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California Court of Appeal Decision Highlights Importance of Technical Details in Billing Practices and Managed Care Agreements

Hospitals and other health care providers work hard to eliminate billing and coding errors, but mistakes still happen. When those mistakes occur, health plans sometimes try to capitalize on the error by using it as a basis to...more

HHS Updates Frequently Asked Questions For CARES Act Provider Relief Funds

On July 30, 2020, HHS released several new Frequently Asked Questions (FAQs) regarding payments distributed to providers under the Coronavirus Aid, Relief, and Economic Security (CARES) Act Provider Relief Fund. Providers...more

IRS Publishes Guidance on Taxation of CARES Act Provider Relief Fund Payments

The IRS announced, through its FAQ page, that for-profit healthcare providers, including hospitals and physician practices, will have to pay federal income taxes on any distributions they receive from the Public Health and...more

CMS Calls for Renewed Commitment to Value-Based Care in Light of New COVID-19 Data

On June 22, 2020, CMS issued a press release calling for a renewed national commitment to value-based payment models for healthcare providers rather than fee-for-service models. The proclamation came as CMS also released...more

DOJ Settles False Claims Act Case Against Southern California Ophthalmology Group

On October 4, 2019, the DOJ announced a $6.65 million settlement with a Southern California ophthalmology group, its former CEO, and several physicians, to resolve False Claims Act (FCA) allegations related to fraudulent...more

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