Exploring Procedural Justice | Judge Steve Leben | Texas Appellate Law Podcast
Handling Post-Conviction Death Penalty Cases Pro Bono | McKenzie Edwards | Texas Appellate Law Podcast
Inside the Fourth Court of Appeals’ Clerk’s Office | Michael Cruz | Texas Appellate Law Podcast
Supersedeas and Other Recent Rule Changes | Texas Appellate Law Podcast
Supreme Court Miniseries: Tribal Rights in the 21st Century
SDNY Chooses “Time Approach” to Calculating Lease Termination Damages Collectible Against a Bankrupt Estate
AGG Talks: Home Health & Hospice - Reimbursement Audits and Appeals
After ALJ: Options and Opportunities in the Face of an Unfavorable ALJ Decision
Understanding the SCOTUS Shadow Docket | Steve Vladeck | Texas Appellate Law Podcast
Podcast: The Legal Battle Over Mifepristone - Diagnosing Health Care
Checking in On the 88th Texas Legislature | Jerry Bullard | Texas Appellate Law Podcast
Law Brief®: Rich Schoenstein and New York State Senator Luis Sepúlveda Discuss The Chief Judge Controversy
Appellate Justice for Domestic Violence Survivors
Jury Charges and Oral Argument | David Keltner | Texas Appellate Law Podcast
The Evolution of Texas Appellate Practice| David Keltner | Texas Appellate Law Podcast
Podcast: California Employment News - Time to Do Away With Rounding Policies
Two Federal Courts Deal Blow to Biden Administration’s Federal Student Loan Forgiveness Program: A Close Look at the Decisions
This Am Law 50 senior counsel cements his authority through two appellate analytics blogs - Legally Contented Podcast
An Inside Look as a Juror - FCRA Focus Podcast
Reflections on 100 Episodes | Texas Appellate Law Podcast
Our firm is seeing an uptick in Medicare demand letters for the recovery of overpayment for skin substitutes, such as WoundFixTM, Biobrane, Dermagraft®, AmnioBand®, or AlloPatch®, used in the treatment of wounds. CMS auditors...more
In a recent decision, the Northern District of Texas, Dallas Division, granted a health care provider a preliminary injunction to prevent the Centers for Medicare & Medicaid Services ("CMS") from withholding Medicare payments...more
HHS’s Office of Medicare Hearings and Appeals (OMHA) has long faced a backlog in Medicare appeals to Administrative Law Judges (ALJs). In an effort to address this backlog, OMHA established a Settlement Conference...more
This year CMS is rolling out two new programs aimed, finally, at helping to settle certain types of pending provider reimbursement appeals. The programs are the Low Volume Appeals Initiative and Settlement Conference...more
On January 9, 2018, the Centers for Medicare and Medicaid Services (CMS) announced details on the new low volume appeal settlement option, which is the latest alternative available to Medicare Part A and Part B providers and...more
For years the hospital industry has been in an uproar over the mountainous backlog of Medicare claim appeals. Current estimates are that a whopping 650,000 claims are at the Administrative Law Judge level awaiting...more
Over the past decade, health care providers seeking to challenge Medicare claim denials have faced increasing delays in reaching what many consider the most important step in the Medicare appeals process - a hearing before an...more
On Feb. 25, 2016, the Office of Medicare Hearings and Appeals (OMHA) conducted a teleconference to address Phase III of the Settlement Conference Facilitation (SCF) project, which also became effective on Feb. 25, 2016. SCF,...more
On October 15, 2015, the Office of Medicare Hearings and Appeals (“OMHA”) conducted a teleconference to address Phase II of the Settlement Conference Facilitation (“SCF”) Pilot, effective October 1, 2015. SCF, launched in...more
In keeping with the trend to strengthen its authority to deny an enrollment or revoke Medicare billing privileges, CMS has modified the appeals process in a manner that will significantly shorten the time allotted to mount an...more
For providers who have received inconsistent or varying reasons for denial while navigating through the Medicare appeals process, the Centers for Medicare & Medicaid Services (CMS) has provided much-needed relief in the form...more
On June 3, 2015, the Senate Finance Committee passed an original bill that aims to streamline and improve the Medicare Audit and Appeals Process. The Medicare appeals process has recently faced scrutiny from industry leaders...more
CMS officially added a new Section 3.9 to the Medicare Program Integrity Manual, effective October 27, 2014. These provisions instruct Medicare Administrative Contractors (MACs) to assign a physician to participate at...more
The Office of Medicare Hearings and Appeals (OMHA), which oversees the Administrative Law Judge (ALJ) level of appeal, recently posted two important announcements regarding a new Statistical Sampling Initiative (SSI) and...more
Before a Medicare contractor can use extrapolation to determine an overpayment amount, the Medicare statute requires that it must make a finding that there is a sustained or high level of payment error or that documented...more
The OIG recently published a report reviewing the implementation of 2005 regulations regarding the administrative law judge (ALJ) level of appeals, the third level of the Medicare appeals system. The 2005 regulatory changes...more