News & Analysis as of

Medical Reimbursement

Robinson+Cole Health Law Diagnosis

OIG Posts Telemedicine Advisory Opinion

The Office of Inspector General (OIG), Health and Human Services issued an Advisory Opinion allowing an arrangement proposed by a federally qualified health center look-alike (FQHC look-alike) to provide free technology items...more

White and Williams LLP

Another Court Broadly Construes “Interrelated Wrongful Acts” Provision

by White and Williams LLP on

A key component to any claims-made policy is the existence of an “interrelated wrongful acts” provision. Claims-made policies typically provide coverage only for claims first made during the given policy period. Interrelated...more

Butler Snow LLP

Increased Transparency For Litigation Funding Companies May Impact the Collateral Source Rule

by Butler Snow LLP on

“Litigation investment” companies have been in the news frequently in the past year, and state legislatures and courts are taking note and taking action. ...more

Chambliss, Bahner & Stophel, P.C.

Managing Medical Bills and Insurance Paperwork: 7 Tips for Maximizing Reimbursement

Do you become frustrated and overwhelmed when managing medical bills and filing health insurance claims? Managing and filing insurance claims can be a complex, frustrating, stressful, confusing and time-consuming process,...more

Akerman LLP - Health Law Rx

Health Insurers Contend Allergy Test Maker’s Antitrust Claims Make No Economic Sense – Seek Early Dismissal on that Basis

Three health insurers accused of having violated the antitrust laws in Academy of Allergy & Asthma in Primary Care v. Blue Cross Blue Shield of Louisiana, et al. (Eastern District of Louisiana), have filed motions seeking a...more

Sheppard Mullin Richter & Hampton LLP

CMS Rolls Out Provider Appeals Settlement Efforts

This year CMS is rolling out two new programs aimed, finally, at helping to settle certain types of pending provider reimbursement appeals. The programs are the Low Volume Appeals Initiative and Settlement Conference...more

Ropes & Gray LLP

China Announces New Initiatives to Level the Playing Field for Innovative and Generic Drugs

by Ropes & Gray LLP on

China’s Government will launch several incentives to enhance accessibility of innovative drugs, especially imported oncology drugs. The State Council, China’s cabinet, has decided not to apply any tariff on imported drugs,...more

Hogan Lovells

MDRP: CMS issues new rebate agreement; all current agreements terminate October 1, 2018

by Hogan Lovells on

On March 23, 2018, the Centers for Medicare and Medicaid Services (CMS) published Final Notice that implements a substantially revised Medicaid National Drug Rebate Agreement (NDRA). All agreements currently in place will...more

Hogan Lovells

Life sciences and health care horizons - March 2018

by Hogan Lovells on

Innovation in the life sciences and health care industries is occurring at a dizzying pace. Five years ago, anti-PD-1 antibodies from Merck and BMS had yet to be approved, CAR-T therapies were still in small-scale clinical...more

The Brown Firm

Why Do Personal Injury Lawsuits Take So Long? - Here Are 4 Common Reasons

by The Brown Firm on

You may be asking yourself, "why do personal injury lawsuits take so long?" Today, our attorneys at The Brown Firm are going to share four factors that play into the length of your case. It is our hope to provide you insight...more

Dickinson Wright

As Telemedicine Soars, Reimbursement for Telemedicine Services Slowly Evolve

by Dickinson Wright on

The use of telemedicine has soared in recent years, as new technologies develop and consumer demand for instant access to healthcare increases. ...more

Akin Gump Strauss Hauer & Feld LLP

United States Intervenes in Suit Against Private Equity Firm Based on Health Care Portfolio Company's Alleged False Claims Act...

• In an unusual move, the government has decided to pursue a False Claims Act (FCA) suit against a private equity firm based on an alleged commission scheme at its pharmacy portfolio company to promote sales of products...more

Cadwalader, Wickersham & Taft LLP

Health Care Investors Beware: U.S. Attorney Sues Private Equity Firm For Portfolio Company’s Alleged Billing Fraud

The U.S. Attorney for the Southern District of Florida has recently decided to intervene in a lawsuit brought under the Federal False Claims Act and initiated by a whistleblower. The U.S. Attorney has filed his own...more

Robinson+Cole Health Law Diagnosis

CMS Revises National Coverage Determination for Implantable Cardioverter Defibrillators

On February 15, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a Decision Memo outlining revisions to its 2005 National Coverage Determination (NCD) for Implantable Automatic Defibrillators (ICDs) ....more

Holland & Knight LLP

Ruling: Medical Providers Not Subject to Double Damages Under Medicare Secondary Payer Act

by Holland & Knight LLP on

• In a matter of first impression, the U.S. District Court for the Middle District of Florida has ruled that a private right of action under the Medicare Secondary Payer Act (MSP Act), which provides for double damages in the...more

Butler Snow LLP

Bills, Bills, Bills: Calculation of Past Medical Expenses under Texas Law

by Butler Snow LLP on

Under Texas law, recovery of past medical expenses is limited to the amount actually paid or incurred. Section 41.0105 was enacted in 2003 by the Texas Legislature as a tort reform initiative to limit past medical damages to...more

Farrell Fritz, P.C.

New York State’s Prohibition of the Corporate Practice of Medicine – A Not-So-Gentle Reminder

by Farrell Fritz, P.C. on

Spurred in large part by the changing landscape of medicine, more and more medical professionals are seeking to become a part of something bigger. Often, they are under the misassumption that they can set up and run their...more

Akerman LLP - Health Law Rx

CMS Expands Reimbursement for Telehealth Services

Despite telehealth’s significant expansion over the past ten years, it has been plagued by a historically unstable regulatory and reimbursement landscape....more

Dickinson Wright

The Trump Administration Proposes a Budget Increase to Fight Healthcare Fraud

by Dickinson Wright on

The Trump administration proposed a budget increase of 19 million to aid in the fight against health care fraud. This showcases the continued (and heightened) importance of anti-fraud programs, especially compared to the...more

Foley & Lardner LLP

Top 5 Ways Telehealth Will Change Under the New Federal Funding Bill

by Foley & Lardner LLP on

The telemedicine industry has been abuzz upon learning that provider-friendly legislation was included in the new federal Bipartisan Budget Act of 2018, signed into law by the President on February 9, 2018. But telehealth...more

Hogan Lovells

2019 White House and HHS Budgets Released: Key Changes to Drug Pricing and Reimbursement Proposed

by Hogan Lovells on

On February 12, 2018, the White House Office of Management and Budget released an overview of the president's Fiscal Year (FY) 2019 Budget (the Budget), which makes, among many others, several proposals regarding drug pricing...more

Robinson+Cole Health Law Diagnosis

Escobar Compels Florida District Court to Overturn $350 Million Jury Verdict Arising from Claims of Inadequate Documentation

Last month, a U.S. District Court in the Middle District of Florida overturned judgments totaling $347,864,285 returned by a jury under the federal False Claims Act (FCA) and Florida’s state equivalent against the owners and...more

Seyfarth Shaw LLP

Vindication! Fifth Circuit Reverses Notorious District Court Health Care Fraud Decision

by Seyfarth Shaw LLP on

Seyfarth Synopsis: In a major victory for ERISA plans and other payors, the Fifth Circuit recently overturned a district court’s notorious decision in favor of a healthcare provider and reinstated a plan administrator’s...more

Pullman & Comley, LLC

2017 Round-Up: Key Decisions Affecting Connecticut Health Care Providers

by Pullman & Comley, LLC on

Connecticut state and federal courts faced a number of significant health care issues last year. We have summarized those cases that we think are particularly relevant to Connecticut hospitals, group practices and individual...more

Nexsen Pruet, PLLC

What the Blazes is a Healthcare Reimbursement Attorney, Anyway?

by Nexsen Pruet, PLLC on

As I sit on a delayed plane attempting to fight my way back home, I have the difficult task of attempting to clarify what it is I do. When I was a kid, I never, ever, thought, “When I grow up, I want to be a Healthcare...more

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