William Mathias

William Mathias


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Latest Posts › CMS


Open Payments Update: End of CME Exception for Sunshine Reporting

On July 17, 2015, CMS announced updates to the Law and Policy page on the Open Payments website to provide additional guidance regarding the termination of the continuing medical education (CME) exception for reporting under...more

8/17/2015 - CME CMS Medicare Open Payments Reporting Requirements Sunshine Act

Stark Regulations: Technical Revisions

The proposed Physician Fee Schedule for CY 2016 includes multiple technical revisions to the regulations implementing the Stark law. These revisions appear to be designed to provide greater clarity and flexibility with...more

7/22/2015 - Anti-Kickback Statute CMS Commercial Leases Exceptions Physician Compensation Arrangements Physician Fee Schedule Remuneration Self-Referral Disclosure Protocol Signatures Stark Law Timeshare

Paperwork Burden Eased in CMS Voluntary Self-Referral Disclosure Protocol Filings

In late December 2014, CMS made a small change to its voluntary Self-Referral Disclosure Protocol (SRDP) to help reduce some of the paperwork burden associated with filing under the SRDP. Section 6409 of the Affordable...more

1/20/2015 - Affordable Care Act CMS Healthcare HHS Self-Referral Disclosure Protocol Stark Law

ACO Fraud and Abuse Waivers Extended Through November 2, 2015

On October 17, 2014 the Centers for Medicare and Medicaid (CMS) and Office of Inspector General (OIG) within the Department of Health and Human Services published a continuation notice in the Federal Register extending the...more

11/21/2014 - ACOs Anti-Kickback Statute CMP Law CMS Fraud and Abuse HHS OIG Shared Savings Program Stark Law Waivers

Medicare Proposes Prior Authorization Process for Certain DMEPOS Items

On May 28, 2014, CMS issued a proposed rule to establish a permanent prior authorization process for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are “frequently subject to...more

6/9/2014 - CMS DMEPOS Enforcement Healthcare Medicare Prior Authorization Proposed Regulation

OIG Proposes Updates to Exclusion and CMP Authority

The Department of Health and Human Services, Office of Inspector General (OIG) recently issued a pair of proposed regulations to update its exclusion and civil monetary penalty (CMP) authority. The proposed regulations...more

6/3/2014 - Affordable Care Act Civil Monetary Penalty CMS Compliance Exclusions Healthcare Healthcare Reform HHS Medicaid Medicare OIG

Chance to Comment on Future of DMEPOS Payments

CMS recently took the unusual step of issuing an Advance Notice of Proposed Rulemaking (ANPR) regarding changes to Medicare payment methodologies for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)...more

3/26/2014 - Affordable Care Act CMS Competitive Bidding Durable Medical Equipment Healthcare Medical Devices Medicare

Program Integrity Priorities Revealed in FY 2015 HHS Budget

On March 14, 2014, President Obama unveiled his Administration’s proposed fiscal year 2015 budget for the Department of Health and Human Services (HHS). In total, the Administration is seeking $77.1 billion to fund HHS in FY...more

3/14/2014 - Affordable Care Act CMS Federal Budget Healthcare Fraud Healthcare Reform HHS Medicare Physician Medicare Reimbursements Stark Law

Dodging the AKS: Marketplace Plans Are Not "Federal Health Care Programs"

In an October 30th letter addressed to Congressman Jim McDermott, the Department of Health and Human Services (HHS) Secretary, Kathleen Sebelius, left little to interpretation: Qualified health plans (QHPs) purchased through...more

11/8/2013 - Affordable Care Act Anti-Kickback Statute CMS False Claims Act (FCA) Health Insurance Exchanges Healthcare Healthcare Reform HHS OIG Premiums Qualified Health Plans

2013 Healthcare Fraud and Abuse Bootcamp Webinar Series, Part V: Compliance

Bill Mathias of Ober|Kaler's Health Law Group presented on compliance as a part of the 2013 Healthcare Fraud and Abuse Bootcamp Webinar Series sponsored by the American Health Lawyers Association. This webinar...more

6/17/2013 - Anti-Kickback Statute Audits CMS Compliance Documentation False Claims Act (FCA) Healthcare Fraud Internal Investigations Medicaid Medicare OIG Penalties Self-Disclosure Requirements Stark Law

Physician Payment Sunshine Rule is Finalized

The Final Rule implementing the Physician Payment Sunshine Act was announced on February 1st and published in the Federal Register on February 8th. The Final Rule establishes procedures for drug and device manufacturers to...more

2/15/2013 - Applicable Manufacturers Biologics CMS Common Ownership Continuing Medical Education Covered Products Covered Recipients Dispute Resolution GPOs Medical Devices Medical Research Medical Supplies Payment Records Pharmaceutical Industry Physician Payments Physicians Sunshine Act Teaching Hospitals Transfers of Value

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