Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 187: South Carolina Hospitals and Healthcare Industry Trends with Thornton Kirby, SCHA President
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Medical Device Legal News with Sam Bernstein: Episode 19
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Opting Out of Medicare: When and How to Do It
Medical Device Legal News with Sam Bernstein: Episode 11
Show Me the Money: New Study Confirms Hospice Saves Money for Medicare
An Unwanted Spotlight: DOJ Announces Hospice Fraud Is Top Priority
The Chartwell Chronicles: Medicare & Medicaid
Navigating EMTALA Rules
Heed Caution: Takeaways From the OIG's Advance Care Planning Report
Podcast: The End of the Public Health Emergency – What's to Come? – Diagnosing Health Care
Patient Steering and Charting
Telehealth Risk Report: What the Government Found
Do You Have a Backup? Building Redundancies Into Your Written Certification Process
COVID-19 Hospice How-To Series | The Results Are In: More Wins for Hospices in HIS Appeals
The House and Senate voted last week, and President Biden signed into law on December 10, 2021, a bill to delay looming reduction in Medicare rates set to take effect in 2022. The bill, the Protecting Medicare and American...more
Physicians and other providers can take a deep breath as Congress has acted to prevent the trio of Medicare payment cuts that were set to take effect at the beginning of 2022—a 3.75% cut due to scheduled changes in the...more
Medicare providers face a nearly 10% reimbursement cut in 2022. Our Health Care Legislative & Public Policy Team does the math and explains how a combination of sequester cuts and expiring reimbursement support could bring a...more
In the wake of the government-wide sequestration cuts in 2011, the hospice industry was not spared. Medicare hospice payments were reduced by two percent in accordance with a sequestration order issued March 1, 2013, pursuant...more
One of the many relief efforts contained in the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”), signed into law on March 27th, 2020, is a hiatus of sequestration as it applies to Medicare payments....more
Section 4408 of the CARES Act suspends the 2% sequestration reduction to payments under the Medicare program that have been in place since April 1, 2013. The suspension of sequestration in Medicare will run from May 1, 2020...more
Certain provisions of the recent CARES Act impact how hospitals are reimbursed under original Fee-For-Service Medicare (i.e., Part A and Part B) and existing Medicare Advantage contracts. Specifically, the CARES Act...more
On October 28 and 30, 2015, the U.S. House of Representatives and U.S. Senate approved the Bipartisan Budget Act of 2015 (the Act)—a measure designed to raise the limit on Federal borrowing that would also have significant...more
On October 28, 2015, the U.S. House of Representatives approved legislation that, if enacted, would, among other things, substantially alter how and how much Medicare pays for outpatient services furnished by hospitals. The...more
As you likely are aware, Medicare hospice payments were reduced by two percent in accordance with a sequestration order issued March 1, 2013, pursuant to Section 251A of the Balanced Budget and Emergency Deficit Control Act....more
In a case of first impression, a Pennsylvania court recently ruled in favor of 12 independent community hospitals (the “Hospitals”) that sued health insurer Highmark Inc. (“Highmark”) for passing on its 2 percent Medicare...more
A Pennsylvania judge found, on May 6, 2015, that a Medicare Advantage Plan had no right under its participation agreements to pass CMS sequestration reductions through to participating providers. Judge R. Stanton Wettick Jr....more
On September 22, 2014, twelve hospitals filed a complaint in a Pennsylvania state court against a Medicare Advantage plan, Highmark, Inc., along with its HMO subsidiary, for implementing a two-percent reduction to the...more
On Wednesday, February 12, 2014, the U.S. Senate passed legislation that, among other things, would further extend Medicare sequestration by one year (until 2024) in part to avoid a reduction in military pensions. Earlier in...more
A recent Congressional budget deal, the Bipartisan Budget Act of 2013, would exclude hospitals from sequester relief. Medicare provider payment cuts would be extended through 2023, two years longer than the cuts set by the...more
While many in Washington, D.C. are celebrating today the unusual display of bipartisan budgetary comity as the new budget deal is announced, there is a direct and immediate adverse effect for hospitals and physicians. As...more
While the focus over the past 16 days has been on the shuttered government and the prospect of the United States defaulting on its debt obligations, there are subtexts that are relevant to the health care industry. This On...more
A June 3, 2013 letter from CMS Administrator Marilyn Tavenner to Rep. Pete Sessions (R-Tex.) states that the agency does not believe it has any discretion under the Budget Control Act of 2011 to exempt Part B cancer drug...more
One of King & Spalding’s clients reported to us that its Medicare contractor had not correctly calculated the 2 percent sequestration reduction in payments for purposes of biweekly pass-through payments. ...more
As the federal government scrambles to cut burgeoning health care costs, yet increase health care coverage to the uninsured or underinsured, the paradox of expansion, on the one hand, yet constriction, on the other, has...more
On March 8, 2013, CMS announced that it will apply the two-percent sequestration reduction to all Medicare provider payments with dates of service/discharge on or after April 1, 2013. The announcement also states that claims...more
On March 1, 2013, President Obama issued a sequestration order directing the Office of Management and Budget (OMB) to administer across-the-board cuts to federal spending. Concurrently, OMB issued a report to Congress...more
As Washington and the rest of the country brace for cuts from the sequester to kick in on March 1, Florida Gov. Rick Scott surprised many and confirmed others' predictions by announcing his state will expand its Medical...more
In This Issue: - OMB Directs Department Heads to Prepare for Sequestration - HHS Finalizes Omnibus HIPAA Rule, Enhances Privacy Requirements - SCOTUS Says Equitable Tolling Not a Factor in DSH Case - Report...more
On January 2, 2013, President Obama signed into law the American Taxpayer Relief Act of 2012 (ATRA), to avert the so-called fiscal cliff. While most popular coverage has focused on ATRA’s changes to the tax code, the new law...more