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Centers for Medicare & Medicaid Services (CMS) Dispute Resolution

McDermott+

No Surprises Act Implementation Bumpy Period Reaches One-Year Mark

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We are now in September! And while many folks are thinking about how summer has come and gone so quickly, those following the No Surprises Act implementation process may also be wondering how a whole year has passed since the...more

King & Spalding

The Fifth Circuit Affirms Decision Vacating CMS Regulations Implementing the No Surprises Act IDR Process

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On August 2,2024, the Fifth Circuit affirmed the vacatur of federal rulemaking related to the No Surprises Act’s (NSA) Independent Dispute Resolution (IDR) process. The Court held that the No Surprises Act does not permit the...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | April 2024 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for April 2024. We discuss several US Department of Health and Human Services (HHS) agency actions, including the Calendar Year (CY) 2025...more

Hall Benefits Law

Federal Agencies Issue Final Rules on Federal IDR Process Administrative Fee and Certified Entity IDR Fee Ranges

Hall Benefits Law on

The Internal Revenue Service, Employee Benefits Security Administration, and the Centers for Medicare & Medicaid Services (collectively, “the Departments”) recently issued final rules concerning fees established by the No...more

American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

Holland & Knight LLP

Holland & Knight Health Dose: January 24, 2024

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

King & Spalding

CMS Makes Several Updates to the Federal Independent Dispute Resolution (IDR) Process

King & Spalding on

Over the past month, CMS announced several updates to the Federal No Surprises Act IDR Process. On December 15, 2023, the Federal IDR portal was re-opened for all remaining disputes. The portal is now open for all disputes...more

McDermott+

Navigating the New IDR Batching Rules and Deadline Extensions

McDermott+ on

If you have been following the implementation of the No Surprises Act independent dispute resolution (IDR) process, you have likely seen a bunch of new rules, guidance documents and deadline extensions come out recently and...more

McDermott+

McDermottPlus Check-Up: November 3, 2023

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CONGRESS - House Ways & Means Chair Smith, House Energy & Commerce Chair Rodgers and Senate Finance Ranking Member Crapo Call for Withdrawal of Nurse Staffing Mandate. Rep. Smith (R-MO), Rep. Rodgers (R-WA) and Sen. Crapo...more

ArentFox Schiff

No More Surprise Medical Bills: Providers Score Yet Another Victory as Texas Court Again Vacates Provisions of Biden...

ArentFox Schiff on

On August 24, 2023, health care providers in Texas scored yet another victory when a federal court vacated additional portions of the Biden Administration’s rulemaking under the federal No Surprises Act (the Act). This marked...more

Foley & Lardner LLP

The No Surprises Act: A District Court’s Decision Results in Federal IDR Outage

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Although the No Surprises Act was signed into law almost three years ago and has been in effect for the past year and a half, there have been numerous delays in implementation and execution due to the complexity of elements...more

Tucker Arensberg, P.C.

CMS Halts “No Surprises Act” Arbitration

Tucker Arensberg, P.C. on

CMS has halted the arbitration process for “Surprise Billing” established by the “No Surprises Act” for the second time, stating as follows...more

Husch Blackwell LLP

Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences

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Hospices have been the target of increased government scrutiny in 2023, and the Centers for Medicare and Medicaid Services (CMS) is planning to take further aim in 2024 through surveys. Join Husch Blackwell’s Meg Pekarske,...more

Venable LLP

A Proposed New Regulatory Environment for Medicare Hospice Providers: Application of the 36-Month Rule, Increasing Enrollment...

Venable LLP on

On July 10, 2023, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) that would (i) include hospices in the 36-month rule ownership transfer restrictions that currently exist for home...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - May 2023

The May Monthly Minute examines a recent Seventh Circuit decision upholding unambiguous plan language against class action attack, the status of the federal IDR process under the No Surprises Act, and the DOL’s recent...more

Foley & Lardner LLP

Key Takeaways from the Foley/PYA “Let’s Talk Compliance” 2-Day Virtual Conference

Foley & Lardner LLP on

Session #1: State of the Healthcare Industry Effective Compliance Plans and Enforcement Trends - In their discussion of compliance program effectiveness and enforcement, attorneys Kolarik and Waltz and Ms. Sumner...more

Holland & Knight LLP

Holland & Knight Health Dose: December 6, 2022

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include: -...more

Hogan Lovells

340B Program: HRSA Proposes to Modify Administrative Dispute Resolution Process

Hogan Lovells on

On November 30, 2022, the Health Resources and Services Administration (HRSA) published a proposed rule (Proposed Rule) in the Federal Register that proposes to introduce several changes to the current administrative dispute...more

Holland & Knight LLP

Holland & Knight Health Dose: November 29, 2022

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include . . ....more

Manatt, Phelps & Phillips, LLP

Challenges to the Final August 2022 No Surprises Act Independent Dispute Resolution Rule

Controversy continues to surround the independent dispute resolution (IDR) provisions of the No Surprises Act (NSA). On November 18, bipartisan leadership of the House Ways and Means Committee sent a letter to the Secretaries...more

Maynard Nexsen

No Surprises Act Updates – New Final Rule, CMS Resources and New FAQs

Maynard Nexsen on

On August 19, 2022, the United States Department of Health and Human Services, Department of Labor, and Department of the Treasury (the Departments) published a new final rule (Final Rule) under the federal No Surprises Act,...more

Arnall Golden Gregory LLP

Considerations for the Next Phase of the No Surprises Act Implementation

The No Surprises Act (“NSA”) went into effect on January 1, 2022. The NSA places numerous obligations on certain healthcare providers, facilities, and providers of air ambulance services to protect consumers against surprise...more

Epstein Becker & Green

No Surprises Act Update – New IDR Guidance

Epstein Becker & Green on

On April 14, 2022, the Centers for Medicare & Medicaid Services (CMS) issued new guidance on the Independent Dispute Resolution (IDR) process, created under the No Surprises Act (NSA) to provide a mechanism for payers and...more

McGuireWoods LLP

CMS Continues Implementation of No Surprises Act With IDR Portal and FAQs

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The No Surprises Act (NSA) went into effect Jan. 1, 2022, with the goal of protecting consumers from unexpected medical bills. The NSA places numerous obligations on certain healthcare providers, facilities and providers of...more

Greenbaum, Rowe, Smith & Davis LLP

Texas Court Sides with Challengers to Independent Dispute Resolution Process Under No Surprises Act

What You Need to Know- •A federal court sided with challengers in finding that certain CMS rules conflict with the federal No Surprises Act, pressuring healthcare providers to lower their offers in arbitration. ...more

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