Latest Publications

Share:

CMS Finalizes Regulations with Hope of Reducing Medicare Appeals Backlog

On January 17, 2017, CMS published the final rule titled “Medicare Program: Changes to the Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage Determination...more

2/1/2017  /  ALJ , CMS , HHS , Medicare , Medicare Appeals Council , OMHA

Court Orders HHS to Fix the Medicare Appeals Backlog by the End of 2020

Medicare providers with pending cases at the administrative law judge (“ALJ”) level received positive news last week as a federal judge for the United States District Court for the District of Columbia (the “Court”) granted...more

Looking Ahead to a Trump Administration: Health Care and Life Sciences Industry Perspectives

Observers are digesting what the Trump Administration will mean for the health care and life sciences industry. Forecasting is more challenging for this incoming Administration than most given the relatively sparse policy...more

CMS Still Finding Its Way Through Significant Medicare Appeals Backlog – Proposes New Rule in an Effort to Catch Up

In the proposed rule, CMS focuses on taking administrative actions to alleviate the backlog, including introducing the concept of precedential decisions, delegating certain administrative law judge tasks to “attorney...more

Bigger Apparently is Better in DOJ’s Eyes – DOJ Piles On as False Claims Act CMPs Set to Almost Double on August 1, 2016

On June 30, 2016, the Department of Justice published an interim final rule with request for comments that applies an inflation adjustment to civil monetary penalty (CMP) amounts assessed by the Department, as mandated by the...more

CMS Eases 60-Day Overpayment Requirement in Final Rule While Raising New Questions

On February 11, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released the long awaited final rule clarifying the statutory requirement under the Affordable Care Act for providers and suppliers to report and...more

Identification of Overpayments: A Win for DOJ Cautions 'Prosecutorial Discretion' in Enforcement of an 'Unforgiving Rule'

On August 3, 2015, the Southern District of New York issued the first judicial opinion interpreting the Affordable Care Act’s “60-Day Overpayment Rule” in a False Claims Act (“FCA”) case. In a clear win for the Department of...more

Analysis of HHS OIG Proposed Rule to Amend the Anti-Kickback Safe Harbors, CMP Rules on Beneficiary Inducements & Gainsharing...

On October 3, 2014, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) published a major proposed rule that would amend the safe harbors to the Anti-Kickback Statute (AKS) and the Civil...more

HHS OIG Proposes Rule to Expand Exclusion Authorities

On May 9, 2014, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) published a proposed rule that would significantly expand the exclusion regulations applicable to persons or entities...more

9 Results
/
View per page
Page: of 1

"My best business intelligence,
in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.