On October 3, 2022, the Supreme Court of the United States denied the request to review the Eighth Circuit’s decision that upheld a federal rule that limited the use of arbitration agreements in nursing homes.
On October 3, 2022, the Department of Justice (“DOJ”) announced that a hematology and oncology practice in Fort Lauderdale, Florida will pay $130,000 to settle allegations that the practice violated the False Claims Act and Anti-Kickback statute by accepting illegal kickbacks from its pharmaceutical distributor.
On June 29, 2022, the Centers for Medicare & Medicaid Services (“CMS”) issued updated guidance on minimum health and safety standards for Long- Term Care facilities (“LTC”). The guidance involved regulations that were originally adopted in 2016, with planned implementation in three phases.
In Advisory Opinion No. 22-17, posted on September 6, 2022, the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) stated that it would not impose sanctions on a hospital system (Hospital) and a federally qualified health center look-alike (FQHCLA) that were parties to agreements under which the Hospital provided financial support to the FQHCLA.
Medically Unlikely Edits (MUEs) are used to flag potential fraud and billing errors for claims by identifying the maximum number of units that a provider reports for a specific code in a single day for an individual patient. While third-party payers are not required to follow CMS’s MUEs, many incorporate them in their claims manuals.