Adam Romney

Adam Romney

Davis Wright Tremaine LLP

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Latest Publications


Medicare to Implement CJR: Mandatory Bundled Payment Program for Joint Replacement Surgeries

On Nov. 24, the Centers for Medicare & Medicaid Services will publish in the Federal Register the final rule for the Comprehensive Care Joint Replacement (CJR) Program. The CJR Program is a new payment model that requires...more

11/24/2015 - CMS Fee-for-Service Healthcare Healthcare Fraud Payment Methods Telehealth

Changes to the “Two-Midnight Rule” on the Horizon

On July 1, CMS published proposed changes to the so-called “Two-Midnight Rule,” which currently governs when inpatient hospital admissions are entitled to Medicare Part A payment. The proposed changes were announced in a...more

7/7/2015 - CMS Healthcare Hospitals Inpatient Billing Medicare Patient Prospective Payment System Proposed Amendments Two-Midnight Rule

Hold the Phone! Washington Adopts Telemedicine Parity Law

On April 17, Washington Governor Jay Inslee signed Substitute Senate Bill 5175 (the “Parity Law”), which expands coverage for telemedicine services paid by health plans in the state of Washington. With the new law, Washington...more

5/1/2015 - Governor Inslee Health Insurance Healthcare New Legislation Popular Telemedicine

The SGR Fix: Congress Charts a New Course for Physician Payments and Gainsharing

On April 16, President Obama signed into law the “Medicare Access and CHIP Reauthorization Act of 2015,” (“MACRA”) which repealed the Sustainable Growth Rate (“SGR”) payment formula used to limit annual updates to Medicare...more

4/23/2015 - CHIP Gainsharing Medical Devices Medicare Access and CHIP Reauthorization (MACRA) New Legislation Physician Medicare Reimbursements Physician SGR Formula Physicians Repeal

The Dark Side of Health Care Reform: The First “60-Day Rule” False Claims Act Case

The U.S. Department of Justice and New York State Attorney General’s Office recently intervened in a federal False Claims Act case in federal District Court based on allegations that a provider failed to report and refund an...more

7/11/2014 - Affordable Care Act DOJ False Claims Act (FCA) Healthcare Reform Hospitals Overpayment Reporting Requirements

Finishing at the Top of the Class: The Risks Faced by High Achievers on the Medicare Billings List

In this increasingly competitive world, providers generally want to be at the top of almost any official ranking. CMS’s recently released list of medical groups and physicians receiving the most Medicare reimbursement dollars...more

6/26/2014 - CMS Healthcare Medicare

Emerging EHR Risks: When Documentation May Not Be Enough (or Too Much)

Today’s Electronic Health Record (EHR) technologies feature many tools that help providers practice more efficiently and allow them to spend more time caring for patients. However, the federal government recently has posted...more

4/17/2014 - Audits CMS EHR Electronic Records MACs Medicare OIG Required Documentation Risk Mitigation

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