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What does the Escobar Decision Mean for Healthcare Providers?

On June 16, 2016, the U.S. Supreme Court in Universal Health Servs., Inc. v. United States ex rel Escobar, No. 13-317, — S. Ct. — (June 16, 2016), confirmed that the implied certification theory may serve as a basis for...more

New CMS rule clarifies when 60-day overpayment clock starts ticking

Four years after publication of its proposed rule related to reporting and returning overpayments within 60 days, CMS has issued a final rule that responds to comments and provides greater clarity. The published rule is under...more

Providers On Prepayment Review May Now Face Exclusion From Medicare

Providers on prepayment review could be facing exclusion from Federal healthcare programs if they don't correct the problems which caused them to be subject to prepayment review. CMS has directed its contractors to consider...more

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