Medicare, Medicaid | JD Supra Law News

Exclusions: OIG Offers Relationship Counseling to Providers

by Summer Swallow | BakerHostetler on 5/22/2013

On May 8, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued an updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs...more

CMS Announces $1 Billion in Funding for Innovation Grants

by King & Spalding on 5/21/2013

On May 15, 2013, CMS released a funding opportunity announcement for round two of the Health Care Innovation Awards. The grants are administered by the CMS Innovation Center, which is authorized by the Affordable Care Act to...more

Does A Person Submitting False Medicare Bills Abuse The Trust Of The Doctor Making Money Off Of The False Bills?

by Matthew G. Kaiser | The Kaiser Law Firm PLLC on 5/17/2013

Hiring is always hard, especially in a small office. You have work that needs to be done. You can't do it all. Maybe you're a professional, like a doctor, and some of the work isn't the best use of your time....more

Health Care Reform Update -- May 13, 2013

by Joseph P. Hammang, Alexander Hecht, Abby Matousek, Jeremy Rabinovitz | Mintz Levin - Health Law on 5/15/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

OIG Issues Updated Bulletin on Exclusion from Federal Health Care Programs

by Aaron Graham | Bradley Arant Boult Cummings LLP on 5/14/2013

On May 8, 2013, the Office of Inspector General (OIG) issued an updated Special Advisory Bulletin on the effect of exclusion from federal health care programs. A federal health care program (e.g., Medicare and Medicaid) is...more

Health Care Reform Update -- May 6, 2013

by Joseph P. Hammang, Alexander Hecht, Abby Matousek, Jeremy Rabinovitz | Mintz Levin - Health Law on 5/8/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups Scheduled....more

Mcnees Insights - Asset Planning and Federal Taxation - Spring 2013

by Vance E. Antonacci, Scott Alan Mitchell | McNees Wallace & Nurick LLC on 5/8/2013

In This Issue: ATRA 2012 – How Does it Affect You?; Planning and Paying for Long-Term Care; and Obama Revenue Raising Proposals. Excerpt from ATRA 2012 – How Does it Affect You?: The American Taxpayer...more

Arrests Made and Investigation Underway at a Chicago Hospital

by King & Spalding on 4/23/2013

On April 16, 2013, the United States Department of Justice (DOJ) and U.S. Attorney’s Office in the Northern District of Illinois announced the arrest in Chicago of the owner and senior executive of Sacred Heart Hospital...more

HHS Extends Sunset Date for Stark Exception and Anti-Kickback Safe Harbor for EHR Donations

by Daniel F. Gottlieb | McDermott Will & Emery on 4/19/2013

The Centers for Medicare & Medicaid Services and the U.S. Department of Health and Human Services issued proposed rules that would extend the sunset date for the Stark Law exception and the federal Anti-Kickback Statute safe...more

Significant Proposed Changes for Federal Health Care Programs in President’s Fiscal Year 2014 Budget Plan

by Elizabeth K. Isbey, Eric Zimmerman | McDermott Will & Emery on 4/19/2013

On April 10, 2013, President Obama released his budget proposal for fiscal year (FY) 2014 (the Budget). The President reiterated his long-standing goal of reducing the deficit by $4.3 trillion over 10 years and his...more

Court Grants Unexpected Victory to Providers on Medicare DSH Adjustment

by Thomas W. Coons, Mark A. Stanley | Ober|Kaler on 4/18/2013

The United States District Court for the Eastern District of Pennsylvania’s opinion in Nazareth Hosp. v. Sebelius, slip op. no. 10-3513 furnished a surprising victory to two providers that challenged the calculation of the...more

Seven Tips to Protect Your Facility from a False Claims Act Lawsuit

by Amy McCracken | Duane Morris LLP on 4/8/2013

The False Claims Act is a federal law that imposes liability on persons and companies who make false claims for payment to the federal government. Many states have similar laws. The Act encourages whistleblowers to file suit...more

Court of Appeals Rules for Government in DSH Exhausted Benefit Day Appeal

by Thomas W. Coons | Ober|Kaler on 4/5/2013

For the last several years, hospitals and the government have fought hard over where days associated with certain “dual eligible” patients should be placed in the Medicare disproportionate share hospital (DSH) calculation. At...more

Health Care Reform Update -- April 2, 2013

by Joseph P. Hammang, Alexander Hecht, Kevin M. Kappel, Tom Koutsoumpas, Jeremy Rabinovitz, Robert C. Skinner | Mintz Levin - Health Law on 4/3/2013

In This Issue: Implementation of the Affordable Care Act (ACA); Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

6th Circuit Rules in Favor of HHS on Dual-Eligible Exhausted Benefit Days Issue

by King & Spalding on 4/2/2013

On March 27, 2013, the 6th Circuit, sitting en banc, issued its decision in Metropolitan Hospital v. U.S. Department of Health and Human Services, Case Nos. 11-2465\2466. At issue in the case was whether the HHS Secretary’s...more

Final Regulations Governing Closure of Long Term Care Facilities

by Howard Sollins | Ober|Kaler on 3/29/2013

The federal Centers for Medicare and Medicaid Services (CMS) published a final regulation to further implement section 6113 of the federal health reform law, the Patient Protection and Affordable Care Act. The March 19, 2013,...more

Health Care Reform Update -- March 25, 2013

by Joseph P. Hammang, Alexander Hecht, Kevin M. Kappel, Tom Koutsoumpas, Jeremy Rabinovitz, Robert C. Skinner | Mintz Levin - Health Law on 3/26/2013

In This Issue: Leading the News; Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

Health Care Reform Implementation Update - March 26, 2013

by Mark Alderman | Cozen O'Connor on 3/26/2013

Last week, as the Affordable Care Act turned three, the drumbeat of concern over Medicare Advantage cuts grew louder when Senate Finance Committee Chairman Max Baucus and Ranking Member Orrin Hatch – as well as 98 house...more

Long-Term Care and Medicaid Managed Care Initiatives in Illinois

by Neville M. Bilimoria, Nicholas Lynn | Duane Morris LLP on 3/25/2013

Currently, Illinois has three Medicaid managed care programs: Primary Care Case Management; Voluntary Managed Care; and the Integrated Care Program. Illinois Medicaid reform requires 50 percent of Illinois' Medicaid clients...more

Health Care Reform Update -- March 19, 2013

by Mintz Levin - Health Law on 3/20/2013

In This Issue: Leading the News – Budgets and the Continuing Resolution (CR); Implementation of the Affordable Care Act; Other Congressional and State Initiatives; Other HHS and Federal Regulatory Initiatives; Other...more

Medicaid Receiving Startlingly Little Attention As Everyone Discusses Medicare [Video]

by LXBN on 3/15/2013

As Republicans and Democrats conitnue to bicker over how much to spend or not spend on Medicare, Medicaid is receivingly alarmingly little attention—attention it desperately needs. As our guest on LXBN TV explains the program...more

CMS Issues Rules On Physician Payments Sunshine Act

by Michael Volkov on 3/15/2013

People like to think they have it the hardest in life. I call it the competition among victims. If you are in the healthcare industry and fall under the Physician Payments regulations, then I think you are on your way to...more

No Sale -- Sales Commissions Violate Anti-Kickback Statute; Prevent Enforcement of Nonsolicitation

by Robert Wolin | BakerHostetler on 3/13/2013

A durable medical equipment (DME) distributor, Joint Technology, Inc., entered into an agreement to pay a salesman commissions ranging from 18 to 22 percent on the volume of his sales. The court held that the salesman did not...more

Health Care Reform Update -- March 11, 2013

by Joseph P. Hammang, Alexander Hecht, Kevin M. Kappel, Tom Koutsoumpas, Jeremy Rabinovitz, Robert C. Skinner | Mintz Levin - Health Law on 3/12/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

GAO Report Concludes Medicare Remains High-Risk Federal Program Due to Failure to Lower Rate of Improper Payments

by King & Spalding on 3/12/2013

On February 27, 2013, the Government Accountability Office (GAO) released its High-Risk Update for Medicare and Medicaid, stating that “CMS has not met GAO’s criteria to have the Medicare program removed from the High-Risk...more

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Medicare › Medicaid

Exclusions: OIG Offers Relationship Counseling to Providers

CMS Announces $1 Billion in Funding for Innovation Grants

Does A Person Submitting False Medicare Bills Abuse The Trust Of The Doctor Making Money Off Of The False Bills?

Health Care Reform Update -- May 13, 2013

OIG Issues Updated Bulletin on Exclusion from Federal Health Care Programs

Health Care Reform Update -- May 6, 2013

Mcnees Insights - Asset Planning and Federal Taxation - Spring 2013

Arrests Made and Investigation Underway at a Chicago Hospital

HHS Extends Sunset Date for Stark Exception and Anti-Kickback Safe Harbor for EHR Donations

Significant Proposed Changes for Federal Health Care Programs in President’s Fiscal Year 2014 Budget Plan

Court Grants Unexpected Victory to Providers on Medicare DSH Adjustment

Seven Tips to Protect Your Facility from a False Claims Act Lawsuit

Court of Appeals Rules for Government in DSH Exhausted Benefit Day Appeal

Health Care Reform Update -- April 2, 2013

6th Circuit Rules in Favor of HHS on Dual-Eligible Exhausted Benefit Days Issue

Final Regulations Governing Closure of Long Term Care Facilities

Health Care Reform Update -- March 25, 2013

Health Care Reform Implementation Update - March 26, 2013

Long-Term Care and Medicaid Managed Care Initiatives in Illinois

Health Care Reform Update -- March 19, 2013

Medicaid Receiving Startlingly Little Attention As Everyone Discusses Medicare [Video]

CMS Issues Rules On Physician Payments Sunshine Act

No Sale -- Sales Commissions Violate Anti-Kickback Statute; Prevent Enforcement of Nonsolicitation

Health Care Reform Update -- March 11, 2013

GAO Report Concludes Medicare Remains High-Risk Federal Program Due to Failure to Lower Rate of Improper Payments

Medicaid Receiving Startlingly Little Attention As Everyone Discusses Medicare [Video]

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