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President Biden Signs End-of-Year Legislation Including Telehealth, Medicare & Medicaid, Mental Health, Pandemic Preparedness, and Other Health Care Provisions

C&M Health Law

Telehealth Section 4113 of the Act extends certain Medicare telehealth flexibilities that were allowed during the COVID-19 PHE for two years, through 2024. The section ensures that telehealth flexibilities under Medicare are extended for two years, regardless of the status of the PHE.

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CMS’s Final Rule on Medicare Advantage Risk Adjustment Data Validation

Health Law Advisor

On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. million from non-extrapolated errors based for PYs 2011–2015, an estimated average of $8.2

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Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

Kaiser Health News

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday. Medicare Advantage plans accept a set fee from the government for covering a person’s health care.

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CMS Issues Long-Awaited Medicare Advantage RADV Final Rule

Healthcare Law Blog

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology.

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Medicare Advantage RADV Audit Final Rule Challenged in Court

Healthcare Law Blog

The Centers for Medicare & Medicaid Services (“CMS”) released the final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”) on January 30, 2023. MAOs will be required to remit improper payments identified during RADV audits in a manner specified by CMS.

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HHS Issues Proposed Rule to Provide Clarity on Rights of Conscience in Healthcare

Healthcare Law Blog

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients.

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Biden Administration Extends Suspension of Mandatory 2% Medicare FFS Payment Sequestration

Health Law Attorney

The Act extends the temporary suspension of certain mandatory Medicare FFS claim payment reductions until December 31, 2021. By way of background, the Budget Control Act of 2011 required mandatory across-the-board reductions to be made in federal spending, otherwise referred to as “sequestration.” Continue Reading ?.