Thomas W. Coons

Thomas W. Coons

Ober|Kaler

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District Court Rejects Hospitals' Challenge to CMS's Rebilling Policy

On September 17, the United States District Court for the District of Columbia ruled that it lacked jurisdiction over a challenge brought by the American Hospital Association (AHA) and several hospitals and systems (the...more

10/7/2014 - American Hospital Association Billing CMS Healthcare Hospitals Medicare Part B

SGR-Driven Payment Reduction Postponed Again

As part of the Balanced Budget Act of 1997 (BBA), Congress enacted a number of payment reforms designed to curb the growth of expenditures under Medicare Part B. One of the more notable of those provisions was the Sustainable...more

1/8/2014 - CMS Healthcare Healthcare Professionals Medicare Medicare Part B Physician SGR Formula Physicians

CMS Revises Part B Billing Policy for Unnecessary Inpatient Admissions

For many years, CMS policy has been that, if an inpatient admission was denied for medical necessity reasons, the hospital could bill under Part B for only a limited set of services that, significantly, did not include...more

3/29/2013 - Administrative Appeals ALJ CMS Hospitals Medicare Medicare Part B

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