News & Analysis as of

Provider Reimbursement Review Board Bad Debt

Baker Donelson

D.C. District Court Issues Two Decisions Addressing CMS's Medicare Bad Debt "Must Bill" Policy – One Rejecting the Policy and the...

Baker Donelson on

In a significant break from preceding court decisions, the United States District Court for the District of Columbia recently struck down CMS's "must bill" policy, which requires that Medicare providers bill Medicaid and...more

Baker Donelson

Court Rules in Favor of Hospitals in Bad Debt Collection Effort

Baker Donelson on

On July 25, 2016, the United States District Court for the District of Columbia issued an opinion favoring provider flexibility in the reasonable collection of Medicare bad debt. Winder HMA, LLC, et al. v. Sylvia Burwell. The...more

Baker Donelson

The Bad Debt Moratorium Requires a Flexible Approach to Evaluating "Reasonable Collection Efforts"

Baker Donelson on

On September 10, 2015, District Judge Randolph D. Moss of the U.S. District Court for the District of Columbia issued an opinion in Mountain States Health Alliance v. Burwell (Mountain States) involving Section 310 of the...more

King & Spalding

D.C. District Court Holds that CMS’s Rigid Application of the “Similar Collection Efforts” Requirement Violates the Bad Debt...

King & Spalding on

In a case of first impression in the U.S. District Court for the District of Columbia, brought by King & Spalding on behalf of Mountain States Health Alliance, the court held that CMS’s disallowance of certain Medicare bad...more

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