Polsinelli is pleased to share the Health Care Reimbursement and Payor Dispute Update. This newsletter is a designated source of news, information and guidance on the constantly evolving reimbursement industry.
...more
11/1/2019
/ Administrative Appeals ,
Centers for Medicare & Medicaid Services (CMS) ,
Contract Disputes ,
Enrollment ,
Health Care Providers ,
Injunctive Relief ,
Managed Care Contracts ,
Medical Reimbursement ,
Medicare ,
Payor Contracts ,
Revocation ,
Site-Neutral Exception ,
Universal Health Services Inc v United States ex rel Escobar
As part of an increasing trend towards regulation of behavioral health, a pair of new laws have been adopted that will impact certain California behavioral health providers and laboratories, with two proposed companion laws...more
10/23/2019
/ Clinical Laboratories ,
Governor Newsom ,
Governor Vetoes ,
Health Care Providers ,
Health Insurance ,
Legislative Agendas ,
License Suspensions ,
Licensing Rules ,
Mental Health ,
New Legislation ,
Outpatient Services ,
Public Health ,
Regulatory Agenda ,
Regulatory Oversight ,
Revocation ,
State and Local Government
California Senate Bill 425, introduced in February 2019, would require health facilities and clinics to report any allegations of sexual abuse or sexual misconduct made against a clinician within 15 days of receiving the...more
What the New Law Does and How Substance Abuse Treatment Facilities Are Impacted -
Senate Bill 1228, also known as the Substance Use Disorder Patient Protection Act, was passed with overwhelming bipartisan support and...more
Nonprofit health care facilities should evaluate what upcoming California law changes mean for their businesses. The new laws, which impact required notices and approvals from the state Attorney General’s office, take effect...more
Within just weeks of each other, the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued separate documents that health care organizations may use to...more
4/21/2017
/ Compliance Management Systems ,
Corporate Governance ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Health Care Providers ,
Healthcare Fraud ,
Investigations ,
OIG ,
Policies and Procedures ,
Resource Guide ,
Third-Party Relationships
Olympus Corporation of the Americas, the United States’ largest distributor of endoscopes and related medical equipment, recently agreed to pay $623.2 million to resolve criminal charges and civil claims, according to a...more
In This Issue:
- ACO Eligibility Requirements
- Establishing and Maintaining the ACO Participation Agreement
- Data Sharing and Assignment of Beneficiaries
- Shared Savings and Losses
- Waivers of...more
7/7/2015
/ ACO Participant Agreements ,
ACOs ,
Centers for Medicare & Medicaid Services (CMS) ,
Data-Sharing ,
Electronic Health Record Incentives ,
Healthcare ,
Medicaid ,
Medicare ,
Medicare Shared Savings Program ,
Skilled Nursing Facility ,
SNF
In This Issue:
- Top News
..CMS Releases Payment Rules for the Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System, Renal Dialysis and Home Health
..President Signs the Drug Quality...more
In This Issue:
- Top News
..Obama Administration Delays Employer Mandate One Year
..House Energy and Commerce Committee Releases Draft Legislation for SGR Fix
..CMS Proposes Payment Changes for Medicare...more
7/11/2013
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Competitive Bidding ,
Contraceptive Coverage Mandate ,
Contraceptives ,
Delays ,
Department of Health and Human Services (HHS) ,
Drug Distribution ,
Food and Drug Administration (FDA) ,
Healthcare ,
Healthcare Reform ,
Home Health Care ,
Medicaid ,
Medical Devices ,
Medicare ,
OIG ,
Over-the-Counter Sales ,
Pay or Play ,
Pharmaceutical Industry ,
Prescription Drugs
In This Issue:
- Minimum Essential Coverage
..HHS Proposed Rule
- Shared Responsibility Payments and Exemptions
..HHS Proposed Rule
..IRS Proposed Rule
..IRS Final Rule
- Essential Health Benefits
...more
In This E-Alert:
- Notable ATRA Provisions
- Medicare Extensions
- Other Health Provisions
- Other Health Extensions
- Excerpt from Notable ATRA Provisions:
Medicare Physician Payment Update...more