On July 27, 2026, the U.S. District Court for the Northern District of Texas in Covenant Medical Center v. Kennedy (“Covenant”) once again vacated a 2023 Centers for Medicare & Medicaid Services (“CMS”) regulation that excluded inpatient days covered by an uncompensated care funding pool when counting Medicaid Days in the Disproportionate Share Hospital (“DSH”) payment calculation. The regulation at issue, found at 42 C.F.R. § 412.106(b)(4)(iii) and known as the “Exclusion Rule,” was previously vacated by the same
Continue Reading District Court (Again) Vacates HHS § 1115 Waiver Day Exclusion Rule in Covenant Medical Center v. Kennedy
FDA Proposes Distributed Manufacturing Registration Pathway and Aligns Foreign Establishment Registration and Listing Requirements With Current Law
The U.S. Food and Drug Administration (“FDA”) issued a proposed rule to update drug establishment registration and listing requirements for distributed manufacturing (“DM”) and certain foreign drug establishments. If finalized, the rule would create a streamlined registration pathway for qualifying distributed manufacturing establishments (“DMEs”) that manufacture drugs at multiple physical locations, while also aligning the FDA’s foreign establishment registration and listing regulations with statutory changes made by Section 2511 of the PREVENT Pandemics Act. Comments on the proposed rule
Continue Reading FDA Proposes Distributed Manufacturing Registration Pathway and Aligns Foreign Establishment Registration and Listing Requirements With Current Law
Indiana HCBS Update: Indiana Imposes Statewide HCBS Provider Certification and Enrollment Moratorium
The Indiana Health Coverage Programs announced that it has received approval from the Centers for Medicare & Medicaid Services (“CMS”) to implement a statewide provider certification and enrollment moratorium for numerous Home- and Community-Based Services (“HCBS”) 1915(c) waiver providers. The moratorium becomes effective August 1, 2026, and initially will remain in effect for six months, although Indiana may seek six-month extensions.
Unlike many Medicaid enrollment moratoria that apply to a single provider type or geographic area, Indiana’s action applies
Continue Reading Indiana HCBS Update: Indiana Imposes Statewide HCBS Provider Certification and Enrollment Moratorium
Weekly Hospital Real Estate Briefing: Nearly 1 in 10 US Hospitals Now PE-Owned | Pearl Innovation District Generates $224M in Economic Impact | AdventHealth Continues Land Banking
Turning TEAM Risk into Opportunity: The Case for a Value-Based Enterprise
On January 1, 2027, mandatory downside financial risk under the Centers for Medicare & Medicaid Services’ (“CMS”) Transforming Episode Accountability Model (“TEAM”) will begin for most participating hospitals. TEAM is a mandatory, episode-based alternative payment model that took effect on January 1, 2026, and will end on December 31, 2030. Most hospitals located in any of the 188 Core-Based Statistical Areas (“CBSAs”) selected by CMS were required to participate. Calendar Year 2026 is Performance Year One (“PY1”) and is
Continue Reading Turning TEAM Risk into Opportunity: The Case for a Value-Based Enterprise
Wisconsin’s APRN Modernization Act – New Emergency Rules Chart the Path to Independent Practice
For years, Wisconsin has been among a shrinking group of states that require advanced practice nurses to maintain a collaborative agreement with a physician or dentist in order to practice. That is about to change. On September 1, 2026, the APRN Modernization Act (Act 17) takes effect, moving Wisconsin from a system that certifies advanced practice nurse prescribers (APNPs) to one that licenses advanced practice registered nurses (APRNs) and, for qualifying nurses, permits independent practice for the first time.
Continue Reading Wisconsin’s APRN Modernization Act – New Emergency Rules Chart the Path to Independent Practice
Skilled Nursing Update: CMS Implements Nationwide Risk-Based Surveys For Higher-Performing Skilled Nursing Facilities
The Centers for Medicare & Medicaid Services (“CMS”) has announced the nationwide implementation of a new Risk-Based Survey (“RBS”) process for qualifying nursing homes beginning September 8, 2026. CMS Memorandum QSO-26-14-NH explains that the RBS is intended to allow State Survey Agencies (“SAs”) to use fewer survey resources at higher-performing facilities and redirect resources toward complaint investigations and facilities where residents may face greater risk of harm.
CMS estimates that approximately 12% of nursing homes nationwide currently qualify. Qualifying
Continue Reading Skilled Nursing Update: CMS Implements Nationwide Risk-Based Surveys For Higher-Performing Skilled Nursing Facilities
Weekly Hospital Real Estate Briefing: What Hospitals Need to Know About Credit Tenant Lease Financing
Over the past few years, we’ve seen an increase in hospitals and health care systems using credit tenant lease (“CTL”) financing for new outpatient projects. Below is an overview of CTL financing.
Wisconsin’s APRN Modernization Act is Effective September 1
Last year, Hall Render introduced you to the APRN Modernization Act (“the Act”) after Wisconsin passed it into law in early August 2025. The Act, which takes effect on September 1, 2026, modifies licensure requirements so that qualified advanced practice nurses may practice without a collaborative arrangement with a physician or dentist. Since last month’s update, questions remain regarding how the Act will interact with payor requirements, including the Medicare Conditions of Participation, the Wisconsin Injured Patients and
Continue Reading Wisconsin’s APRN Modernization Act is Effective September 1
FDA Requests Input on Non-Device Software Functions and Patient Safety; Brief Comment Period Now Open
The U.S. Food and Drug Administration (“FDA”) is seeking public input as it prepares its 2026 report on the risks and benefits to health associated with non-device software functions, including their impact on patient safety and related best practices. Stakeholders have only about one month to submit comments, which are due by August 13, 2026, under Docket No. FDA-2018-N-1910. FDA’s 2026 report will update the findings of its December 2024 Report on Risks and Benefits to Health of
Continue Reading FDA Requests Input on Non-Device Software Functions and Patient Safety; Brief Comment Period Now Open
OIG’s New CIA Template Enhances Compliance Obligations for Health Care Organizations
On April 30, 2026, at the Health Care Compliance Association’s 2026 Compliance Institute, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) introduced its updated Corporate Integrity Agreement (“CIA”) template, using the Kinex Medical Company CIA as its model. The updated template retains the core elements of an effective compliance program while introducing significant enhancements that reflect OIG’s evolving compliance expectations.
Evolution of Corporate Integrity Agreements and Compliance Program Requirements
The new CIA template introduces
Continue Reading OIG’s New CIA Template Enhances Compliance Obligations for Health Care Organizations
Post Acute Update: HHS-OIG Issues Unfavorable Advisory Opinion on Subscription-Based Referral Management Software
The U.S. Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 26-15 addressing a subscription-based referral management software platform used during hospital discharge planning. OIG concluded that, under the facts presented, the arrangement could generate prohibited remuneration under the Federal Anti-Kickback Statute (“AKS”) because providers paying subscription fees received a competitive advantage in obtaining referrals for federally reimbursable services.
Although advisory opinions apply only to the requesting parties, Advisory Opinion 26-15 reflects OIG’s
Continue Reading Post Acute Update: HHS-OIG Issues Unfavorable Advisory Opinion on Subscription-Based Referral Management Software
Weekly Hospital Real Estate Briefing: Ascension to Purchase Williamson Health for $950M | Bridgepoint to Acquire Kayne Anderson for $1.4B | Hospitals Increase MOB Transactions in 2026
How Much Does Long-Term Care Cost and How Do I Pay for It?
By McKenna K. Coffeen | Elder Law
July 8, 2026
One of the most common concerns families face when discussing long-term care is cost. Whether care is provided at home, in an assisted living facility, or in a nursing home, long-term care expenses can become significant very quickly.
In Wisconsin, nursing home care can cost thousands of dollars each month, and even part-time in-home assistance may create substantial financial strain over time. Because Medicare coverage for long-term care is
Continue Reading How Much Does Long-Term Care Cost and How Do I Pay for It?
DOJ’s Continued Focus on Medicare and Medicaid Fraud Produces $6.5 Billion Health Care Fraud Takedown
The results of the 2026 National Health Care Fraud Takedown (the “Takedown”) were announced on June 23, 2026; the Department of Justice (“DOJ”) charged 455 individuals in connection with alleged health care fraud schemes involving over $6.5 billion in false claims. Ninety of the charged individuals were physicians or other medical professionals.
The Takedown, dating back to 2007, is conducted annually by DOJ, the Department of Health and Human Services Office of Inspector General (“HHS-OIG”), the Federal Bureau
Continue Reading DOJ’s Continued Focus on Medicare and Medicaid Fraud Produces $6.5 Billion Health Care Fraud Takedown
Mandatory Provider-Based Attestations Are Taking Shape: CMS Releases Proposed Implementation Framework
Earlier this year, Congress enacted Section 6225 of the Consolidated Appropriations Act, 2026 (“CAA”), establishing a new Medicare condition of payment for off-campus hospital outpatient departments beginning January 1, 2028. As discussed in our prior alerts (here and here), the statute generally prohibits Medicare payment for services furnished by an off-campus hospital outpatient department unless the department bills under a separate National Provider Identifier (“NPI”) assigned to that off-campus department, the hospital submits an initial provider-based attestation
Continue Reading Mandatory Provider-Based Attestations Are Taking Shape: CMS Releases Proposed Implementation Framework