Compliance

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +

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News & Analysis as of May 18, 2013

Ordering/Referring Phase 2 Begins May 1st - Claims Will Be Denied

by Donna Senft | Ober|Kaler on 3/30/2013

In an April 24, 2009 transmittal, CMS announced a two-phase claims editing expansion designed to allow verification that the physician or non-physician practitioner (NPP) listed as the ordering/referring provider on a...more

OIG Recommends Increased CMS Enforcement of SNF Standards

by Holly Barker, Kathleen McDermott | Morgan Lewis on 3/22/2013

Amid alleged failures of skilled nursing facilities to meet care and discharge planning requirements, OIG identifies substantial payment errors....more

CMS Announces Proposed Rule Implementing the ACA's MLR Requirements for MA and Prescription Drug Plans

by Darryl Landahl, Ishra Solieman | Brownstein Hyatt Farber Schreck on 2/22/2013

On February 15, the Centers for Medicare & Medicaid Services (CMS) released its Proposed Rule, effective calendar year (CY) 2014, implementing the Medical Loss Ratio (MLR) requirements for Medicare Advantage (MA)...more

Mandatory Compliance Programs for Healthcare Companies

by Michael Volkov on 9/28/2012

The healthcare industry always has taken the lead in compliance issues, developing innovative compliance tools and programs. Anti-corruption compliance borrows heavily from many healthcare compliance ideas....more

The Healthcare Sector and the Future of ACA Implementation

by Morgan Lewis on 7/17/2012

Even with the lingering uncertainty over Medicaid program expansion, the High Court's decision brings some certainty and the need to focus on ramifications of ACA implementation. On June 28, the U.S. Supreme Court held...more

Healthcare Reform: What Connecticut Employers Need to Know After Supreme Court’s Health Law Ruling

by Pullman & Comley, LLC on 7/16/2012

On June 28, 2012, the Supreme court ruled that the Patient Protection and Affordable Care Act (the “Act”) is constitutional. What does the decision mean for employers? The Supreme Court’s decision rests on some...more

What Do Healthcare Reform and the "Fiscal Cliff" Have In Common? Tax Increases

by Venable LLP on 7/9/2012

On June 28th, the U.S. Supreme Court upheld the new healthcare reform law in part by ruling that the individual mandate is a tax and Congress has authority to impose the individual mandate under Congress’s taxing power. As a...more

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