CMS Withdraws Proposed MFAR Rule

The Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced on Monday, September 14, 2020 that CMS is officially withdrawing the controversial proposed Medicaid Fiscal Accountability Regulation (MFAR).  If finalized, MFAR would have drastically altered the way states are able to finance their share of Medicaid.  MFAR was opposed by a variety of stakeholders, including hospitals, physicians, national healthcare associations, governors, and state health departments.  Verma cited that these stakeholders raised concerns about “unintended consequences” of MFAR.

Written by: Catherine Moore

The New World of House Calls: Telehealth, COVID19, Fraud, and the Anti-Kickback Statute

On April 30th, the federal government released new changes in covered services in response to the COVID19 pandemic in addition to those previously announced in March. These changes are in effect for the duration of the COVID19 pandemic, which for is indefinite for the time being. Such changes include, generally, the following:

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Louisiana Will Loosen Restrictions on Non-Emergency Healthcare Services Starting April 27, 2020

The Louisiana Department of Health (LDH) has issued multiple directives significantly restricting non-emergency healthcare services in light of the COVID-19 crisis. The limitations have been reinforced by additional directives from the Louisiana State Board of Medical Examiners emphasizing the importance of discontinuing services and by the Louisiana Attorney General who launched a COVID-19 Task Force to enforce LDH restrictions on providers. Continue reading

CARES Act Relief: Conditions, Compliance, and Potential Whistleblower Complaints

Laws and regulations are changing rapidly. After the publication of this article, they are subject to change. Check back regularly for updates.

The CARES Act (Coronavirus Aid, Relief, and Economic Security Act), the Coronavirus Preparedness and Response Supplemental Appropriations Act, and the Families First Coronavirus Response Act all provide funds to healthcare providers. In applying for funds under these Acts, the HHS has set up “Relief Fund Payment Terms and Conditions.” As with any government grant program, compliance with the terms and conditions form the basis of the government’s eventual evaluation of any complaint it may receive or any audit it may conduct regarding the healthcare provider’s use of the grant funds.

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COVID-19 UPDATE: CMS Issues Recommendations to Re-Open Health Care Systems to Follow up Previous Guidance on Non-Essential Surgical Procedures

On Sunday, April 19th, the Centers for Medicare & Medicaid Services (CMS) issued new recommendations specifically for communities that are in Phase 1 of the Guidelines for President Trump’s Opening Up America Again and that have low incidence or relatively low and stable incidence of COVID-19 cases. The recommendations are an update to earlier guidance provided by CMS on limiting non-essential surgeries and medical procedures. The new CMS guidelines recommend a gradual transition and encourage health care providers to coordinate with local and state public health officials and to also review the availability of Personal Protective Equipment (PPE) and other supplies, workforce availability, facility readiness, and testing capacity when making the decision to re-start or increase in-person care.

The new CMS recommendations can be found here: https://www.cms.gov/files/document/covid-flexibility-reopen-essential-non-covid-services.pdf

Written By: Clay Countryman

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