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On November 2, 2023, the Centers for Medicare & Medicaid Services ("CMS") released the final rules for the calendar year ("CY") 2024 outpatient prospective payment system ("OPPS")...
On August 1, 2023, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the federal fiscal year (FFY) 2024 inpatient prospective payment system (IPPS)...
“Full Financial Risk” A. Overview of Key Safe Harbors and Exceptions An important initial consideration is that there are multiple differing requirements between corresponding Stark Law exceptions and AKS safe harbors. Stakeholders must navigate the requirements under both regulatory regimes for arrangements that potentially implicate each law. Although a number of commenters sought a unified set of requirements between Stark Law and AKS requirements, CMS and OIG rejected this approach, noting the different purposes of each law. In general, CMS provides more flexibility for Stark Law exce...
Tuesday, February 2, 2021 On 2 December 2020, the U.S. Department of Health and Human Services’ (HHS) issued two Final Rules in conjunction with its “Regulatory Sprint to Coordinated Care,” which will markedly change the regulatory fraud and abuse landscape for “value-based” arrangements: (i) The HHS Office of the Inspector General (OIG) published a Final Rule that introduces new safe harbor protections under the federal Anti-Kickback Statute (AKS) for certain coordinated care and risk-sharing value-based arrangements between or among clinicians, providers, suppliers, and...