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Building an Effective Compliance Program

We both recently returned from presenting to groups of health care providers on creating and implementing effective compliance programs. Although compliance plans and compliance programs are not new to the health care realm,...more

How Medicaid Affects Behavioral Health: Coverage, Expansion and Reform

Medicaid expansion has already had a huge impact on whether mental health needs are treated in certain populations. That may not be at the top of all the stories lately about the U.S. House of Representatives passing its...more

Federal Health Care Leaders Write Governors About New Direction for Medicaid

While much of the attention related to health care this week is focused on our nation’s capital, all 50 state governors have received a letter from recently confirmed U.S. Health & Human Services Secretary Tom Price and...more

Caution About Fake Phone Calls from Health Care Agencies

Individuals should be cautious about sharing personally identifiable information when contacted via phone, including by health care agencies. The Centers for Medicare & Medicaid released an alert earlier this week warning of...more

CMS Finalizes Rule on Reporting and Returning Medicare Overpayments

The Affordable Care Act (sometimes referred to as Obamacare) included a requirement for providers to report and return all Medicare and Medicaid overpayments within 60 days of identification. Although this requirement has...more

Supreme Court Holds that Medicaid Providers Do Not Have Right to Challenge Medicaid Reimbursement Rates under Supremacy Clause

Yesterday, the United States Supreme Court issued an opinion that denies providers the right to challenge low Medicaid reimbursement rates by suing state agencies in federal court. In Armstrong v. Exceptional Child...more

Supreme Court Case Does Not Directly Challenge Obamacare, But Could Lead to Its Implosion.

The media coverage in the run-up to today’s Supreme Court oral arguments in King v. Burwell has described King as an attack on Obamacare. That isn’t quite right. Understandably, some of the imprecise language is due to the...more

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