This week, the Department of Health and Human Services (HHS) issued its “Report on Improving Cybersecurity in the Health Care Industry,” which is the culmination of a year-long effort on behalf of the Cybersecurity Task Force, made up of industry professionals from the public and private sectors to identify and develop recommendations “on the growing challenge of cyber-attacks targeting health care.”…
On February 17, 2017, the U.S. Department of Health & Human Services (HHS) announced that it had delayed the effective date of provisions of a Centers for Medicare & Medicaid Services (CMS) Final Rule that were scheduled to take effect February 18, 2017. The Final Rule – titled “Advancing Care Coordination through Episode Payment Models” – was issued January 3, 2017 (see our previous analysis here) and in pertinent part implements:
- Three new Medicare episode payment models (EPMs) surrounding 90-day episodes of care arising from (a) an acute myocardial
The Centers for Medicare and Medicaid Services (CMS) recently issued a Final Rule to streamline and address the substantial backlog of Medicare administrative appeals at the Administrative Law Judge (ALJ) and Departmental Appeals Board (DAB)/Medicare Appeals Council levels.
Among other changes to the appeals process, the Final Rule:
- Permits the designation of Medicare Appeals Council decisions as precedential, in order to provide clarity
- Gives attorney adjudicators certain authority that had been previously reserved to the ALJs, including the authority to decide appeals that can be determined without a hearing, to
On September 13, 2016, the Department of Health and Human Services (HHS) published its Medicaid Fraud Control Units Fiscal Year 2015 Annual Report (Report). Medicaid Fraud Control Units (MFCUs) operate in 49 states and the District of Columbia. Typically part of the state-level Attorney General’s offices, the MFCUs investigate and prosecute Medicaid provider fraud as well as patient abuse and neglect. The Report found that in FY 2015, there were 1,553 reported convictions, seventy-one percent of which involved fraud. In addition, 731 civil settlements were entered into.…