New Cares Funding Available For Medicaid Providers

by Jeanne L. Vance
The Healthcare Law Blog

On June 9, 2020, the U.S. Department of Health and Human Services (HHS) announced that it will allocate approximately $15 billion to providers who participate in state Medicaid program and Children’s Health Insurance Program (CHIP) and who did not receive payments from the initial $50 billion in general allocations from the Provider Relief Fund under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This funding is intended to provide relief to Medicaid and CHIP providers experiencing lost revenues or increased expenses due to COVID‑19.

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California Attorney General Clarifies Effective Date For Filing Adverse Action 805 Report By Health Care Peer Review Bodies

On April 20, 2020, the California Attorney General (“AG”) issued a published opinion clarifying that the “effective date” for purposes of filing a Business and Professions Code 805 report is the date on which a peer review body’s decision becomes final, following the conclusion of a licentiate’s appeal to the body of its proposed final action, and not the date of the peer review body’s final proposed decision. Section 805 requires a report to be filed with the relevant state healing arts licensing agency “within 15 days after the effective date” of certain actions taken by a peer review body against specified health care licentiates,

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Postponing Elective Surgeries To Contain Covid-19 Spread And Conserve Resources Presents Challenges For Healthcare Providers

by Jeanne L. Vance

The World Health Organization (WHO) declared the COVID-19 pandemic on March 11, 2020.[1] As a result, there are more patients in need of immediate and attentive care, and many practices now have to consider how to continue providing necessary services while containing the spread of COVID-19 with balancing current and future needs for clinician services, medical supplies and access to personal protective equipment (PPE). In response to this, the Centers for Disease Control and Prevention have recommended the postponement of non-essential adult elective surgeries and medical and surgical procedures to conserve resources,[2] and the Centers for Medicare &

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California Implements Provider Enrollment Fingerprinting Requirements Effective October 2

by Jeanne L. Vance

On September 10, 2104, the California Department of Health Care Services (“DHCS”) announced that it will implement federal requirements for fingerprinting in the Medi-Cal provider enrollment process starting October 2, 2014. This new process implements a portion of the federal Patient Protection and Affordable Care Act that requires DHCS to establish categorical risk levels for certain providers determined to have a high risk of program abuse. Provider types that are categorically determined to be “high risk” are newly enrolling home health agencies,

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Medi-Cal Enrollment Fees Go Into Effect Today! Dhcs Failure To Issue Implementing Instructions Leaves Providers With Questions

by Jeanne L. Vance

Starting today, Department of Health Care Services (“DHCS”) is required to collect Medi-Cal enrollment fees of $505 per enrollment for “institutional providers.” DHCS Provider Enrollment Unit has issued no formal guidance regarding how it will implement the new requirements, and requests for information guidance from DHCS’ Acting Chief of Provider Enrollment have revealed few details regarding how a provider can comply with the new requirements.

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Initial Enrollments And Changes Of Ownership Impacted By Home Health Medicare Enrollment Rule Changes

by Jeanne L. Vance

In the March 2011 edition of The Rap Sheet, Weintraub attorney Jeanne Vance writes the Centers for Medicare & Medicaid Services (CMS) modified home health agency (HHA) Medicare provider enrollment provisions in two important ways. First, it extended the amount of time that a Medicare-certified HHA must meet initial capitalization requirements. Second, it narrowed the scope of business transactions that are subject to the so-called 36-Month Rule, which causes the deactivation of an HHA’s Medicare billing entitlements upon the occurrence of certain HHA ownership transfers that occur within three years of the last ownership change.

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CMS Issues Proposed Rule To Implement Provider Enrollment Aspects Of Affordable Care Act

by Jeanne L. Vance

The Centers for Medicare & Medicaid Services (“CMS”) recently published proposed regulations that would implement provisions of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (collectively, the “Affordable Care Act”) relating to provider enrollment in Medicare, Medicaid and Children’s Health Insurance Program (“CHIP”). Published in the September 23, 2010 Federal Register, the proposed rules, if adopted, would introduce fingerprinting to the public-program enrollment process,

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