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Health Care Providers Medicare Physician Medicare Reimbursements

Dentons

Ep. 32 – An Easy Audit Tip to Help Avoid Overpayments

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Looking for a simple, easy-to-implement way to lower your risk of overpayments? We have one on this week’s podcast!...more

Sheppard Mullin Richter & Hampton LLP

Key Telehealth Updates in the CY 2025 Physician Fee Schedule Proposed Rule

On July 31, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (“Proposed Rule”) for the 2025 Medicare Physician Fee Schedule, which includes implications for telehealth services reimbursable...more

Nelson Mullins Riley & Scarborough LLP

Physicians Face Proposed Medicare Reimbursement Cuts for 2025 (RIN 0938-AV33)

Physician Fee Schedule Faces Cuts in CY25 - Overall Medicare payments to physicians and clinicians would be cut by a proposal to decrease average base payment rates by 2.93% from calendar year 2024 under a proposed rule...more

Dorsey & Whitney LLP

The Supreme Court Update - June 10, 2024

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Today, the Supreme Court of the United States granted certiorari in two cases: Facebook v. Amalgamated Bank, No. 23-980: This securities law case arises from a shareholder lawsuit against Facebook, which claimed Facebook...more

Oberheiden P.C.

What Does it Take to Win Medicare Appeals in 2024?

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Lots of health care service providers find themselves in the position of needing to file a Medicare appeal. Despite the systematic nature of modern Medicare billing, wrongful denials remain common, and errors during Medicare...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - November 2023 #2

News Briefs - Lawmakers Reintroduce Healthcare Workforce Resilience Act - Federal lawmakers are trying again to push through immigration reform that would allow officials to recapture unused visas and reprocess them for...more

Alston & Bird

Health Care Week in Review: CMS Releases Three Major Medicare Final Rules

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Holland & Knight LLP

Holland & Knight Health Dose: October 24, 2023

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

Sheppard Mullin Richter & Hampton LLP

CMS Announces Proposed Rule for 2024 Medicare Physician Fee Schedule

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). The Proposed Rule, which was issued in the Federal...more

Benesch

Dialysis & Nephrology Digest - January 2023

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Federal omnibus spending bill rolls back some Medicare payment cuts scheduled for 2023, 2024 - Buried within the $1.7-trillion spending package signed by the President on Dec. 29 was partial relief for a planned 4.5% cut...more

Sheppard Mullin Richter & Hampton LLP

Key Healthcare Provisions of the Consolidated Appropriations Act, 2023

Introduction On December 29, 2022, President Biden signed the Consolidated Appropriations Act, 2023 (the “Act”). The Act provides for nearly $1.7 trillion in funding across a range of domestic initiatives, including certain...more

Holland & Knight LLP

Holland & Knight Health Dose: December 13, 2022

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include: ...more

Bass, Berry & Sims PLC

Summary of Medicare Drug Negotiation Program in Inflation Reduction Act and Impact on Pharmacies and Providers

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The U.S. House of Representatives is expected today to pass legislation passed by the U.S. Senate that will significantly alter the landscape for pharmaceutical pricing and reimbursement under the Medicare program for certain...more

Oberheiden P.C.

DOJ Announces Criminal Charges in Alleged $1.2 Billion Health Care Fraud Scheme

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Yesterday, the U.S. Department of Justice (DOJ) announced that it has filed charges against 36 defendants in relation to an alleged health care fraud scheme that resulted in approximately $1.2 billion in fraudulent payments....more

K&L Gates LLP

Health Care Triage: The Drive to Align ESG and Health Equity Priorities With Medicare Reimbursement Models

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Steve Pine and Alexa Sengupta address the Centers for Medicare and Medicaid Services’ emerging focus on ESG and health equity priorities, and how these priorities are impacting health data collection and Medicare value-based...more

Miles & Stockbridge P.C.

Anesthesiologists Potentially “Pinged” for Checking Their Phones During Surgery

The federal False Claims Act results in a host of interesting relator claims. This one caught my eye. In United States of America v. Intermountain Healthcare, Inc., Case No. 2:20-cv-00372-TC-CMR (U.S. Dist. Ct. D. Utah...more

Morgan Lewis - Health Law Scan

Flawed Formula Drives Academic Medical Center Underpayments; Impacted Hospitals Should Consider Preserving Right to Payment

In the complex world of Medicare reimbursement, there are a multitude of payment formulae, mathematical adjustments, and reimbursement calculations that translate congressional policy into operational payments for hospital...more

Benesch

CMS Proposes Steep Cuts to Office-Based Dialysis Vascular Access Reimbursement...Again!

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On July 13, 2021 the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) proposed rule for calendar year (CY) 2022 that could result in potentially significant reductions to...more

Manatt, Phelps & Phillips, LLP

340B Roundup: Trump-Era Rule Rescinded, Motion to Dismiss Denied & HRSA Advisory Opinion Withdrawn

The last two weeks of June saw several key developments affecting the 340B Drug Pricing Program—a federal government program created in 1992 that requires pharmaceutical manufacturers to provide outpatient drugs to eligible...more

Epstein Becker & Green

[Webinar] The Future of CMS: A Conversation with Three Former CMS Administrators - July 15th, 12:00 pm - 1:00 pm ET

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Epstein Becker Green invites you to join former CMS Administrators Tom Scully, Leslie Norwalk, and Marilyn Tavenner for a unique panel discussion on their thoughts, advice, and predictions for President Biden’s newly...more

Baker Donelson

Repayment of Medicare Accelerated and Advance Payments Begins for Providers and Suppliers

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Medicare providers and suppliers that received Medicare loans to address cash flow issues stemming from the COVID-19 public health emergency (PHE) may start seeing a reduction in Medicare reimbursement as Medicare begins to...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 8. News Briefs: March 2021

Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more

Health Care Compliance Association (HCCA)

Telehealth Risks Come into Focus; Some Payers Don't Cover Audio-Only

Report on Medicare Compliance 30, no. 8 (March 1, 2021) - After the 2021 Medicare Physician Fee Schedule extended coverage of many telehealth services until the end of the public health emergency (PHE), including...more

Bass, Berry & Sims PLC

Supreme Court Declines to Weigh in on Key Falsity Question

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For several years, courts have wrestled with the question of whether subjective clinical decisions regarding the type and amount of treatment patients may need can be false for purposes of establishing False Claims Act (FCA)...more

Polsinelli

Health Care Reimbursement and Payor Dispute Update Special Edition – Year End Regulatory Review

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The Centers For Medicare & Medicaid Services Issues New Inpatient Prospective Payment System Final Rule - On September 3, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2021 Medicare...more

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