Brennan, Manna & Diamond
Listen. Solve. Empower.
About
Our Core Values
Diversity & Inclusion
Community Involvement
Team
Practice
Contact
Resources
Events
Payment
Careers
Resources
Client Alerts, News Articles, Blog Posts, & Multimedia
Everything you need to know about BMD and the industry.
Client Alert
IMPORTANT PRF UPDATE! HRSA Allows Providers the Opportunity to Correct Missed Period 1 Reporting
April 7, 2022
Late Wednesday, April 6, HRSA announced that it was going to allow providers with extenuating circumstances that prevented them from preventing a completed Period 1 Report to submit a Request to Report Late Due to Extenuating Circumstances.
Posted by
Amanda Waesch
Client Alert
Supreme Court Upholds CMS Vaccination Mandate for Health Care Providers
January 18, 2022
Last week, the U.S. Supreme Court struck down the COVID-19 vaccine-or-test mandate for employers with more than 100 employees (the OSHA ETS) and upheld the COVID-19 vaccination mandate for employees of health care providers who receive Medicaid or Medicare funding (the CMS rule).
Posted by
Daphne Kackloudis
Client Alert
Surprise! A Cautionary Tale for Out-Of-Network Billing: The No Surprises Act and the Impact on Healthcare Providers
February 25, 2021
SURPRISE! Congress passed The No Surprises Act at the end of 2020. Providers, particularly those billing as out-of-network providers, should start thinking about strategies to comply with this new law, set to take effect on January 1, 2022. In its most basic sense, the new law prohibits providers from billing patients for more than the in-network cost-sharing amount in most situations where surprise bills happen. It specifically applies to non-government payers and the amounts will be set through a process described in the new law. In particular, the established in-network cost-sharing amount must be billed for the following services:
Posted by
Jeana Singleton
Client Spotlight
BMD Client Spotlight: Eating Recovery Center
February 8, 2021
With 6,500 patients per year, locations across 7 states, and daily long-term support capabilities, ERC and Pathlight comprise the nation’s leading mental health care system dedicated to the treatment of eating disorders and primary mood, anxiety and trauma-related disorders. They aim to patch the need for more specialized behavioral health treatment across the country. ERC and Pathlight fill the gap with developmentally appropriate treatment that includes: An expert care team that coordinates therapeutic, psychiatric, medical and dietary needs of each patient Evidence-based psychotherapy treatment, with emphasis on exposure therapy to develop and practice new skills Intensive Treatment Units for patients with complex medical and/or behavioral needs Unmatched family programming with expanded spaces dedicated to family therapy and skill-building Round-the-clock nursing supervision and support An education specialist who oversees patients' academic needs, so they don’t fall behind in school
Posted by
Brennan Manna Diamond
Client Alert
Should I Apply for Phase 3 Funds? Important Considerations Every Provider Should Know
November 2, 2020
On October 1, 2020, the Department of Health and Human Services (“HHS”) announced an additional $20 billion in new funding for providers through a Phase 3 distribution. Importantly, providers that previously received HHS Provider Relief Funds or already received payments of approximately 2% of annual revenue from patient care are eligible to apply. Eligible providers have until November 6, 2020 to apply for these Phase 3 Funds. However, the question from providers continues to be: Should I Apply for Phase 3 Funds?
Posted by
Amanda L. Waesch
Client Alert
Ohio House Passes Bill 388 Including Out-of-Network Reimbursement Requirements
July 6, 2020
On May 20, 2020, the Ohio House of Representatives unanimously passed House Bill 388, which would enact five new Ohio Revised Code sections regarding out-of-network care and reimbursement.
Posted by
Kevin M. Cripe
Client Alert
HHS Delays Quarterly Reporting for Provider Relief Funds
June 19, 2020
There is good news for providers that received either (1) General Distributions from the HHS Provider Relief Funds [link to my article], or (2) Targeted Distributions from the HHS Provider Relief Funds [link to Ashley’s article]. HHS reversed its stance requiring quarterly reports for providers that received Provider Relief Funds and PPP loan monies. The initial quarterly reports would have been due by July 10, 2020. However, on June 13, 2020, HHS delayed the quarterly reporting requirement.
Posted by
Amanda L. Waesch
Client Alert
July 20 is Important Deadline for HHS Fund Distributions to Medicaid and CHIP Providers
June 19, 2020
On June 10, 2020, the U.S. Department of Health and Human Services (“HHS”) released details on the distribution of more CARES Act Provider Relief Fund payments. After allocating $50 billion to Medicare providers through its General Distribution fund, HHS has now announced that it will distribute $15 billion to eligible Medicaid and CHIP providers who apply by the deadline through a Targeted Distribution. Applicants must apply through the Enhanced Provider Relief Fund Payment Portal. The application form itself can be found on the HHS website and is due by July 20, 2020.
Posted by
Ashley Watson & Amanda Waesch
Client Alert
DOJ Updates Corporate Compliance Plan Guidance
June 18, 2020
With the passage of the Affordable Care Act in 2010, all healthcare providers were required to adopt and implement a corporate compliance plan. Historically, having an effective corporate compliance plan in place has been key to defending healthcare providers in fraud and abuse actions by Medicare, Medicaid, and commercial payers. Over the past couple of years, the U.S. Department of Justice’s (DOJ) Criminal Division has increased the number of prosecutions against U.S. corporations, including healthcare providers. Earlier this month, the DOJ’s Criminal Division updated its “Evaluation of Corporate Compliance Programs” guidance to educate prosecutors on how a corporate compliance program will be evaluated going forward.
Posted by
Jeana Singleton & Richard Crosby
Client Alert
Important Updates, Deadlines, and Clarifications for the HHS Provider Relief Funds
May 22, 2020
On May 20, 2020, HHS made important updates and clarifications regarding the General Distribution payments to providers. Between April 10, 2020 and April 24, 2020, HHS distributed an initial $30 billion to providers based on the provider’s 2019 Medicare fee-for-service receipts. These funds were distributed automatically and providers did not need to submit an application in order to receive these funds. The funds were originally touted as a “no strings attached” stimulus payment reserved for healthcare providers. But HHS issued a 10-page Terms and Conditions and required that providers sign an attestation confirming receipt of the funds and agreeing to the Terms and Conditions.
Posted by
Amanda L. Waesch
Client Alert
The $70 Billion Question – CARES Act Provider Relief Fund Helping Hardest Hit Hospitals First
April 23, 2020
HHS finally unveiled its preliminary plan for disbursement of the remaining $70 billion of CARES Act Provider Relief Funds. The initial $30 billion was disbursed to providers based on 2019 Medicare fee-for-service payments. HHS indicated that the remaining $70 billion would be disbursed to (1) providers that incurred COVID-19 expenses, (2) rural providers, (3) providers that primarily receive payments from other sources (such as Medicaid), and (4) providers that treat uninsured Americans.
Posted by
Amanda L. Waesch
Client Alert
Important Items Every Provider Should Know if Accepting the HHS Provider Relief Funds
April 22, 2020
On April 10, 2020, the Department of Health and Human Services (HHS) issued $30 billion to healthcare providers as part of the Provider Relief Fund under the CARES Act. Providers will have 30 days from the date of receipt to access the HHS portal, attest to the payment, and accept the Terms and Conditions. The Terms and Conditions require providers to take substantial steps to ensure compliance.
Posted by
Amanda Waesch
Client Alert
Healthcare Providers: Comparison of New OIG Waivers and Flexibilities under Anti-Kickback Statute in Response to COVID-19
April 21, 2020
On March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) issued several temporary regulatory waivers to further enable the American healthcare system to respond to the COVID-19 pandemic with more efficiency and flexibility (the “Blanket Waivers”).
Posted by
Chelsea M. Remick & Jeana M. Singleton