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Eric uses his deep knowledge of Medicaid and Medicare reimbursement, compliance and regulatory matters to help healthcare clients find the answers they need. As the leader of the firm’s Healthcare Regulatory & Compliance Counseling team, Eric advises healthcare providers nationwide on state and federal regulatory and operations issues, including requirements related to reimbursement, fraud and abuse, licensure and other matters. Eric is especially well-versed in Medicaid supplemental payment programs.

Today, the Texas Governor, Greg Abbott, issued an Executive Order that significantly loosens his previous restrictions on the performance of elective surgeries by modifying prior language and adding an additional exception to the prohibition.  Specifically, the new Order states that, effective April 21, 2020 and continuing until 11:59 pm on May 8, 2020.

All licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician; provided, however, that this prohibition shall not apply to either of the following:
Continue Reading Gov Abbott to allow more elective procedures 4-22

As many of you are aware, the Centers for Medicare and Medicaid Services (CMS) along with many states have waived licensing and other requirements to allow healthcare providers to use non-hospital space to treat COVID-19 and non-COVID-19 patients, conduct testing and perform other clinical operations.  Healthcare providers across the country are exploring options to increase

Hallway in a hospitalOn Friday, 3/13/20, CMS issued blanket 1135 waivers that impact acute care hospitals as a result of President Trump’s declaration of a state of an emergency due to COVID-19. The blanket waivers temporarily allow acute care hospitals to relocate acute care inpatients to their excluded distinct part units (DPUs), and patients from the DPUs to the acute care hospital to respond to the COVID-19 emergency. In addition, to these CMS blanket waivers, on 3/13/20, the Texas Hospital Association (THA) requested additional waivers from CMS and the Texas Health and Humans Services Commission (HHSC) from other federal and state requirements. EMTALA has also issued guidance on setting up alternative screening sites to respond to the COVID-19 emergency. Further, HHSC has issued guidance on what visitors are allowed in the hospital.
Continue Reading Update for Acute Care Hospitals on CMS Waivers and HHSC Guidance for COVID-19

The Families First Coronavirus Response Act (the Act) was passed and signed into law on March 18 and will go into effect on April 2, 2020 and continue until December 31, 2020. As our colleagues Josef Glynias and Paul Pautler noted in their excellent summary, this Act has two provisions which speak to employee leave and may have significant implications for employers, including healthcare providers. The Department of Labor has not yet issued guidance on this Act, and we will update this blog as guidance is issued.Continue Reading New Coronavirus-Related Employment Laws to Impact Healthcare Providers

On Friday, March 13, 2020, CMS issued blanket waivers under 42 U.S.C. 1320b-5 that impact long term acute care hospitals (LTCHs) and inpatient rehabilitation facilities (IRFs) as a result of President Trump declaring a state of an emergency due to COVID-19. The blanket waivers temporarily allow facilities operating inpatient rehabilitation units to exclude patients admitted

Centers for Medicare and Medicaid Services (CMS) has issued broad waivers to assist in the national COVID-19 response. They impact all provider types and generally remove regulatory burdens that could restrict access to care. For example, the waivers remove bed limits on Critical Access Hospitals and will allow Long Term Hospitals to exclude from the 25 ALOS calculation patients who were admitted or discharged to “meet the demands of the emergency.” Restriction on the separation of patients in excluded units in IPPS hospitals are waived. The requirement for three days of hospitalization to receive skilled nursing coverage is also waived. There are a number of other waivers.
Continue Reading COVID-19: CMS Waiver Information for Providers

Pursuant to the Affordable Care Act, the Centers for Medicare and Medicaid Services recently adopted a final rule implementing $1.1 billion in cuts to the Medicaid disproportionate share hospital (DSH) program in 2014 and 2015.  The new rule reduces Medicaid DSH payments by $500 million in 2014 and $600 million in 2015. 

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