AGG health care litigation partners Jason Bring, Chesley McLeod, and Jerad Rissler recently filed a friend of the court brief with the Georgia Court of Appeals on behalf of both the Georgia Hospital Association and the...more
We are seeing a wide range of new state laws that impact the prescribing of opioids to hospice patients. Several bills are before the New York State Assembly that, if passed, could affect how prescriptions are written to...more
Every year, health lawyers, providers, consultants, and government experts from across the country convene in Baltimore for the American Health Lawyers Association’s Institute on Medicare and Medicaid Payment Issues, the most...more
Although we are seeing a wide range of new state laws that impact the prescribing of opioids to hospice patients, this year’s legislative session in Georgia has not produced any such laws. Because of the nation’s opioid...more
On Friday, September 14, 2018, U.S. District Judge Steven Merryday for the Middle District of Florida sentenced Dr. John Janick of Port Charlotte to five months in prison and three years of supervised release, plus...more
Medicare’s implementation of post-payment review through overly aggressive zone program integrity contractors (ZPICs) and unified program integrity contracts (UPICs), combined with an ineffective review process at the first...more
Medicare’s implementation of post-payment review through overly aggressive private contractors, combined with an ineffective review process at the first two levels of the administrative appeal process (redetermination and...more
Georgia has enacted a new law implementing a comprehensive program of background checks for Georgia long-term care facilities. The “Georgia Long-term Care Background Check Program” consolidates three existing background check...more
Medicare’s implementation of post-payment review through private contractors who are overly aggressive in denying payments, combined with an ineffective review process at the first two levels of administrative appeal...more
The Georgia General Assembly is considering new legislation that would implement a comprehensive program of national fingerprint background checks for Georgia long-term care facilities. If passed, Senate Bill 406, the...more
On August 16, 2017, the Centers for Medicare and Medicaid Services (CMS) released the Hospice Compare website. This website joins a variety of other CMS “Compare” websites – including Inpatient Rehabilitation Facility...more
On July 13, 2017, the Department of Justice, in conjunction with the Department of Health and Human Services, announced the largest series of health care charges in American history. The government charged 412 individuals,...more
People in this country have long enjoyed the right to contract. Included with that right is the ability to agree to resolve potential disputes out of court and in arbitration. The Centers for Medicare & Medicaid Services’...more
A bill introduced last week in the Georgia General Assembly sought to eliminate the state’s Certificate of Need (“CON”) program, which has been in place since 1979. The CON program’s goals are: “(1) to measure and define...more
Medicare’s implementation of post-payment review through private contractors who are overly aggressive in denying payments, combined with a severe backlog of cases in queue for hearing before an Administrative Law Judge...more
11/11/2015
/ Administrative Appeals ,
Administrative Law Judge (ALJ) ,
Centers for Medicare & Medicaid Services (CMS) ,
Due Process ,
Hospice ,
Medicare ,
Medicare Provider Agreements ,
OMHA ,
RAC Audits ,
Recoupment ,
Recovery Audit Contractors (RACs)
During the 90-day public comment period on the Center for Medicare & Medicaid Services (CMS) proposed rule entitled “Reform of Requirements for Long-Term Care Facilities” which closed October 14, 2015, CMS received nearly...more
In July, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the requirements for long-term care facilities, including implementation of new restrictions on the use of binding arbitration agreements between...more
“The buck needs to stop somewhere where corporate misconduct is concerned,” said Attorney General Eric Holder in a September 17, 2014 speech to NYU School of Law. He went on to say that “corporations are structured to blur...more
(...) Saving Money – The Proof is in the Empirical Data -
A recent national study concluded that arbitration awards are approximately 35% lower than recoveries in the court systems. Moreover, attorney’s fees for defending...more