News & Analysis as of

Healthcare Ambulance Providers

Cornerstone Research

5 Questions with Erin Trish: Surprise Billing in Healthcare

Cornerstone Research on

5 Questions is a periodic feature produced by Cornerstone Research, which asks our professionals, senior advisors, or affiliated experts to answer five questions. We interview Professor Erin Trish, of the Schaeffer Center...more

Sheppard Mullin Richter & Hampton LLP

Another No Surprises Act Update: Texas Court Vacates Rules and Guidance Related to the “Qualified Payment Amount”

On August 24, 2023, the United States District Court for the Eastern District of Texas again largely ruled in favor of the Texas Medical Association and other plaintiffs (including air ambulance providers) and vacated certain...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 31, Number 43. News Briefs: December 2022

HealthOne Critical Care Transport Service Inc., doing business as MedicOne Medical Response of Marion, Illinois, has agreed to pay $302,124 to settle allegations it improperly billed Medicare for scheduled, non-emergency...more

Polsinelli

Federal Court Strikes Additional Portions of Regulations Implementing No Surprises Act Addressing Air Ambulance Services

Polsinelli on

Five months ago, in TMA v. HHS, et al. (“TMA”), a federal court in Texas struck down portions of a controversial interim final rule (“Rule”) jointly issued by three federal executive agencies (“Departments”) intended to...more

King & Spalding

CMS Releases Additional Section 1135 Waivers and Flexibilities to Assist the U.S. Healthcare System with COVID-19 Patient Surge

King & Spalding on

On March 30, 2020, CMS issued additional Section 1135 blanket waivers to provide the American healthcare system with additional flexibility to respond to the COVID-19 pandemic. CMS is authorized under Section 1135 of the...more

Foley & Lardner LLP

Ambulance Suppliers: CMS Is Not Planning to Issue Fraud Waivers for ET3

Foley & Lardner LLP on

On February 14, 2019, CMS’ Innovation Center announced its Emergency Triage, Treat, and Transport (ET3) Model for EMS / ambulance suppliers to partner with other health care providers such as telehealth entities and urgent...more

Lewitt Hackman

California Ballot Guide 2018: Propositions 8-12

Lewitt Hackman on

We continue with Part Three in our series on California’s ballot propositions for 2018, providing a glimpse of the pros and cons of each measure. ...more

Best Best & Krieger LLP

12 Orange County Cities Prevail in Federal Antitrust Lawsuits Over Ambulance Services - Ninth Circuit Affirms Lower Court’s...

The Ninth Circuit U.S. Court of Appeals upheld a lower court decision to dismiss 12 Orange County cities from federal antitrust lawsuits alleging the municipalities monopolized ambulance services in their boundaries....more

Robinson & Cole LLP

OIG Recognizes New Local Transportation Safe Harbor and Exceptions to CMP in Updated Fraud and Abuse Regulations

Robinson & Cole LLP on

On December 7, 2016, the Department of Health and Human Services Office of Inspector General (OIG) issued a long-awaited final rule (Final Rule) that expands the safe harbor regulations under the Anti-Kickback Statute (AKS)...more

Proskauer Rose LLP

HHS OIG Adopts NewAnti-Kickback Safe Harbor and Civil Monetary Penalty Exceptions

Proskauer Rose LLP on

On December 7, 2016, the Department of Health and Human Services (HHS), Office of Inspector General (OIG), issued a final rule that will have a widespread impact on health care service providers, medical transport providers,...more

McDermott Will & Emery

OIG Revises Safe Harbors under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements

McDermott Will & Emery on

On December 7, 2016, the Office of Inspector General of the US Department of Health and Human Services published a final rule containing revisions to both the federal Anti-Kickback Statute safe harbors and the beneficiary...more

King & Spalding

OIG Issues Final Rule Expanding Anti-Kickback Statute Safe Harbors and Revising Civil Monetary Penalty Regulations

King & Spalding on

On December 7, 2016, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) published a final rule to amend the Anti-Kickback Statute (AKS or Statute) by adding new safe harbors. The Final Rule...more

Baker Donelson

Medicare Enrollment Rules - Expanded Enforcement Finalized in Regulations

Baker Donelson on

On December 5, 2014, CMS published final regulations that expand the bases for CMS to deny enrollment or revoke billing privileges of an enrolled provider or supplier. These final regulations also change the method to...more

Parker Poe Adams & Bernstein LLP

The Game Plan for Health Care Enforcement: Office of Inspector General Releases 2015 Work Plan

The Office of Inspector General (“OIG”) within the federal Department of Health and Human Services (“HHS”) is charged with protecting the integrity of HHS programs by combating fraud, abuse and waste. On Halloween of 2014,...more

BakerHostetler

OIG Proposed Anti-Kickback Safe Harbors and CMP Regulations: The End of Frustration or Just the Beginning?

BakerHostetler on

On October 3, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published an unexpected, yet long-awaited, set of proposed rules that would add new anti-kickback law safe harbors,...more

K&L Gates LLP

A Possible Green Light for Patient Transportation Services: OIG Proposes Revised Safe Harbors to the Anti-Kickback Statute for...

K&L Gates LLP on

On October 3, 2014, the Office of Inspector General of the Department of Health and Human Services (“OIG”) published a proposed rule and request for comments (“Proposed Rule”), which would amend the Anti-Kickback Statute...more

King & Spalding

CMS Announces Temporary Enrollment Moratoria on Home Health Agencies in Florida, Texas, and Michigan, As Well As Ambulance...

King & Spalding on

On January 30, 2014, CMS announced a temporary moratorium on Medicare enrollment of home health agencies operating in Fort Lauderdale, Dallas, Houston, and Detroit. It also announced a temporary moratorium on Medicare...more

King & Spalding

OIG Report Details Disproportionate Increase in Ambulance Usage

King & Spalding on

On September 24, 2013, the OIG issued a Memorandum Report titled “Utilization of Medicare Ambulance Transports, 2002-2011” analyzing the continued increases in ambulance usage among Medicare beneficiaries. The OIG found that...more

King & Spalding

CMS Imposes Six-Month Moratoria on New Enrollments of Home Health Agencies and Ambulance Suppliers in Three Fraud “Hot Spots”

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Last week, CMS announced temporary moratoria on the enrollment of new home health providers and ambulance suppliers in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) in three fraud “hot spots.”...more

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