Billing

News & Analysis as of

It’s Too Late to Send Rate Increase Letters

Not every company budgets on a calendar year annual basis, but for those that do, that process is nearly complete by mid-October. In-house counsel typically draft budgets in September, tweak them in October and are now deep...more

FCC Settles With Large Mobile Telephone Company In Connection With Hidden Third-Party Charges

On October 8, the FCC announced a $105 million settlement – the largest in the agency’s history – with a mobile telephone company to resolve allegations that the company engaged in unauthorized billing practices. According to...more

Firm’s collection letter violated Fair Debt Act

A North Attleborough law firm violated the Fair Debt Collection Practices Act when it sent a collection letter which included implied threats to sue that could have confused the debtor as to her statutory right to dispute the...more

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

Overpayments to Skilled Nursing Facilities on the Rise

Nearly $2.5 billion dollars in overpayments were made to Skilled Nursing Facilities (“SNFs”) as a result of billing errors last year. The billing error rate for SNFs jumped to 7.7 percent, virtually doubling in 2013....more

Third Circuit Affirms District Court’s Denial Of Certification Of Nationwide Class Of Plaintiffs Alleging Consumer Fraud And...

Plaintiffs alleged in their putative nationwide class action complaint that Quest Diagnostics was liable for consumer fraud, unjust enrichment, and violations of the Fair Debt Collections Practices Act for overbilling...more

Third Circuit Rejects Class Certification in Yet Another Consumer Case

Consistent with its recent emphasis on the stringency of class certification requirements in consumer cases, the Third Circuit recently affirmed the denial of class certification in a consumer case involving alleged...more

Move Over, Billable Hour; There's a New IP Fee Arrangement in Town

The practice of law has changed greatly over the past decades. We have witnessed great growth in solo and small firm practice, as well as a large movement to in-house practice. We are even seeing growth in freelance attorneys...more

The End of the Hour

Before the twentieth century, state law prescribed set fees for specific legal services, and litigation fees were usually paid by the losing parties. Over time, maximum fee laws were repealed, and by the early twentieth...more

HHS OIG Issues Report on Questionable Billing for Medicaid Pediatric Dental Services

What you need to know: The Office of Inspector General for the US Department of Health & Human Services recently published the results of its study on Louisiana dentists who may be providing unnecessary dental...more

Bundling Gains Momentum, Even as New Study Raises Questions

Health care cost bundling—the aggregating of all the costs of an episode of medical care into a single bill—seems to be here to stay. After all, it’s the way most all other billing is done. When your car is serviced, you...more

Brace Yourself: The RACs Are Back

Under the controversial program private contractors audit hospitals and other Medicare providers for fraudulent and erroneous Medicare billing. Why is it controversial? Because the auditors are paid a percentage of...more

FTC Releases Staff Report on Mobile Phone Bill Cramming

On July 28, 2014, the Federal Trade Commission (“FTC”) released a report, entitled “Mobile Cramming: An FTC Staff Report” (“Report”). The Report focuses on, and makes recommendations regarding, the mobile payment option...more

Focus on “shadow hours” misses the point of AFAs

Aric Press of American Lawyer penned a terrific article, What the Rise of Pricing Officers Says About Big Law’s Future. The article, reflecting the results of a recent survey, offers some great insights into the move to...more

Got Medicare Billing Privileges? Are You Sure? Traps for the Unwary in Medicare Enrollment

To receive payment for items and services furnished to Medicare beneficiaries, a health care professional or facility must have approved Medicare billing privileges, which requires enrollment in the Medicare program. Failure...more

General Counsel To Lawyers: “Do You Understand AFAs?”

Earlier this week, I recapped one component of the General Counsel Panel at this year’s LSSO RainDance conference I attended. It focused on a request these General Counsel had, which was for lawyers to “know our...more

Points & Authorities - Spring 2014

In this Issue: - AB 1000 and Corporate Practice in California: More than Meets the Eye—or Less? - Loose Lips Sink Ships and Careless E-mails Torpedo a Transaction - New Faces - Points from the...more

The Halifax $85 Million Lesson: Compensation Arrangements Between Hospitals and Physicians Must Be Reviewed

The Department of Justice (“DOJ”) announced another multi-million dollar settlement of alleged False Claims Act violations on March 11, 2014. Specifically, Halifax Hospital Medical Center and Halifax Staffing, Inc. agreed to...more

Recent District Court Case Highlights State Variation in Applying Corporate Practice of Medicine and Global Billing Restrictions...

On March 25, 2014, the U.S. District Court for the District of Minnesota held that a magnetic resonance imaging ("MRI") provider, a lay entity (i.e., not owned or controlled by physicians), did not violate the state's...more

Working The Data

This morning as I prepared to write this, a headline flashed across my screen that an exploration company that is not part of the search team for the missing Malaysian airliner claims to have located wreckage that might be...more

CMS Releases Physician Medicare Billing Data

The U.S. Department of Health and Human Services (HHS) announced on April 9th a “historic” release of Medicare payment data to provide consumers with “unprecedented transparency on the medical services physicians provide and...more

Court Confirms Arbitration Award In Reinsurance Billing Dispute

A New York federal district court affirmed an arbitration award in favor of R&Q Reinsurance Company as against its cedent, Utica Mutual, in a reinsurance dispute arising from certificates issued by R&Q reinsuring certain...more

2014 OIG Work Plan: Questionable Billing Patterns for Part B Services During Nursing Home Stays

The 2014 OIG Work Plan includes the following: Billing and Payments. We will identify questionable billing patterns associated with nursing homes and Medicare providers for Part B services provided to nursing home...more

OIG Scrutiny of Hospital Outpatient Evaluation/Management Claims Billed to Medicare

H.H.S’s Office of Inspector General’s yearly work plan was issued on 31 January 2014, which included numerous new and ongoing reviews and activities by OIG for the coming year. Among the new projects, OIG will review...more

Health Care Fraud and Abuse Alert: What CMS’s New Billing Requirement For “Incident To” Services Means For Medicare Providers.

In the final Medicare Physician Fee Schedule for 2014 (“2014 PFS”), CMS implemented a new condition of payment for “incident to” services that has significant fraud and abuse implications for any Medicare provider who relies...more

52 Results
|
View per page
Page: of 3