Leslie Demaree Goldsmith

Leslie Demaree Goldsmith

Ober|Kaler


Latest Publications

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CMS Provides More Information on New Medicare DSH Payment Calculations

In the proposed federal fiscal year (FY) 2014 inpatient prospective payment system (IPPS) rule, CMS provided added details on the new Medicare disproportionate share hospital (DSH) calculation methodology. The provisions of...more

5/30/2013 - CMS DSH Healthcare Hospitals Medicaid Medicare Physician Payments

CMS Proposes New Standard for Hospital Inpatient Admissions

As part of its proposed inpatient prospective payment systems (IPPS) rule for FY 2014, CMS introduced a new standard for determining whether an inpatient admission to an acute care hospital is appropriate. Specifically, CMS...more

5/17/2013 - CMS Healthcare Medicare Medicare Part B Physicians

The New DSH - Are You Supplying The Correct Data That Will Drive Your Payments?

Effective October 1, 2013, CMS will begin paying disproportionate share hospitals differently. Congress ordered the change to the disproportionate share hospital (DSH) adjustment payment methodology as part of the Patient...more

4/8/2013 - Affordable Care Act CMS DSH Healthcare Hospitals Payment Plans Uncompensated Care

D.C. District Court Again Rules That Bad Debt at a Collection Agency is Allowable

The United States District Court for the District of Columbia recently ruled, again, that a Medicare contractor is not permitted to disallow Medicare bad debts solely on the ground that the bad debt is still at an outside...more

4/4/2013 - Bad Debt Collection Agencies Debt Collection Healthcare Hospitals Medicare

CMS Proposes Rules to Promote Efficiency, Transparency and Burden Reduction

CMS recently proposed rules [PDF] in response to President Obama’s directive to government agencies, Executive Order 13563, to reduce outmoded or unnecessarily burdensome rules. CMS estimates that the changes in the rules...more

3/7/2013 - Barack Obama CMS Executive Orders Healthcare

Expect Increased Medicare Denials for Incarcerated Beneficiaries and Unlawful Aliens

The Department of Health and Human Services’ Office of Inspector General (OIG) recently published two reports finding Medicare improperly paid providers millions of dollars for incarcerated beneficiaries and unlawful aliens...more

2/22/2013 - HHS Incarcerated Beneficiaries Medicare Medicare Claims Processing Manual OIG Unlawful Aliens

Payment Matters: Recent PRRB and CMS Administrator Decisions: A Summary for Providers

In recently released decisions, the PRRB and the CMS Administrator addressed a number of issues of interest to many providers. Short summaries of those decisions are provided below. The PRRB and CMS Administrator post their...more

2/8/2013 - Allocation Statistics Bad Debt CMS Disproportionate Share Adjustments GME Healthcare Professionals Hospitals IME Medicaid Fractions Physicians PRRB SNF Teaching Hospitals

Payment Matters: Extension of Time for Overpayment Recoveries in Fiscal Cliff Law Not as Broad as it Sounds

The recently passed fiscal cliff legislation, i.e., the American Taxpayer Relief Act of 2012 (Act) [PDF], includes a number of provisions addressing Medicare and Medicaid. One of these provisions extends the recovery period...more

1/18/2013 - American Taxpayer Relief Act CMS Extensions Fiscal Cliff Medicaid Medicare OIG Overpayment Recovery Laws Reopening Laws Social Security Act

Payment Matters: Recent PRRB and CMS Administrator Decisions: A Summary for Providers

In recently released decisions, the PRRB and the CMS Administrator addressed a number of issues of interest to many providers. Short summaries of those decisions are provided below. ...more

12/14/2012 - CMS FTEs GME IME Medicaid Medicare SNF

Payment Matters: Court Again Rules Medicare’s “Must Bill” Policy for Medicare Dual Eligible Bad Debts Is Reasonable

The United States District Court for the District of Columbia once again upheld the decision of the Secretary of Health and Human Services (Secretary) to deny reimbursement for Medicare bad debts associated with copayments...more

12/5/2012 - HHS Medicaid Medicare

Payment Matters: AHA and Hospitals Sue HHS Over Claims Denials Involving Patient Status

In a suit recently filed in the United States District Court for the District of Columbia, the American Hospital Association (AHA) and several hospitals, assert that the Medicare Program improperly denied payment to hospitals...more

11/16/2012

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