Judith A. Waltz

Judith A. Waltz

Foley & Lardner LLP

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Latest Publications


Precision Medicine - Even Medicare Will Pay for It!

President Barack Obama announced in his 2015 State of the Union address that he was introducing a new Precision Medicine Initiative, supported with over $200 million in the proposed 2016 federal budget. "Precision Medicine"...more

9/21/2015 - Barack Obama Biotechnology Cancer Diagnostic Tests Health Insurance Healthcare HHS Hospitals Innovation Medicare NIH Personalized Medicine Physicians

Fasten Your Seat Belts: District Court Says “Failure to Act Quickly Enough” May Violate 60-Day Refund Rule

A New York Federal District Court issued an Opinion and Order, on August 3, 2015, in a closely-watched False Claims Act (FCA) case, Kane v. Healthfirst, Inc. The Court refused to dismiss the whistleblower complaint in which...more

8/12/2015 - Affordable Care Act False Claims Act (FCA) Health Care Providers Hospitals Internal Investigations Medicaid Medicare Overpayment Whistleblowers

The Medicaid Fraud Control Units: Fiscal Year 2014 Report

The Department of Health and Human Services (HHS) Office of Inspector General (HHS-OIG) has released its Fiscal Year (FY) 2014 Annual Report (Report) on the performance of the Medicaid Fraud Control Units (MFCUs)...more

5/29/2015 - Affordable Care Act Compliance Elder Abuse Fraud HHS Managed Care Contracts Medicare Neglect OIG Pharmaceutical Industry

CMS Issues Final Rule for Inpatient Stays in Acute Care and Long Term Care Hospitals

On August 1, 2014, the Centers for Medicare and Medicaid Services (CMS) issued its annual final rule for policy and payment changes applicable to inpatient stays in acute care and long term care hospitals (Final Rule). This...more

9/4/2014 - Acute Facilities CMS Healthcare Hospitals Medicaid Medicare

Medicare's Fraud Prevention System: CMS Issues Second-Year Report to Congress

The Small Business Jobs Act of 2010 (pertinent sections of which are codified at 42 U.S.C. Section 1320a-7m) directed the Centers for Medicare & Medicaid Services (CMS) to use predictive modeling and other analytics...more

8/13/2014 - CMS Fraud Healthcare Healthcare Fraud

OIG's Proposed Rule to Expand Civil Monetary Penalties

The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) on May 12, 2014 published a proposed rule (Proposed Rule) that would implement the OIG’s expanded authority under the Affordable Care...more

6/10/2014 - Affordable Care Act Civil Monetary Penalty Financial Conduct Authority (FCA) HHS Hospitals Medicare OIG Overpayment Proposed Regulation

OIG Releases Report on Medicaid Fraud Control Units

The Department of Health and Human Services (HHS) Office of Inspector General (HHS-OIG) has released its Fiscal Year (FY) 2013 Annual Report (Report) on the performance of the Medicaid Fraud Control Units (MFCU)...more

3/11/2014 - Healthcare Fraud HHS Medicaid Medical Devices OIG Pharmaceutical Industry Prescription Drugs

340B Drug Pricing Program Developments in the New Year

On January 9, 2014, the Health Resources and Services Administration (HRSA) posted an update on its current and anticipated 340B drug pricing program (340B) program integrity efforts.1 The update includes a discussion of...more

1/14/2014 - Covered Entities HHS HRSA OIG Pharmaceutical Industry Prescription Drugs Section 340B

Provider Reimbursement Review Board Issues Alert 9 and Revised Rules

On March 1, 2013, the Provider Reimbursement Review Board (PRRB or the Board) issued Alert 9, which notified interested parties that the PRRB has made revisions to its Rules and updated its Model Forms. Medicare providers...more

3/27/2013 - CMS Medicare PRRB Reimbursements

Supreme Court Rules Equitable Tolling Cannot Be Used To Extend Deadline For Filing Medicare Part A Reimbursement Appeals

On January 21, 2103, the U.S. Supreme Court unanimously held in Sebelius v. Auburn Regional Medical Center that the Medicare statute does not permit the time period for filing an appeal with the Provider Reimbursement Review...more

2/5/2013 - Appeals CMS Equitable Tolling Medicare Physician Medicare Reimbursements Provider Reimbursement Review Board

Medicare Issues Final Rules for Hospital Outpatient and Ambulatory Surgery Center Payment Systems

On November 15, 2012, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register final rules that would, among other things, update payment policies and rates under the Outpatient Prospective...more

12/7/2012 - CMS Medicaid Medicare

California’s Medi-Cal Program Implements Affordable Care Act Fraud, Waste, and Abuse Provisions

On September 29, 2012, California Governor Jerry Brown signed into law a bill that gives the California Department of Health Care Services (DHCS), the state agency which implements the California Medi-Cal (Medicaid) program,...more

11/27/2012 - Affordable Care Act Jerry Brown Medicaid

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