Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 187: South Carolina Hospitals and Healthcare Industry Trends with Thornton Kirby, SCHA President
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Medical Device Legal News with Sam Bernstein: Episode 19
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Opting Out of Medicare: When and How to Do It
Medical Device Legal News with Sam Bernstein: Episode 11
Show Me the Money: New Study Confirms Hospice Saves Money for Medicare
An Unwanted Spotlight: DOJ Announces Hospice Fraud Is Top Priority
The Chartwell Chronicles: Medicare & Medicaid
Navigating EMTALA Rules
Heed Caution: Takeaways From the OIG's Advance Care Planning Report
Podcast: The End of the Public Health Emergency – What's to Come? – Diagnosing Health Care
Patient Steering and Charting
Telehealth Risk Report: What the Government Found
Do You Have a Backup? Building Redundancies Into Your Written Certification Process
COVID-19 Hospice How-To Series | The Results Are In: More Wins for Hospices in HIS Appeals
As Medicare secondary payer penalties take effect this fall, find out what’s new, what’s on the horizon, and what to watch out for to avoid pitfalls. Join Goldberg Segalla partners Philip Unwin and Jennifer Santoro for a free...more
On October 11, 2023, CMS published a final rule (the Final Rule) regarding how and when CMS will impose civil monetary penalties (CMPs) for Medicare secondary payers (MSPs) that untimely report required information. The Final...more
The Medicare Secondary Payer provisions (MSP) apply to group health plans sponsored by employers with 20 or more employees, in both the private and public sectors. MSP’s mandatory reporting requirements are designed to...more
In Episode 13 of The Chartwell Chronicles, hosts Colin Davis and Brittany Atkinson discuss Medicare and Medicaid and how they relate to New Jersey workers' compensation. Topics of discussion include an overview of both...more
The Centers for Medicare and Medicaid Services (CMS) have been operating a global Medicare Secondary Payer (MSP) approach in healthcare lien resolution for mass tort, class action, and asbestos trust settlements for more...more
Last week the Senate passed the Continuing Appropriations Act, 2023 (“CAA23”). The House of Representatives will likely consider the measure today, and President Biden is expected to sign the bipartisan measure into law...more
Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more
On June 21, 2022, the Supreme Court concluded, in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641, 2022 WL 2203328 (U.S. June 21, 2022), that the terms of a benefit plan limiting...more
The Supreme Court released an opinion Tuesday, June 21, 2022, holding that the Marietta Memorial Hospital Employee Health Benefit Plan (“Marietta Plan”) did not violate the Medicare Secondary Payer statute merely because it...more
I’m currently in the wilds of Alaska, learning about the training of sled dogs. Nevertheless, word of the Supreme Court’s five most recent decisions has traveled northward. While none of these decisions is earthshaking, they...more
On June 21, 2022, the Supreme Court decided Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641, holding that a group health plan that uniformly provides limited benefits for outpatient...more
The U.S. Department of Health & Human Services (HHS) just announced increased penalty amounts for entities who violate the privacy, security, and breach notification rules under the Health Insurance Portability and...more
The U.S. Supreme Court has agreed to review the scope of the Medicare Secondary Payer Act (MSPA) as it relates to the treatment of patients with end-stage renal disease (ESRD). The case to be heard by the high court, Marietta...more
Marietta Memorial Hospital v. Davita Inc., No. 20-1641: This case, involving the Medicare Secondary Payer Act, presents the following questions...more
RumbergerKirk attorneys Nicole Smith, Samantha Duke, and Jeffrey Grosholz secured a final summary judgment in MSPA Claims 1, LLC v. Tower Hill Prime Insurance Co. in the United States District Court for the Northern District...more
The Sixth Circuit has issued an important decision that condemns plan provisions that provide different benefits based on a patient’s need for continued dialysis, even if the provision applies to all dialysis patients and not...more
Seeking to control healthcare costs, many group health plans have adopted amendments that lower reimbursement rates for the treatment of end-stage renal disease ("ESRD"), which requires long-term dialysis treatment or a...more
When a law firm settles or resolves a personal injury claim on behalf of a client, the client’s health insurer has a right to be reimbursed for its past expenditures on the related injury. Reimbursement requests become...more
This article should interest employers who are offering or thinking about offering retiree medical coverage and should especially interest local governmental entities that are required to offer retiree medical coverage under...more
Good news for defendants. The Court of Special Appeals recently decided that the Medicare Secondary Payer Act does not preempt the Maryland statute that allows post-trial motions to reduce judgments for past medical expenses....more
On August 13, 2018, the United States District Court for the Eastern District of Washington decided Empire Health Foundation v. Price by vacating the Secretary’s policy of counting exhausted patient days and Medicare...more
• In a matter of first impression, the U.S. District Court for the Middle District of Florida has ruled that a private right of action under the Medicare Secondary Payer Act (MSP Act), which provides for double damages in the...more
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
The Second Circuit affirmed the dismissal of two False Claims Act ("FCA") cases brought by private relators against insurance and other companies based on the alleged failure to reimburse the Centers for Medicare & Medicaid...more
Liability insurers have always gnashed teeth over the dreaded “super lien” – aka a lien asserted by Medicare for treatment expenses where the patient is reimbursed through a settlement obtained in personal injury litigation....more