A notable headline from the August 12 MLN Connects Newsletter for healthcare providers states “CMS Resumes Targeted Probe & Educate Program.” Designed to help providers reduce claim denials and appeals, CMS suspended prepayment reviews under the Targeted Probe and Educate (TPE) program in response to the COVID-19 public health emergency (PHE) in March 2020. But unlike post-payment audits which have been active since CMS authorized its contractors to begin new audits in August 2020, TPE prepay reviews remained on hold.
Health Law Scan
Legal Insights and Perspectives for the Healthcare Industry
Members of our labor and employment and healthcare teams recently published a LawFlash covering the US Department of Justice’s (DOJ’s) definitive guidance which specifically concluded that “federal law does not prohibit public or private entities from imposing vaccination requirements for vaccines that are subject to emergency use authorizations from the U.S. Food and Drug Administration.”
Our labor and employment team recently published a LawFlash analyzing the US Departments of Treasury, Labor, and Health and Human Services and Office of Personnel Management’s Requirements Related to Surprise Billing; Part 1.
We hope you were able to join us for our July Fast Break on the US Court of Appeals for the Fourth Circuit's recently affirmed $114 million judgment in United States v. Mallory. If not, you missed a great session, featuring Katie McDermott and Howard Young analyzing this protracted suit filed under the qui tam provisions of the False Claims Act (FCA) against the owners of two specialty clinical laboratories and a contracted sales and marketing company.
Members of our emerging business and technology team recently hosted a webinar on seed financing structures for digital health companies. The program, led by partner Benjamin David Novak and associate Jessica Lee, discussed the market trends in digital health company financings as well as the various deal structures frequently used in seed financings.
The Centers for Medicare and Medicaid Services (CMS) recently released a table copy of its calendar year 2022 Medicare physician fee schedule proposed rule. The proposed rule is chock full of policy updates concerning telehealth, remote physiologic monitoring (RPM), and new remote therapeutic monitoring codes. Coming on the heels of the significant telehealth waivers put in place during the COVID-19 public health emergency (PHE), CMS proposes to continue the steady expansion of virtual care options with this rule.
Our immigration team recently published a LawFlash analyzing the US Department of State’s July 2021 Visa Bulletin, which outlines per-country priority date cutoffs that regulate immigrant visa availability and the flow of adjustment of status application and consular immigrant visa application filings and approvals.
Our healthcare team recently launched a publication series highlighting the global impact of COVID-19 on healthcare transactions. Around the globe, the healthcare industry has faced similar issues from the unprecedented pandemic, prioritizing their operational response to COVID-19. Now, as countries begin to reopen, healthcare entities may refocus on planning for long-term transformation of their business models. In this series, we will explore how the pandemic impacted healthcare transactions in specific regions and what we can expect in a post-pandemic world.
Our energy regulatory team published a blog post highlighting the US Nuclear Regulatory Commission’s (NRC’s) recently issued Report to Congress on Abnormal Occurrences for fiscal year 2020. The report documents key aspects of those events that the NRC considers “Abnormal Occurrences” (AOs) and allows the regulated community to review the operating experience of reactor, medical, and industrial users of radioactive materials.
Members of our labor, employment, and benefits team have been busy providing analysis on continued updates to state COVID-19 rules and standards. We know these resources are valuable to readers of Health Law Scan, and we preview two recent LawFlashes that may be of particular interest to those operating in California and New York below.