anti-Kickback Statute Regulations to Address Regulatory Burdens and Value-Based Care Arrangements

On October 9, 2019, the U.S. Department of Health and Human Services (“HHS”) released proposed changes to the physician self-referral law (the “Stark Law Proposed Rule”) and the Anti-Kickback Statute (AKS) and the Civil Monetary Penalty Law (CMPL) (the “AKS Proposed Rule”). These proposed changes to the Stark Law, the Anti-Kickback Statute, and the Civil Monetary Penalty Law contain some of the most significant changes to these laws in the last several years. Continue reading

CMS Announces Initiative to Enhance Nursing Home Transparency

On Monday, October 7, 2019, the Centers for Medicare & Medicaid Services (“CMS”) announced an enhancement available to nursing home residents, families and caregivers on CMS’ “Nursing Home Compare” website.  By the end of the month, CMS will display a consumer alert icon next to nursing homes that have been cited on inspection reports for one or both of the following: 1) Abuse that led to harm of a resident within the past year; and 2) Abuse that could have potentially led to harm of a resident in each of the last two years.

The Nursing Home Compare website is available here.

Written By: Catherine B. Moore

CMS Finalizes DSH Medicaid Payment Reductions

On September 25, 2019, the Centers for Medicare & Medicaid Services published a final rule detailing the methodology for implementing the Affordable Care Act (“ACA”) reductions to state Medicaid Disproportionate Share Hospital (“DSH”) allotments beginning in FY 2020. The final rule calculated $4 billion in state Medicaid DSH cuts for FY 2020 and an estimated $8 billion for each subsequent year through 2025.

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The Supreme Court Clarifies the Statute of Limitations for Qui Tam Cases Brought Under the False Claims Act in Cochise Consultancy, Inc. v. United States ex rel. Hunt

Where the government chooses not to intervene in a whistleblower (qui tam) False Claims Act (FCA) suit, what is the statute of limitations? The federal statute governing the statute of limitations in FCA cases, 31 U.S.C. § 3731, provides that a claim must be brought by the latter of: (1) six years of the violation, i.e., the date of the false claim to the government, or (2) three years from the date that material facts “are known or reasonably should have been known by the official of the United States charged with responsibility to act in the circumstances.” Claims brought under the three-year “discovery” limitations period must be brought within 10 years after the date on which the violation is committed. Continue reading