The 60-day Refund Rule, created by the 2010 Affordable Care Act, requires providers to report and return Medicare and Medicaid overpayments within 60 days of identifying them. See Section 1128J(d) of the Social Security Act,...more
7/16/2024
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Deadlines ,
False Claims Act (FCA) ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part A ,
Medicare Part B ,
Medicare Part C ,
Medicare Part D ,
Overpayment ,
Proposed Regulation ,
Refunds
On October 9, 2019, the Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human Services (HHS) released its long-awaited Proposed Rule (Proposed Rule) updating and clarifying the physician...more
10/17/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Health Care Providers ,
Medicare ,
Physicians ,
Proposed Regulation ,
Self-Referral ,
Stark Law ,
Value-Based Care
Despite the July 4 holiday, the past week featured significant regulatory and legislative action addressing the use of opioids and pain management. The changes are in keeping with the Government-wide push to better understand...more
7/14/2016
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Congressional Committees ,
Drug & Alcohol Abuse ,
Hospitals ,
Legislative Agendas ,
Medicare ,
Opioid ,
Pain Management ,
Pending Legislation ,
Prescription Drugs ,
Proposed Regulation ,
Surveys ,
Value-Based Purchasing
CMS issued its Outpatient Prospective Payment System (“OPPS”) Proposed Rule for 2017 (the “Proposed Rule”) on July 6, 2016. The Proposed Rule will be published in the Federal Register on July 14, 2016. One highly-anticipated...more
7/13/2016
/ Bipartisan Budget Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Grandfathered Status ,
Health Care Providers ,
Hospitals ,
Medicare ,
MPFS ,
Off-Campus Departments ,
OPPS ,
Proposed Legislation ,
Proposed Regulation ,
Section 340B
As required by a 2014 statute, CMS has issued proposed regulations (Proposed Rule) implementing new requirements for laboratory reporting of, and eventually basing Medicare payment on, rates for clinical laboratory services...more
10/12/2015
/ Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
CLFS ,
Clinical Laboratories ,
Comment Period ,
Data Collection ,
Department of Health and Human Services (HHS) ,
Diagnostic Tests ,
Health Insurance ,
Hospitals ,
Managed Care Contracts ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part B ,
Misrepresentation ,
OIG ,
Omissions ,
PAMA ,
Physicians ,
Proposed Regulation ,
Reporting Requirements
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