Medicare is the single largest payer for health care services in the United States. In FY 2023, the Medicare program spent an estimated $1.0 trillion to provide health care services for approximately 66 million elderly and disabled individuals, processing over 1 billion transactions from more than 1.4 million health care providers. When the Centers for Medicare & Medicaid Services (CMS) revokes a provider’s billing privileges, the consequences can be immediate and severe — cutting off revenue, triggering reputational damage, and in some cases, barring the provider from ...
Every healthcare provider—from solo practitioners to large health systems—faces a complex web of federal and state regulations. Whether it's Medicare billing rules, the Stark Law, the Anti-Kickback Statute, HIPAA privacy requirements, or state licensing regulations, the regulatory landscape is vast and constantly evolving. An effective compliance program isn't just a defensive measure against government enforcement—it's a strategic tool that protects your organization, improves operations, and demonstrates your commitment to quality care.
The Office of ...
Healthcare providers subject to HIPAA must revise their Notice of Privacy Practices (NPP) by February 16, 2026, to comply with recent federal regulatory changes. The changes align substance use disorder (SUD) record confidentiality with HIPAA/HITECH rules to improve care coordination. Failure to update your NPP by the deadline could result in noncompliance with federal privacy regulations.
What Changed and Why
The Department of Health and Human Services published amendments to the HIPAA Privacy Rule in April 2024, taking effect February 16, 2026. The principal objective is ...
On July 1, 2020, a slew of new employment laws went into effect in Virginia. While these statutes impact all Virginia employers, a trio of statutes about worker misclassification have particular significance among health care practices. First, under Virginia Code § 40.1-28.7:7, an individual who has not been properly classified as an employee may bring a claim for damages against his or her employer if that employer had knowledge of the individual’s misclassification. The potential damages available under this law include not only unpaid wages or salary that would have been ...
Medicare Providers Can Now Apply for Additional HHS Stimulus Funding. Still Hope for Others!
On April 22, 2020, the Department of Health and Human Services (HHS) finally released a press release detailing how it would distribute the $100 billion in appropriations allocated under the CARES Act to healthcare providers.
General Allocations to Medicare Providers and Facilities
Earlier this month, HHS distributed an initial $30 billion to Medicare providers and facilities as part of the first tranche of the $50 billion allocated for general distribution. Recipients of these funds ...
Recently, CMS issued a series of updated guidance documents based on CDC guidelines to address a variety of issues. This guidance affects a broad range of providers, including hospitals, Critical Access Hospitals (CAHs), psychiatric hospitals, Ambulatory Surgical Centers (ASCs), Community Mental Health Centers (CMHCs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), Outpatient Physical Therapy or Speech Pathology Services (OPTs), Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Intermediate Care Facilities for Individuals ...
Good News for Providers Who Received HHS Relief Funds and Hopeful News for Those Who Have Not!
On Friday, April 10, 2020, the Department of Health and Human Services (HHS) began the immediate delivery of $30 billion in relief funding to providers who provided Medicare fee-for-service services in 2019. This is the first disbursement from the total relief fund of $100 billion provided under the Coronavirus Aid, Relief and Economic Security (CARES) Act. We sent out an alert to our healthcare clients about the disbursement of the HHS stimulus funds on Tuesday, which can be accessed here.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act passed by Congress and signed into law last month contained a couple of provisions beneficial to government contractors, big and small.
Section 3610 of the CARES Act is one provision that is specifically designed to help government contractors regardless of size that is impacted by COVID-19 work restrictions. This provision will be especially beneficial to large government contractors as well as small government contractors that may not receive a Paycheck Protection Program (PPP) loan under Section 1102 of the CARES ...
Beginning on Friday, April 10, 2020, the Department of Health and Human Services (HHS) began the immediate delivery of the initial $30 billion in relief funding to certain Medicare providers that are supporting the national response to the COVID-19 pandemic. This is the first disbursement from the total relief fund of $100 billion provided under the Coronavirus Aid, Relief and Economic Security (CARES) Act.
The first share of relief funding is being delivered to Medicare providers, with their specific relief amount being based on their share of 2019 Medicare fee-for-service ...
The Centers for Medicare & Medicaid Services (CMS) announced an expansion of its accelerated and advance payment program for certain Medicare participating providers and suppliers to ensure they have the financial resources they need during the COVID-19 crisis. Under this program, CMS will provide an approved applicant with up to 100% of the applicant’s Medicare payment amount for a 3-month period (this amount is even more for certain hospitals). The payments can be requested by hospitals, doctors, DME suppliers and other Medicare Part A and Part B providers and suppliers.
To ...
