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McBrayer Blogs
OIG, in a Departure, Approves Hospital Provision of Nurse Practitioner Services
Traditionally, the Office of the Inspector General for the U.S. Department of Health and Human Services (“OIG”) would take a hard stance on any arrangements that might involve some form of remuneration from a hospital to a referring physician, but the winds of change may be blowing. In Advisory Opinion 22-20, published in December of 2022, the OIG has given a green light, albeit in a limited context, to an arrangement in which a hospital may have its employee nurse practitioners perform some services traditionally performed by the patients’ primary care physicians. This is a small step in the direction of a more flexible OIG stance on the federal Anti-Kickback Statute (“AKS”), but it doesn’t completely sidestep risks. More >
Fine Lines in Medical Spa Regulations
Medical spas (also known as ‘medspas,’ ‘medispas,’ or ‘esthetic salons’) combine advanced medical esthetic services that would have previously only been found at plastic surgery clinics or dermatologists’ offices (such as Botox injections, laser hair removal, chemical peels, injectable fillers, and acne treatments) with those found in a traditional day spa. Often, these procedures require the supervision of a licensed physician or nurse practitioner, creating a unique regulatory issue. As medspas have generated billions in revenue annually across the country and involve several types of healthcare and cosmetology professionals, it is critical for healthcare professionals offering services at a medspa to understand their specific obligations to maintain compliance with the law and prioritize patient safety. More >
OIG and CMS Audits Present New Round of Compliance Concerns for Healthcare Providers
Since the beginning of the Public Health Emergency, Centers for Medicare and Medicaid Services (“CMS”) and the Centers for Disease Control and Prevention (“CDC”) data reflect over 44 million COVID-19 cases, 3 million COVID-19 related hospitalizations, and 720,000 COVID-19 deaths. COVID-19 has placed enormous stress on our healthcare system. Federal and state responses to COVID-19 have woven a complex and complicated safety net by easing regulatory requirements through waivers and funneling billions of dollars to providers among many other actions. Just as the pandemic may finally be easing, federal focus on use of COVID-19 resources promises to increase healthcare providers’ stress. More >
WEBINAR - RHCs and FQHCs: What You Need to Know NOW about New CMS Regulations on Vaccine Mandates
SCOTUS Blocks OSHA ETS; Healthcare Mandate Moves Forward
Thursday afternoon, the United States Supreme Court ruled to block the Emergency Temporary Standard (ETS) issued by the U.S. Occupational Safety and Health Administration (OSHA) that would require private employers of 100 or more workers to mandate employee vaccination against COVID-19, or weekly testing for the virus. The Court upheld, however, a similar rule for healthcare employers contracted with the Centers for Medicare and Medicaid Services (“CMS”) as further outlined below. More >
Not All Surprises Are Presents: Preventing Surprise Medical Bills under the No Surprises Act
To address surprise medical costs for consumers, Congress recently passed an extremely complicated bill: No Surprises Act (“The Act”). No Surprises Act aims to prevent surprise medical bills or balance billing in the American health care system. Specifically, The Act prevents surprise medical bills when patients receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center. More >
Vaccination Mandate for Healthcare Facilities Blocked by Federal Court
The Centers for Medicare and Medicaid Services (CMS) Interim Final Rule which would have required COVID-19 vaccination for employees of healthcare facilities that receive Medicare and/or Medicaid funding has been blocked by a federal court in Louisiana. Here’s what healthcare employers need to know. More >
Policy Reversal Means Return of Per Day Fines for Nursing Homes
On July 19, 2021, the Center for Medicare and Medicaid Services (“CMS”) rescinded a guidance issued in 2017 that significantly limited the discretion of CMS Locations to impose substantial fines for noncompliance. (For reference, the 2017 Guidance can be found here. The accompanying CMP Analytic Tool can be found here.) More >
Pandemic Pivot to Telemedicine Creates New Compliance Issues for Healthcare Providers
The shift to telemedicine in the United States predates the pandemic, but COVID-19 has accelerated its widespread use. In April of 2019, the Centers of Medicare and Medicaid Service (CMS) finalized rules to increase telehealth benefits for Medicare Advantage enrollees, effectively incentivizing health systems with high numbers of private Medicare plan recipients to invest in telehealth services. More >
FDA Approval Means Smoother Road to Vaccine Mandates for Healthcare Employers
Amidst the new surge of COVID-19 cases in the U.S. due to the highly contagious Delta variant, the Food and Drug Administration (FDA) has announced that the Pfizer-BioNTech vaccine, one of three that has been available under Emergency Use Authorization, has achieved full approval. As the need for a fully vaccinated healthcare workforce grows more critical, this FDA announcement paves a smoother path for healthcare facilities’ employee vaccine mandates. Healthcare employers should understand how to implement an effective vaccine mandate to protect the health and safety of their employees and patients. More >
