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
Recognizing the ongoing impact of the cyberattack experienced by Change Healthcare/Optum on February 21, 2024, the Centers for Medicare & Medicaid Services (CMS) announced over the weekend that it will allow Part A providers...more
It pays to look closely. Buried deep within a 205-page and 1230-page Federal Register final rules publication, the Centers for Medicare & Medicaid Services (“CMS”) initiated impactful changes for pharmacies and Durable...more
Medical Supplier Agrees to Pay $29 Million for FCA Violations - Earlier this month, the US Department of Justice (DOJ) and medical supplier Lincare Holdings Inc. reached an agreement to settle claims that Lincare violated...more
After a rare False Claims Act (FCA) trial, a St. Paul federal jury has returned a verdict for the government in United States, ex rel. Kipp Fesenmaier v. Cameron-Ehlen Group, Inc., No. 0:13-cv-03003 (D. Minn.). The jury...more
In late January 2023, the Centers for Medicare and Medicaid Services (CMS) issued two updates relevant to provider and supplier organizations enrolled in Medicare: (1) a redesign to the Provider Enrollment, Chain and...more
On April 29, 2022, CMS published a final rule requiring Accreditation Organizations (AOs) to notify CMS of changes of ownership (CHOWs). Effective June 28, 2022, an AO will need to notify CMS when undergoing or negotiating a...more
The Centers for Medicare and Medicaid Services (CMS) has started phasing out certain program flexibilities granted during the COVID-19 public health emergency. Beginning in October 2021, CMS will resume several provider and...more
This week, we examine two decisions confronting novel procedural issues. In the first, the Ninth Circuit sought to promote development of the law by encouraging courts to alter how they address claims under the Fair Credit...more
On Mach 27, 2020, President Trump signed the CARES Act, providing in part for $100 billion in relief funds to eligible health care providers and suppliers affected by COVID-19. The funding is intended to support...more
On March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) announced an expansion of Accelerated and Advance Payments Program (the “Program”) for providers and suppliers impacted by the COVID-19 public health...more
The Centers for Medicare & Medicaid Services has expanded its payment program to provide emergency funding and increased cash flow to providers and suppliers that participate in Medicare based on historical Medicare payments...more
As healthcare providers continue to fight the coronavirus outbreak, many practices are suffering major disruptions due to the cancellation of elective surgeries and office visits, among other things. In an effort to lessen...more
On March 30, 2020, in response to the COVID-19 pandemic, Alex Azar, the Secretary of the Department of Health and Human Services (the “Secretary), used his authority under Section 1135 of the Social Security Act to waive...more
As forewarned, CMS's finalization of the Calendar Year (CY) 2020 Physician Fee Schedule, effective January 1, 2020, brings significant changes to its authority to deny or revoke a Medicare enrollment for physicians and other...more
The OIG updates its Work Plan monthly to identify audits and evaluations that are underway or proposed by the OIG's Office of Audit Services and Office of Evaluation and Inspections. The October 2019 update identifies new...more
Yesterday, a final rule issued by the Centers for Medicare & Medicaid Services (CMS) establishing new enforcement initiatives aimed at removing and excluding previously sanctioned entities from Medicare, Medicaid, and the...more
On September 5, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a final rule expanding CMS’ authority to deny or revoke enrollment in the Medicare program as a result of “bad actor” affiliations. Providers...more
On September 5, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released a final rule with comment period entitled, “Program Integrity Enhancements to the Provider Enrollment Process” (the “Final Rule”). The...more
Since the beginning of 2019, federal and state authorities in Connecticut have announced a number of enforcement actions targeting alleged health care fraud in the state. ...more
While many Medicare providers and suppliers may not yet have experienced a Targeted Probe and Education (TPE) audit, they should be on the lookout for this newest weapon in the medical review arsenal. It is important that...more
The Department of Health and Human Services (HHS) announced on November 3, 2017 additional settlement options for providers and suppliers in an effort to improve the Medicare claims appeals process, which included (1) the Low...more
In November 2017, the Department of Health and Human Services (HHS) announced new settlement options for providers and suppliers stuck in the backlog of the Medicare appeals process. One of the new options available is the...more
CMS payment suspensions can cripple any provider's or supplier's operations. Yet, CMS has the authority to impose a payment suspension upon the mere existence of "reliable information" that an overpayment or fraud may exist....more
Accountable Care Organizations (ACOs) can share costs of telehealth and remote patient monitoring services among their hospitals, providers/suppliers, and other ACO participants, according to federal regulations under the...more
This is the second post in Health Care Law Today’s series on the final rule. This post addresses Eligibility Requirements, and the Application and the Renewal Process. ACO Eligibility Requirements - Under the...more