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Health Care Reimbursement and Payor Dispute Update - September 2022

Co-Location and the Provider-Based Rules – No News is…Good News? On July 15, the Centers for Medicare & Medicaid Services ("CMS") released the 2023 Outpatient Prospective Payment System proposed rule (“OPPS Proposed...more

Health Care Reimbursement and Payor Dispute Update - September 2021

On July 1, 2021, the Departments of Health and Human Services (“HHS”), Treasury, and Labor, along with the Office of Personnel Management (collectively the “Departments”), issued the first tranche of regulations implementing...more

Reimbursement and Payor Dispute Update

Strategies for Complying with Price Transparency and Surprise Billing Laws - State legislatures and the federal government have been busy the past 12 months churning out laws that impose new disclosure and billing obligations...more

Health Care Reimbursement and Payor Dispute Update - August 2020

Introduction - CMS has taken extensive measures to assist providers and promote access to care in light of the Public Health Emergency (PHE) related to the COVID-19 pandemic. The efforts taken have and continue to benefit...more

8th Circuit Ruling Impacting Commercial Payer Practices

After over a year of waiting, The Eight Circuit Court of Appeals aligns itself with the Department of Labor in determining that the practice of Cross-Plan Offsetting orchestrated by many commercial health insurance companies,...more

Update: HHS Announces Two Additional Medicare Appeals Settlement Initiatives

On Nov. 3, Health & Human Services (HHS) announced two additional initiatives to address the mounting Medicare appeals backlog at the Administrative Law Judge (ALJ) level: (i) expand the Settlement Conference Facilitation...more

Update: HHS Decides Appeals Backlog Rule

On January 17, 2017, HHS published a rule addressing public comments and finalizing changes to the Medicare benefit claim appeals processes that were proposed on July 5, 2016. Although there was initially some speculation...more

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