Leah Greenberg Katz on Centers for Medicare & Medicaid Services (CMS)

The No Surprises Act Gets Litigated

On October 28, the Texas Medical Association (TMA), a trade association that represents more than 55,000 physicians and medical students, filed a lawsuit in the Eastern District of Texas challenging key portions of CMS’s...more

11/17/2021 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , No Surprises Act (NSA) , Out of Network Provider , Proposed Rules , Surprise Medical Bills

DC Circuit Revives Medicare Advantage Overpayment Rule

On August 13, the D.C. Circuit revived the CMS 2014 Medicare Advantage Overpayment Rule in deciding UnitedHealthcare Ins. Co. v. Becerra, a ruling that could have broad implications for Medicare Advantage (MA) insurers. See...more

9/21/2021 / Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Medicare , Medicare Advantage , Overpayment

D.C. District Court Upholds Rule Requiring Hospitals To Disclose Privately Negotiated Insurances Prices

On June 23, the U.S. District Court for the District of Columbia dismissed a challenge to a federal rule requiring hospitals to disclose prices they privately negotiated with insurers....more

6/26/2020 / Affordable Care Act , Arbitrary and Capricious , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Final Rules , First Amendment , Health Care Providers , Healthcare Reform , Hospitals , Price Transparency , Public Disclosure , Secretary of HHS , Service Charges

CMS Proposed Rule Could Dramatically Increase Recoupments From Medicare Advantage Insurers

On October 26, the Centers for Medicare and Medicaid Services (CMS) issued a notice of proposed rulemaking that would significantly alter the risk adjustment data validation (RADV) methodology that applies to Medicare...more

11/21/2018 / Centers for Medicare & Medicaid Services (CMS) , Fee-for-Service , Health Care Providers , Medicare Advantage , NPRM , Recoupment , Risk Adjustment Formula

Court Rejects CMS's Attempt to Broaden False Claims Act Liability in Medicare Overpayment Rule

The U.S. District Court for the District of Columbia handed down a major victory to Medicare Advantage issuers on September 7, 2018, vacating a 2014 CMS regulation relating to Medicare Advantage overpayments. ...more

9/12/2018 / Centers for Medicare & Medicaid Services (CMS) , False Claims Act (FCA) , Health Care Providers , Healthcare Fraud , Life Sciences , Medicare , Medicare Advantage , Overpayment , Overpayment Recovery Time Limits , Regulatory Oversight , Regulatory Requirements , Reporting Requirements

Another One Bites the Dust: CMS Quashes Ohio's Plan to Waive ACA Requirements, For Now

We have recently seen an uptick in state initiatives designed to skirt requirements under the Affordable Care Act (ACA). We last wrote about Idaho’s failed attempt to permit health insurers to sell noncompliant plans, which...more

5/29/2018 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Insurance , Provisional Waiver Applications , Public Health Insurance Marketplace , State and Local Government , State Health Insurance Exchanges

CMS Thwarts Idaho's Attempts to Skirt Affordable Care Act, But Provides a Path Forward

Last month, we reported that Idaho announced a controversial plan to allow insurers to sell policies that do not comply with certain ACA requirements — a move that some feared would set a precedent for other states. ...more

3/13/2018 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Health Insurance , Insurance Industry , Insurance Regulations , Policy Terms , State and Local Government

Leah Greenberg Katz

Troutman Pepper

Popular Topics by This Author

Latest Posts › Centers for Medicare & Medicaid Services (CMS)