News & Analysis as of

Medicare

Blog: OIG Releases August Work Plan Items

by Cooley LLP on

As we recently announced, the Office of Inspector General (OIG) is updating its Work Plan monthly rather than its previous twice-yearly publications. The August updates released this week include 4 new Work Plan items:...more

Medicare Secondary Payer Act Class Actions

There have been a substantial number of putative class actions filed recently against insurers involving the Medicare Secondary Payer Act (MSPA). These cases are typically filed by assignees of Medicare advantage...more

MACRA: Proposed Changes to the Merit-Based Incentive Payment System Track

by Polsinelli on

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule on the Medicare Quality Payment Program (QPP) in the Federal Register1 on June 30, 2017. This rule proposes the QPP program requirements for...more

CMS Proposes Cancellation of Medicare Cardiac/Hip Fracture Episode Payment Models, Scale-Back of Mandatory CJR Participation

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) has just released a proposed rule to cancel a significant — but still-pending — Obama Administration program that would require certain hospitals to participate in Medicare...more

340B Covered Entities Beware: CMS Proposes Drastic Drug Reimbursement Rate Cuts

by Polsinelli on

In its Outpatient Prospective Payment System proposed rule ("Proposed Rule"), CMS outlined a significant Medicare Part B payment reduction for separately payable, nonpassthrough drugs provided in the hospital outpatient...more

Federal Government to Target False EHR Incentive Payments

by Barley Snyder on

While health care reform remains bogged down, the federal government’s efforts to curtail fraud, waste and abuse in its health care programs fervently continues. Most recently, the U.S. Department of Health and Human...more

State Official Charged With Taking Bribes In Connection With $1 Billion Healthcare Fraud Scheme

by Arnall Golden Gregory LLP on

On July 22, 2016, the Department of Justice announced the indictment of the owner of more than 30 Miami-area skilled nursing and assisted living facilities, a hospital administrator, and a physician’s assistant in connection...more

California Hospitals Successfully Beat Back Medicaid Payment Cut

by King & Spalding on

Almost a decade ago, California submitted a State plan amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS) that would retroactively implement a ten-percent rate reduction in outpatient services provided to...more

EMTALA Settlement Highlights Continuing Challenges for Hospitals

After 30 years as a fixture in the federal healthcare regulatory landscape, the Emergency Medical Treatment and Labor Act—more commonly known as EMTALA—has been in the news again. In the past year, the U.S. Department of...more

DC Circuit Court Remands Medicare Appeals Backlog Case

by King & Spalding on

Last week, the United States Court of Appeals for the District of Columbia Circuit reversed and remanded the Medicare appeals backlog case American Hospital Association v. Price to the district court. As previously reported,...more

How Medicare and Employer Coverage Coordinate

Medicare benefits start at age 65, but many people continue working past that age, either by choice or need. It is important to understand how Medicare and employer coverage work together....more

CMS Boosts Medicare Inpatient Psychiatric Facility Rates by $45 Million for FY 2018

by Reed Smith on

CMS has published a notice with comment period updating prospective payment system (PPS) rates for Medicare services furnished by inpatient psychiatric facilities (IPFs) during fiscal year (FY) 2018. CMS estimates that its...more

Telehealth Remains a Top Priority for Advancing Quality Health Care

by Faegre Baker Daniels on

Even with the prospect of Obamacare repeal and replace on the backburner for now, the federal government continues to focus on health care. Following August recess, Congress will have less than four weeks to work through...more

Sixth Circuit: Technical Physician Signature Deficiencies not "Material" to Reimbursement Claims

by Jones Day on

The District Court for the Middle District of Tennessee held on June 22, 2017, that the timing requirements related to a physician's certification of need for home health services were not "material" to the Centers for...more

CMS May Decide to Permit Labs to Bill for Certain Tests Provided to Outpatients

In the recently published proposed rule related to the CY 2018 Hospital Outpatient Prospective Payment System (OPPS), the Centers for Medicare & Medicaid Services (CMS) announced that it is considering changes to the...more

Class Certification Granted in Suit Regarding Medicare Outpatient Status

by King & Spalding on

On July 31, 2017, the United States District Court for the District of Connecticut certified a nationwide class of Medicare beneficiaries in an action against HHS regarding whether patients can appeal their status as an...more

CMS Finalizes 1% Update to Medicare IRF Rates for FY 2018; Payments to Rise by $75 Million

by Reed Smith on

CMS has finalized Medicare prospective payment system (PPS) rates for inpatient rehabilitation facility (IRF) services for fiscal year (FY) 2018, which begins October 1, 2017. CMS estimates that IRF PPS payments will increase...more

Relief From Medicare's Part B Late-Enrollment Penalty Offered to Some

Medicare is offering relief from penalties for certain Medicare beneficiaries who enrolled in Medicare Part A and had coverage through the individual marketplace. For a short time, these individuals will be able to enroll in...more

CMS Issues Final FY 2018 SNF PPS Update; Rates to Increase by 1%

by Reed Smith on

CMS has released its final rule to update Medicare skilled nursing facility (SNF) prospective payment system (PPS) rates and policies for FY 2018, which begins October 1, 2017. The final rule incorporates a 1% increase to SNF...more

CMS Issues IPPS and LTCH PPS Final Rule for FY 2018

by King & Spalding on

On August 2, 2017, CMS issued the Fiscal Year (FY) 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule (Final Rule) that updates...more

Antidotes for America’s Addiction Crisis

Opioid addiction and abuse has exploded into a national epidemic. Every three weeks, America faces a death toll equivalent to the September 11th attacks due to drug overdoses, 75 percent of which are from opioid use. ...more

MACRA Quality Payment Program Update

On June 20, 2017, CMS released its proposed rule updating MACRA’s Quality Payment Program (“QPP”) for CY 2018. At over 1,000 pages, the rule might not do much to simplify the already complex requirements of the QPP; however,...more

Health Alert (Australia) 31 July 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 24 July 2017 - Medical Board of Australia v Soo [2017] SAHPT 10 - In this proceeding, the respondent, a physiotherapist, was alleged to have...more

West Virginia Doctor Secures Temporary Restraining Order Against Medicare Exclusion

by Tucker Arensberg, P.C. on

In Robie v. Price, Dr. Robie successfully obtained a temporary restraining order prohibiting CMS from terminating his Medicare billing privileges prior to the exhaustion of his administrative remedies by the U.S. District...more

Yates Memo's Influence Felt in DOJ Health Care Enforcement

by Jones Day on

In September 2015, Deputy Attorney General Sally Yates issued a memorandum titled "Individual Accountability for Corporate Wrongdoing." In it, she stressed that one of the most effective ways to combat corporate misconduct is...more

2,931 Results
|
View per page
Page: of 118
Cybersecurity

"My best business intelligence,
in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.