MediRegs Weekly Regulatory Highlights

Curated content to help make sure your organization remains compliant.

May 1 - May 7, 2021

Start your day with Weekly Regulatory Highlights to see what changes might impact your business.

Learn more about the
full MediRegs experience →

Weekly Highlights

The links below provide access to each title:

Final and Proposed Regulations

CMS Manual Transmittals and MLN Matters Articles

Court Cases and Administrative Actions

Office of Inspector General Actions

Final and Proposed Regulations

Final rule: Medicare Program: Comprehensive Care for Joint Replacement Model Three-Year Extension and Changes to Episode Definition and Pricing; Medicare and Medicaid Programs; Policies and Regulatory Revisions in Response to the COVID-19 Public Health Emergency

As stated by CMS:

"This final rule extends the length of the Comprehensive Care for Joint Replacement (CJR) model through December 31, 2024 by adding an additional 3 performance years (PYs). PY 6 will begin on October 1, 2021 and end on December 31, 2022; PY 7 will begin on January 1, 2023 and end on December 31, 2023; and PY 8 will begin on January 1, 2024 and end on December 31, 2024."

Rule: Medicare Program: Comprehensive Care for Joint Replacement Model Three-Year Extension and Changes to Episode Definition and Pricing; Medicare and Medicaid Programs; Policies and Regulatory Revisions in Response to the COVID-19 Public Health Emergency [23496-23576]

FDA

Proposed Rule: Canadian Oilseed Processors Association; Withdrawal of Food Additive Petition (Animal Use) [24564]

HHS

Proposed Rule: Canadian Oilseed Processors Association; Withdrawal of Food Additive Petition (Animal Use) [24564]

Rule: Coal Workers' Health Surveillance Program: Autopsy Payment [24336-24339]

Rule: Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2022 and Pharmacy Benefit Manager Standards [24140-24295]

Rule: Medicare Program: Comprehensive Care for Joint Replacement Model Three-Year Extension and Changes to Episode Definition and Pricing; Medicare and Medicaid Programs; Policies and Regulatory Revisions in Response to the COVID-19 Public Health Emergency [23496-23576]

Veterans Affairs

Rule: Adopting Standards for Laboratory Requirements [24494-24498]

Instantly compare and understand regulatory and coverage changes over time with one-click.

LEARN MORE →

CMS Manual Transmittals and MLN Matters Articles

New Articles this week

R10729BP Updates to Medicare Benefit Policy Manual for Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services (Manual Updates Only) - 2021-04-26

R10725cp File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions - 2021-04-26

R10721CP New Waived Tests - 2021-04-27

R10708CP July 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files - 2021-04-27

R10730MSP Electronic Correspondence Referral System (ECRS) Updates to the Revised Remote Identity Proofing, Implementation of a New ECRS Web Error Code, and Multi-Factor Authentication (MFA) Process and Requirements for the Transition from Connect Direct to the CMS Electronic File Transfer (EFT) System - 2021-04-27

R10710FM The Fiscal Intermediary Shared System (FISS) Submission of Copybook Files to the Provider and Statistical Reimbursement (PS&R) System - 2021-04-26

R10735PI Updates to Medicare Administrative Contractor (MAC) Appeals and Rebuttals Reporting - 2021-04-27

R10709PI Update to Chapter 12 (The Comprehensive Error Rate Testing (CERT) Program) of Publication (Pub.) 100-08 - 2021-04-27

R10772COM Updates to Pub. 100-09, Chapter 6 Beneficiary and Provider Communications Manual, Chapter 6, Provider Customer Service Program - 2021-04-29

R10746DEMO Primary Care First (PCF) and Serious Illness Patient (SIP) Models: Part 3: IURs and Edits for Non-Sequential Claims - 2021-04-27

R10732OTN Addition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Code 87636 - 2021-04-26

R10718OTN Cognitive Assessment & Care Plan Services - 2021-04-26

R10717OTN MAC Participation in Change Requests Developed through Agile Methodology - 2021-04-27

MM12204 (PDF) New Waived Tests - 2021-04-27

MM12244 (PDF) July 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files - 2021-04-27

MM12269 (PDF) Addition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Code 87636 - 2021-04-26

R10708CP (PDF) July 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files - 2021-04-27

R10709PI (PDF) Update to Chapter 12 (The Comprehensive Error Rate Testing (CERT) Program) of Publication (Pub.) 100-08 - 2021-04-27

R10710FM (PDF) The Fiscal Intermediary Shared System (FISS) Submission of Copybook Files to the Provider and Statistical Reimbursement (PS&R) System - 2021-04-26

R10717OTN (PDF) MAC Participation in Change Requests Developed through Agile Methodology - 2021-04-27

R10718OTN (PDF) Cognitive Assessment & Care Plan Services - 2021-04-26

R10721CP (PDF) New Waived Tests - 2021-04-27

R10725CP (PDF) File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions - 2021-04-26

R10729BP (PDF) Updates to Medicare Benefit Policy Manual for Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services (Manual Updates Only) - 2021-04-26

R10730MSP (PDF) Electronic Correspondence Referral System (ECRS) Updates to the Revised Remote Identity Proofing, Implementation of a New ECRS Web Error Code, and Multi-Factor Authentication (MFA) Process and Requirements for the Transition from Connect Direct to the CMS Electronic File Transfer (EFT) System - 2021-04-27

R10732OTN (PDF) Addition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Code 87636 - 2021-04-26

R10735PI (PDF) Updates to Medicare Administrative Contractor (MAC) Appeals and Rebuttals Reporting - 2021-04-27

R10746DEMO (PDF) Primary Care First (PCF) and Serious Illness Patient (SIP) Models: Part 3: IURs and Edits for Non-Sequential Claims - 2021-04-27

R10772COM (PDF) Updates to Pub. 100-09, Chapter 6 Beneficiary and Provider Communications Manual, Chapter 6, Provider Customer Service Program - 2021-04-29

R19P232I (PDF) This transmittal updates Chapter 32, Home Health Agency Cost Report, Form CMS-1728-94 to sunset the forms and update and clarify the instructions. - 2021-04-30

This transmittal updates Chapter 45, Community Mental Health Center Cost Report, Form CMS–2088–17, by clarifying, and correcting the existing instructions, forms, and electronic cost report (ECR) specifications. - 2021-04-30

R2P246I (PDF) This transmittal revises, clarifies and makes corrections to Chapter 46, Rural Health Clinic (RHC) Cost Report, Form CMS–222–17, by revising existing edits, creating new edits, and updating references. - 2021-04-30

R2P247I (PDF) This transmittal updates Chapter 47, Home Health Agency Cost Report, Form CMS-1728-20, to update the forms and clarify the instructions. - 2021-04-30

R4P243I (PDF) This transmittal updates Chapter 43, Hospice Cost Report, (Form CMS-1984-14) to revise and modify the forms and instructions as follows: - 2021-04-30

R4P244I (PDF) This transmittal updates Chapter 44, Federally Qualified Health Center (FQHC) Cost Report, Form CMS-224-14, by revising existing edits, creating a new edit, updating references, and clarifying instructions. - 2021-04-30

This transmittal updates Chapter 42, Independent Renal Dialysis Facility Cost Report, Form CMS–265–11, by revising the existing instructions and electronic cost report (ECR) specifications. - 2021-04-30

R9P233I (PDF) This transmittal clarifies and makes corrections to Chapter 33, Organ Procurement Organizations (OPOs) and independent Histocompatibility Laboratories (Labs) Cost Report, Form CMS–216–94, effective for cost reporting periods ending on or after December 31, 2020. - 2021-04-30

Medicare Secondary Payer (PUB. 100-05)

Attachement 1 - Electronic Correspondence Referral System (ECRS) Web User Guide v6.6 (Rev. 10730; Issued: 04/27/21; Effective: 05/27/21; Implementation: 05/27/21)

Attachement 2 - Electronic Correspondence Referral System for the Web (ECRS) Quick Reference Card (Rev. 10730; Issued: 04/27/21; Effective: 05/27/21; Implementation: 05/27/21)

Medicare Contractor Beneficiary and Provider Communications (PUB. 100-09)

Provider Customer Service Program (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

10 - Introduction to Provider Customer Service Program (PCSP) (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

20 - Provider Outreach and Education (POE) (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

30 - Provider Contact Center (PCC) (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

40 - PCSP Staff Development and Education (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

50 - Provider Self-Service (PSS) Technology (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

60 - Surveys (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

70 - PCSP Performance Management (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

80 - PCSP Data Reporting (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

90 - Disclosure of Information (Rev. 10772 **Rescinds and Replaces Rev. 10519, dated 12/14/20**, Issued: 04/29/21, Effective: 12/16/20, Implementation: 12/16/20)

National Coverage Determinations

Index of NCD Coding Guidelines (ICD-10)

Court Cases and Administrative Actions

CMS - Provider Reimbursement Review Board Decisions

Jurisdictional Decisions for March 2021 (PDF)

PRRB 04/28/2021 21-D16 Jewish Healthcare Center, Inc. d/b/a JHC HomeCare (PDF)

PRRB 03/30/2021 21-D15 Lamb Healthcare Center (PDF)

PRRB 03/24/2021 21-D14 Hazard ARH Regional Medical Center (PDF)

PRRB 03/19/2021 21-D13 ProHealth Home Care, Inc. (PDF)

HHS - Departmental Appeals Board Civil Remedies Decisions

DAB(CR) 2020-12-21 - TB5271 - CTP v. Baha Enterprises II Inc. d/b/a Mobil

DAB(CR) 2020-12-08 - TB5267 - CTP v. Madison-Food-Mart-Inc. d/b/a Madison Food Mart

DAB(CR) 2020-12-03 - TB5094 - CTP v. Fenkel Petro, Inc. d/b/a Mobil Mart

DAB(CR) 2020-12-01 - TB5264 - CTP v. Wafeeq and Saladdin Brothers, LLC d/b/a Citgo

DAB(CR) 2020-10-19 - CR5737 - Ararat Nursing Facility v. CMS

DAB(CR) 2020-10-08 - CR5732 - Clinton County Indiana v. CMS

DAB(CR) 2020-10-08 - CR5730 - CNH, Inc., d/b/a Carbondale Nursing & Rehabilitation Center v. CMS

DAB(CR) 2020-10-02 - CR5729 - In re LCD Complaint: Nuclear Medicine Study (L35083)

DAB(CR) 2020-09-30 - CR5727 - Sally H. Dowling, M.D. and Sally H. Dowling M.D., LLC v. CMS

DAB(CR) 2020-09-30 - CR5726 - Stonegates v. CMS

DAB(CR) 2020-09-25 - ALJ Ruling No. 2020-17 - Linda A. Herman, CRNA v. CMS

DAB(CR) 2020-09-04 - ALJ Ruling No. 2020-16 - The Inspector General of the Social Security Administration v. William G. Coggins, Jr.

Court Cases - United States Supreme Court

04/19/2021 - Empire Health Foundation, for Valley Hospital Medical Center v. Secretary of Health and Human Services (PDF)

04/14/2021 - Donna M. Gilbert, Julie Mohney, Charmaine White Face v. READM Michael D. Weahke, Director of the Indian Health Service (IHS), James Driving Hawk, Great Plains Regional IHS Director, William P. Barr, Attorney General - Case No. 20-1487 (PDF)

04/12/2021 - Andrew Stoveken v. State of New Jersey (PDF)

04/12/2021 - Robert David Dupuch-Carron and Elizabeth Joann A Carron v. Xavier Becerra, Secretary of Health and Human Services (PDF)

04/12/2021 - George Beecher v. State of New Jersey (PDF)

Court Cases - Federal Court of Appeals

04/27/2021 - Avon Nursing and Rehabilitation, Brightonian Nursing and Rehabilitation, Woodside Manor Nursing and Rehabilitation, the Shore Winds Nursing and Rehabilitation, the Hurlbut Nursing and Rehabilitation, Hornell Gardens Nursing and Rehabilitation, New York Center for Rehabilitation and Nursing v. Xavier Becerra, Secretary of the United States Department of Health and Human Services - Docket No. 19-3953 (PDF)

04/26/2021 - Reddy Vijay Annappareddy v. Sandra Wilkinson and Catherine Schuster Pascale; Maura Lating; Robert Mosley; Pam Arnold; James P. Ryan; Steven Capobianco; United States of America - No. 19-2370 (PDF)

04/26/2021 - Reddy Vijay Annappareddy v. Robert Mosley and Catherine Schuster Pascale; Maura Lating; Pam Arnold; James P. Ryan; Sandra Wilkinson; Steven Capobianco; United States of America - No. 19-2369 (PDF)

04/26/2021 - Reddy Vijay Annappareddy v. Steven Capobianco and Catherine Schuster Pascale; Maura Lating; Robert Mosley; Pam Arnold; James P. Ryan; Sandra Wilkinson; United States of America - No. 19-2352 (PDF)

04/26/2021 - Reddy Vijay Annappareddy v. James P. Ryan and Catherine Schuster Pascale; Maura Lating; Robert Mosley; Pam Arnold; Sandra Wilkinson; Steven Capobianco; United States of America - No. 19-2351 (PDF)

04/26/2021 - Reddy Vijay Annappareddy v. Maura Lating and Catherine Schuster Pascale; Robert Mosley; Pam Arnold; James P. Ryan; Sandra Wilkinson; Steven Capobianco; United States of America - No. 19-2344 (PDF)

04/26/2021 - Reddy Vijay Annappareddy v. Maura Lating; Robert Mosley; James P. Ryan; Sandra Wilkinson; Steven Capobianco and Catherine Schuster Pascale; Pam Arnold; United States of America - No. 19-2337 (PDF)

04/26/2021 - Reddy Vijay Annappareddy v. Catherine Schuster Pascale and Maura Lating; Robert Mosley; Pam Arnold; James P. Ryan; Sandra Wilkinson; Steven Capobianco; United States of America - No. 19-2285 (PDF)

04/20/2021 - MAO-MSO Recovery II, LLC; MSP Recovery, LLC; MSPA Claims 1, LLC; and MSP Recovery Claims Series LLC v. State Farm Mutual Automobile Insurance Company, an Illinois Company - No. 20-1268 (PDF)

04/27/2021 - Robert H. Odell, Jr.; Robert Odell, M.D., Ph.D. Medical Enterprises, a Nevada Corporation v. U.S. Department of Health & Human Services; Xavier Becerra - No. 19-15262 (PDF)

Court Cases - Federal District Court (by State)

04/26/2021 - Robert Edward Taylor, Jr., as the Personal Representative and Administrator of the Personal Estate of Brett Verdun Taylor v. Eric Starr, et al. - Case No.: 1:20-cv-00489-CLM (PDF)

04/21/2021 - United States of America v. Liana Karapetyan - Case No. 2:21-cr-50 TLN (PDF)

04/14/2021 - Inova Health Care Services, for Inova Fairfax Hospital and its Department, Life with Cancer, et al. v. Omni Shoreham Corporation, et al. - Civil Action No. 20-784 (JDB) (PDF)

04/20/2021 - State Farm Mutual Automobile Insurancy Company, and State Farm Fire and Casualty Company v. Robert Lewin, D.C., et al. - Case No. 8:20-cv-2428-VMC-TGW (PDF)

04/23/2021 - Illinois Insurance Guaranty Fund v. Norris Cochran, Acting Secretary Department of Health and Human Services, United States Department of Health and Human Services, and Centers for Medicare and Medicaid Services - Case No. 20 C 5920 (PDF)

04/26/2021 - Gerald Daneshvar v. United States of America - Civil Case Number 19-13749 (PDF)

04/23/2021 - United States of America, ex rel. Ruqiayah Madany and John B. Collins v. Paul M. Petre, M.D., et al. - Case No. 2:09-cv-13693 (PDF)

04/26/2021 - Robert Doran, Maria Baez, Alexander Shaporov, and Bernard Linn v. Erin Ives, Dennis Rosen, Dan Coyne, Anna Coschignano, Robert Byrnes, Russell S. Rizzo, Christopher Mulhall, Edward Michael Dressler, Sean Mahoney, Gabrielle Ares, and John and Jane Does 1-5 - 15-cv-7217 (PKC) (PDF)

04/20/2021 - United States of America and the State of New York, ex rel. Lee M. Mandel, MD, FACS v. James A. Sakr, MD - 17-CV-907S (PDF)

04/23/2021 - George Kariuki v. The North Carolina Department of Insurance - No. 5:18-CV-00341-D (PDF)

04/14/2021 - United States of America and State of North Carolina ex rel. Bronson Lowery v. All Medicines, Inc. d/b/a Townsend's Pharmacy; James Craig Bell; and Melisha West - No. 7:17-CV-128-FL (PDF)

04/26/2021 - United States of America v. Nicole Georges - Case No. 2:20-cr-157 (2) (PDF)

04/21/2021 - D.W. v. Fresenius Medical Care North America - Case No. 3:21-cv-571-SI (PDF)

04/19/2021 - Don Ascolese v. Shoemaker Construction Co., et al. - Civil Action No. 18-1864 (PDF)

04/27/2021 - Gloria Santiago-Rivera v. Hospital General Menonita de Aibonito, et al. - Civ. No.: 18-1084 (SCC) (PDF)

04/21/2021 - Dyersburg Family Walk-In Clinic, Inc. v. Tennessee Department of Finance and Administration: Butch Eley, in his Official Capacity as Commissioner of the Tennessee Department Finance and Administration; Bureau of Tenncare; and Stephen Smith, in his Official Capacity Deputy Commissioner and Director of the Bureau of Tenncare - No. 1:20-cv-1280-STA-jay (PDF)

04/21/2021 - Debbie Ann Bolton, Surviving Child of Decedent, Ruth Clara Summers v. Gallatin Center for Rehabilitation & Healing, LLC - No. 3:20-cv-00683 (PDF)

04/16/2021 - United States of America v. Rhonda Ann Fleming - Criminal Action No. H-07-513-1 (PDF)

04/15/2021 - Tammy Alvarado, et al. v. Clark, Love & Hutson, G.P., et al. - Civil Action No. 4:19-CV-2148 (PDF)

Court Cases - State Courts

04/16/2021 - Marilyn Herns, as Guardian of the Estate of Clematine Leonard v. Symphony Jackson Square LLC, an Illinois Limited Liability Company, d/b/a Symphony of Chicago West; Maestro Consulting Services, LLC, an Illinois Limited Liability Company, and Norwegian American Hosptial, Inc. - No. 18 L 1749 (PDF)

04/16/2021 - Gulf South Psychiatry, LLC v. Greenbrier Hospital, LLC d/b/a Covington Behavioral Health - No. 2020 CA 0957 (PDF)

04/14/2021 - Candes Prewitt v. Saint Thomas Health - No. M2020-00858-COA-R3-CV (PDF)

04/22/2021 - Steward Medical Group d/b/a Permian Premier Health Services and John Lee v. Michelle Armstrong, Individually and as Representative of the Estate of Bobby Fosha, and Peggy Fosha - No. 09-20-00243-CV (PDF)

04/20/2021 - In Re: Gilead Sciences, Inc. - No. 06-21-00027-CV (PDF)

04/20/2021 - Ruth Awah v. Synergenx Physician Services, PLLC - No. 01-19-00674-CV (PDF)

04/16/2021 - Ramona Rogers, M.D., Modesto Zamorano, Stephanie Cumpian, Rolando Flores, Hector Ontiveros, Priscilla Nieto, Sonia Hernandez-Keeble, Blas Ortiz, Jr., David Moron, M.D., Jaime Flores and Rio Grande State Center v. David Saxon Bagley, Individually and as Representative of the Estate of Jeremiah Ray Bagley - No. 19-0634 (PDF)

04/15/2021 - Esteban O. Brown, M.D. v. Florence Nocar - No. 13-19-00503-CV (PDF)

04/19/2021 - Fawn Becker v. Valley Medical Center, Public Hospital District No. 1, Jose Gomez, and Does 1 Through 10, Inclusive - No. 80526-6-I (PDF)

HIPAA

CMS - EHR Incentive Programs

Promoting Interoperability Programs

Educational Resources

Scoring, Payment Adjustment, and Hardship Information

Promoting Interoperability Programs Events

News

CMS - Press Releases

2021.05.06: HHS Secretary Becerra Announces Nearly 940,000 Americans Have Signed Up for Health Coverage through HealthCare.gov During Special Enrollment Period

2021.05.06: CMS Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions

2021.05.03: HHS and National Partners Mark Asian Pacific Heritage Month by Encouraging Asian Americans and Pacific Islanders to Enroll in Quality, Affordable Health Coverage through HealthCare.gov

2021.04.30: CMS Selects Winner and Runner-Up in Artificial Intelligence Health Outcomes Challenge

2021.04.30: CMS to Adopt Rules to Lower Health Care Costs in 2022 Federal Health Insurance Marketplace Plans

2021.03.15: Biden-Harris Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine

DOJ - Press Releases

2021.05.05: Alabama Doctor Sentenced For Conspiracy To Distribute A Controlled Substance

2021.05.04: Incyte Corporation To Pay $12.6 Million To Resolve False Claims Act Allegations For Paying Kickbacks

2021.05.03: Three Florida Men Charged In $46 Million Health Care Fraud, Kickback, And Money Laundering Conspiracy

2021.05.03: Neurosurgeon And Two Affiliated Companies Agree To Pay $4.4 Million To Settle Healthcare Fraud Allegations

HHS - Press Releases

2021.05.07: Readout of HHS Secretary Becerra's Bilateral Meeting with Indian Minister of Health and Family Welfare

2021.05.06: HHS Secretary Becerra Announces Nearly 940,000 Americans Have Signed Up for Health Coverage through HealthCare.gov During Special Enrollment Period

2021.05.05: HHS Secretary Becerra, HUD Secretary Fudge Announce Joint Effort to Increase Access to COVID-19 Vaccinations

2021.05.04: HHS Announces Nearly $1 Billion from American Rescue Plan for Rural COVID-19 Response

2021.05.04: HHS Announces $250 Million from American Rescue Plan to Develop and Support a Community-Based Workforce to Increase COVID-19 Vaccinations in Underserved Communities

2021.05.03: HHS Launches New Reimbursement Program for COVID-19 Vaccine Administration Fees not Covered by Insurance

2021.05.03: HHS and National Partners Mark Asian Pacific Heritage Month by Encouraging Asian Americans and Pacific Islanders to Enroll in Quality, Affordable Health Coverage through HealthCare.gov

2021.05.01: Pomona Fairplex Emergency Intake Site (EIS)

CMS - Fact Sheets

2021.05.06: 2021 Marketplace Special Enrollment Period Report

2021.04.30: Notice of Benefit and Payment Parameters for 2022 Final Rule Part Two Fact Sheet

2021.04.27: Fiscal Year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) Rates Proposed Rule (CMS-1752-P)

2021.03.10: CMS Updates Nursing Home Guidance with Revised Visitation Recommendations

CMS - HPMS Guidance History

May 06, 2021 - Reminder: County Removal Deadline for Contract Year 2022 Medicare Advantage Applications [Email]

May 04, 2021 - CY 2022 Plan Connectivity Data Submission and Verification [PDF]

May 03, 2021 - Process for Requesting an HPMS Crosswalk Exception for Contract Year 2022 [Email]

May 03, 2021 - Retail Pharmacy Network Access and Preferred Cost-Sharing Pharmacy Access Analysis Results for Q1 CY 2021 [PDF]

May 03, 2021 - CY 2022 Plan Connectivity Data Submission and Verification [PDF]

Office of Inspector General Actions

Corporate Integrity Agreements

Aveanna Healthcare see Pediatric Services of America - Atlanta, GA - 07/27/2018 - CLOSED: 04/20/2021 (PDF)

Chuang, Lino see Excellent Choice Physical Therapy, P.C., and Lino Chuang - Huntington Station, NY - 11/29/2017 - CLOSED: 04/09/2021 (PDF)

Edwards, D.D.S., Robert J. - Baton Rouge, LA - 12/18/2017 - CLOSED: 04/02/2021 (PDF)

Excellent Choice Physical Therapy, P.C., and Lino Chuang - Huntington Station, NY - 11/29/2017 - CLOSED: 04/09.2021 (PDF)

Geada, Glenn see Southern States Physical Medicine and Rehabilitation, LLC - Lancaster, SC - 09/12/2014 - CLOSED: 04/02/2021 (PDF)

Gindi, Chad S. see Southern States Physical Medicine and Rehabilitation, LLC - Lancaster, SC - 09/12/2014 - CLOSED: 04/02/2021 (PDF)

North Broward Hospital District - Fort Lauderdale, FL - 08/31/2015 - CLOSED: 04/21/2021 (PDF)

Pediatric Services of America, Inc. - Atlanta, GA - 07/27/2015 - CLOSED: 04/20/2021 (PDF)

Southern States Physical Medicine and Rehabilitation, LLC - Lancaster, SC - 09/12/2014 - CLOSED: 04/02/2021 (PDF)

Swarup, M.D., Jitendra see Albemarle Eye Center, PLLC and Jitendra Swarup, M.D. - Elizabeth City , NC - 02/05/2018 - CLOSED: 04/15/2021 (PDF)

List of Excluded Individuals/Entities

OIG 04/21 Cumulative Sanction Report-Reinstatements for April 2021 (Excel)

OIG 04/21 Cumulative Sanction Report-Update for April 2021 (Excel)

OIG 04/21 Cumulative Sanction Report-Profile Corrections for April 2021 (PDF)

Medicaid Fraud Control Units

2021.04.29: Michael Maggiacomo and Tina Allen Indicted for Medicaid Fraud

2021.04.29: Attorney General Josh Stein Announces $300,000 “Operation You’ve Got Nerve” Settlement

2021.04.26: Old Town Pharmacy Owner and Pharmacy Technician Indicted on 34 Counts Related to Medicaid Fraud, Forgery, Identity Theft

2021.04.23: Florida Nurse Arrested for Exploiting a Senior

OIG - Medicare Fraud Strike Force

Medicare Fraud Strike Force Overview

Audit Reports - Centers for Medicare and Medicaid Services

Medicare Hospital Provider Compliance Audit: Virtua Our Lady of Lourdes Hospital A-02-18-01018 (05/04/2021) (PDF)

We hope you enjoyed this weekly MediRegs content provided courtesy of Wolters Kluwer. To get the latest updates delivered directly to your inbox every day, contact us today about a subscription.

LEARN MORE →

Learn more about MediRegs current awareness products and complete coding, reimbursement, and compliance research solutions.

Wolters Kluwer Legal & Regulatory U.S. | 28 Liberty Street, 44th Floor | New York, NY 10005
Copyright 2021 CCH Incorporated and its affiliates.
All rights reserved.

Follow Us:

Licensing Agreement | Privacy Policy | About Us

When you have to be right