Each July, the Medicare Administrative Contractors issue notices of a 2% Medicare payment reduction to those providers who did not meet quality data reporting requirements. Those notices have been sent. In this episode, Husch Blackwell’s Meg Pekarske and Jacob Harris talk about the issues providers faced in 2021 and how to pursue an appeal of

Recent legislative changes indicate that Congress is committed to continuing to allow patients to access telehealth services after the COVID-19 public health emergency (PHE) ends, but it is gathering more information before making such changes permanent. Comments from the U.S. Department of Health & Human Services (“HHS”) Secretary Xavier Becerra and the HHS Office of Inspector General (“OIG”) indicate that HHS is committed to expanding telehealth beyond the end of the PHE and that the OIG recognizes the long-term benefits of access to these services.
Continue Reading Telehealth Flexibilities Extended to Late 2022 and Likely Beyond

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to Transform

Change, transformation, disruption: whatever you want to call it, it’s happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consolidation is changing the playing field. How do hospices respond? In this series, we explore how hospices are and can restructure their businesses. We discuss the opportunities and limits of different models: palliative care, affiliations for payor contracting or the more transformative change brought through a merger or acquisition. While there is no one-size-fits-all approach, hospices can explore new ways of being. We are excited to guide you on this road and hope these conversations help as you explore these important questions within your organization and determine your best path into the future.
Continue Reading Strategic Restructuring for the Future, Think Before You Sign: Five Key Insights for VBID and Managed Care Contracts

On September 10, the Biden-Harris Administration, in conjunction with the Department of Health and Human Services (HHS), announced that $25.5 billion in relief funds will be distributed to healthcare providers through the Health Resources and Services Administration (HRSA). The American Rescue Plan (ARP) will provide $8.5 billion in funding and an additional $17 billion will be distributed as Phase 4 Provider Relief Funds (PRF).
Continue Reading Healthcare Providers to Receive $25.5 Billion in Relief Funds

By October 1, 2021, hospices will need to update their election addendum form to address a change made by the Centers for Medicare & Medicaid Services (CMS) in the final rule. The government has provided much-needed clarification and flexibility to certain aspects regarding the addendum. When should hospices provide the addendum to patients? What should hospices do if a patient refuses a signer’s discharge prior to signing the addendum? In this episode we answer these questions and discuss other key changes related to the addendum announced in the final rule: https://bit.ly/3zx5SGJ
Continue Reading Parsing Out Changes in the Election Addendum Made by the Final Hospice Wage Index Rule

On October 1, 2020 the Department of Health and Human Services (“HHS”) announced that it will distribute a total of $20 billion as part of Phase 3 of the Provider Relief Funds. The application for Phase 3 funding is now open and will be available from October 5 – November 6, 2020. However, HHS has urged providers to apply early, which may be an indication that the funds will be available on a first-come first-serve basis.

Below are some key details regarding Phase 3:
Continue Reading HHS Opens Application for $20 Billion of Phase 3 General Distribution Provider Relief Funds

On July 20, 2020, The U.S. Department of Health and Human Services (HHS) notified providers that if they received $10,000 or more in funds from the general or targeted Provider Relief Fund (PRF) established under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, reports on how those funds were used will be required. HHS expects to release (through the Health Resources and Services Administration [HRSA] website) detailed instructions on reporting requirements by August 17, 2020. Specifically, reports will be required of any provider who received one or more payments exceeding $10,000 in the aggregate from:
Continue Reading HHS Begins Clarifying Reporting Requirements for Provider Relief Funds

Updated Thursday, April 2, 2020

CMS 1135 waivers allow the U.S. Dep’t of Health and Human Services Secretary to temporarily waive or modify certain Medicare, Medicaid, Children’s Health Insurance Policy (CHIP), and Health Insurance Portability and Accountability Act (HIPAA) requirements to ensure that sufficient health care items and services are available to meet needs during a declared public health emergency.  Individual health care providers and associations may trigger additional waivers through feedback and requests to the Assistant Secretary for Preparedness and Response or CMS Regional Offices.
Continue Reading COVID-19 Update: Kansas 1135 Waivers and State Flexibilities

Updated Thursday, April 2, 2020

CMS 1135 waivers allow the U.S. Dep’t of Health and Human Services Secretary to temporarily waive or modify certain Medicare, Medicaid, Children’s Health Insurance Policy (CHIP), and Health Insurance Portability and Accountability Act (HIPAA) requirements to ensure that sufficient health care items and services are available to meet needs during a declared public health emergency.  Individual health care providers and associations may trigger additional waivers through feedback and requests to the Assistant Secretary for Preparedness and Response or CMS Regional Offices.
Continue Reading COVID-19 Update: Missouri 1135 Waivers and State Flexibilities

On March 24, 2020, the Wisconsin Department of Health Services (DHS) prepared correspondence to the Center for Medicare and Medicaid Services (CMS) seeking waivers of certain Medicaid requirements pursuant to Section 1135 of the Social Security Act (42 U.S.C. § 1320b-5) due to the COVID-19 pandemic. The correspondence to CMS was shared on March 24, 2020 with the Wisconsin Legislature Joint Committee on Finance seeking their approval to submit the Section 1135 Waiver to CMS. The letter to CMS prepared by DHS states that Wisconsin is implementing all the blanket waivers issued by CMS on March 13, 2020 in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP), to the extent applicable.
Continue Reading Wisconsin DHS requests authority to seek additional Medicaid Waivers from CMS