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Hall Render’s This Week in Washington – February 15, 2019

[02/15/19]

Posted on February 15, 2019 in Federal Advocacy

Published by: Hall Render

Government Funded After Congress Borders on Another Shutdown Congressional negotiators have reached an agreement on a funding deal that avoids another partial government shutdown that would have occurred at midnight tonight. The measure would fund nine out of fifteen federal departments through September 30, 2019. President Trump is expected to sign the legislation into... READ MORE

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Claims Denials Start April 1: What You Should Know About CMS’s New Preclusion List

[02/15/19]

Posted on February 15, 2019 in Health Law News

Published by: Hall Render

Beginning April 1, 2019, Medicare Part C and D plans, PACE organizations and 1876 cost contract plans (“Plans”) will be required to deny payment for services rendered or prescriptions ordered by any provider on the new Centers for Medicare & Medicaid Services (“CMS”) Preclusion List. The Preclusion List, which was first made available to... READ MORE

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Hall Render’s This Week in Washington – February 1, 2019

[02/01/19]

Posted on February 1, 2019 in Federal Advocacy

Published by: Hall Render

HHS Previews 2019 Regulatory Agenda At a symposium on Tuesday, Deputy HHS Secretary Eric Hargan and CMS Administrator Seema Verma outlined the administration’s health care strategy for 2019, which includes advancing the use of technology, adjusting payments in rural areas and testing new ways to reward high-quality care and reforms to the Stark and... READ MORE

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Clinical Diagnostic Labs Enter a New Collection and Reporting Period as Medicare Payment Updates Continue

[01/18/19]

Posted on January 18, 2019 in Health Law News

Published by: Hall Render

January 1, 2019 marked the start of a new data collection period for laboratories pursuant to the Medicare Clinical Diagnostic Laboratory Tests Payment System Final Rule (“CLFS Rule”).¹ The CLFS Rule establishes the Centers for Medicare & Medicaid Services’s (“CMS’s”) new private payor-based rate-setting system for clinical diagnostic laboratory tests (“CDLTs”) paid under the... READ MORE

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Impact Analysis: Federal Court Blocks 2018 Cuts to 340B Drug Discount Program Payments

[01/11/19]

Posted on January 11, 2019 in Health Law News

Published by: Hall Render

On December 27, 2018, a federal judge ruled in favor of hospital associations and hospitals challenging the reduction in reimbursement for drugs purchased at a discount under the 340B Program established in the 2018 Outpatient Prospective Payment System final rule (“2018 OPPS Rule”). Judge Rudolph Contreras of the United States District Court in Washington,... READ MORE

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CMS Targets Inadequate Registered Nurse Staffing in Skilled Nursing Facilities – More Weekend Surveys and F-Tag Directive

[12/31/18]

Posted on December 31, 2018 in Long-Term Care, Home Health & Hospice

Published by: Hall Render

On November 30, 2018, CMS issued a Memorandum to State Survey Agency Directors (QSO-19-02-NH), announcing its concerns about adequate registered nurse staffing in skilled nursing facilities and that it will provide CMS Regional Offices and State Survey Agencies with a list of facilities with potential staffing issues to support survey activities for evaluating sufficient staffing and... READ MORE

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Nursing Home Fine Upheld for Inadequately Addressing Sexual Interactions Between Cognitively Impaired Residents – Policy Reviews Needed

[12/13/18]

Posted on December 13, 2018 in Health Law News, Long-Term Care, Home Health & Hospice

Published by: Hall Render

Last week, the United States Court of Appeals for the Seventh Circuit (“Court of Appeals”) released an opinion that confirmed a Centers for Medicare & Medicaid Services (“CMS”) assessment of an immediate jeopardy citation and an $83,800 civil money penalty against a nursing home for inadequately addressing sexual interactions between cognitively impaired nursing home... READ MORE

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Countdown to Phase 3 – Skilled Nursing Facilities Need to Create a Compliance and Ethics Program

[11/29/18]

Posted on November 29, 2018 in Long-Term Care, Home Health & Hospice

Published by: Hall Render

This is another article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations the Requirements for States and Long-Term Care Facilities (“Final Regulations”) by the Centers for Medicare & Medicaid Services (“CMS”). Beginning on November 28, 2019, surveyors will use the requirements detailed in... READ MORE

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CMS Proposes to Require Manufacturers to Disclose Drug Prices in TV Ads

[11/21/18]

Posted on November 21, 2018 in Health Law News

Published by: Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) recently issued a proposed rule (“Proposed Rule”) that would require pharmaceutical manufacturers to disclose the list price for a typical course of treatment of prescription drugs and biologics covered by Medicare or Medicaid in direct-to-consumer television advertisements. This policy development comes just two months after the... READ MORE

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CMS Proposes Major Change to Medicare Part B Drug Payment System Introducing International Pricing Index Model

[11/09/18]

Posted on November 9, 2018 in Health Law News

Published by: Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) Center for Medicare and Medicaid Innovation proposed to lower the cost of Medicare Part B outpatient prescription drugs by establishing their prices based on lower drug prices of other advanced industrial nations as compiled in an “international price index” (“IPI”) and changing the way the current drug... READ MORE

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