News & Analysis as of

Medicare Teaching Hospitals

Baker Donelson

Noteworthy GME Payment Policy Takeaways from the CMS FY 2025 IPPS Proposed Rule

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CMS's FY 2025 Inpatient Prospective Payment System (IPPS) Proposed Rule (Proposed Rule) includes several noteworthy proposals and requests for information related to graduate medical education (GME) payment policies. Below...more

Rivkin Radler LLP

Surgeon Settles Simultaneous Surgery Suit

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The U.S. Department of Justice announced on February 27 that the University of Pittsburgh Medical Center (UPMC), James Luketich, its Chair of Cardiothoracic Surgery, and University of Pittsburgh Physicians have agreed to pay...more

Burr & Forman

Hot Topics in Health Care January 2023

Burr & Forman on

Court Remands Remedy for Unlawful 340B Rule to HHS - On January 10, 2023, the DC District Court remanded the issue of how to remedy five years of underpayments to 340B hospitals to the Department of Health and Human...more

King & Spalding

Federal Court Invalidates Medicare DGME Rule that Penalizes Hospitals for Training Fellows

King & Spalding on

On Monday, May 17, 2021, Judge Timothy Kelly of the United States District Court for the District of Columbia issued a decision setting aside a regulatory formula CMS has adopted to compute Medicare DGME payments to...more

McDermott Will & Emery

Consolidated Appropriations Act Includes GME Support Provisions

McDermott Will & Emery on

The Consolidated Appropriations Act, 2021, creates 1,000 new Medicare-funded graduate medical education (GME) residency positions, expands opportunities for rural residency training, and allows hospitals that have very low...more

Verrill

Avoid Rejection: Make Sure Your Medicare Cost Report is Properly Completed

Verrill on

As the calendar year draws to a close, hospitals with a 9/30 fiscal year end are working intensely on completing their FY 2019 Medicare cost reports. This seemed like a good time to remind everyone of some of CMS’s more...more

King & Spalding

Massachusetts District Court Allows FCA Lawsuit Alleging Hospital Overbilled for Double-Booked Surgeries Performed Without...

King & Spalding on

On June 17, 2019, the U.S. District Court of the District of Massachusetts rejected Massachusetts General Hospital’s (MGH) request to dismiss a qui tam complaint alleging that the teaching hospital fraudulently overbilled...more

King & Spalding

Concurrent Surgeries Under Review by the Senate Finance Committee

King & Spalding on

Senator Orrin G. Hatch, chairman of the Senate Finance Committee, recently sent inquiries to 20 hospital systems throughout the country, asking for detailed information and records regarding concurrent surgeries. Concurrent...more

King & Spalding

MedPAC Convenes to Discuss Open Payments, Payment for Post-Acute Care, and Other Issues

King & Spalding on

On September 10-11, 2015, MedPAC held a meeting to discuss several issues related to the Medicare program, including (1) improving the Open Payments program, which makes public the payments from drug and device manufacturers...more

King & Spalding

CMS Open Payment Program Data Indicates $6.49 Billion Paid by Manufacturers, GPOs to Physicians and Hospitals in 2014

King & Spalding on

CMS recently released data collected through the Open Payments Program in accordance with the Affordable Care Act from applicable manufacturers and group purchasing organizations (GPOs) about payments and other transfers that...more

Morgan Lewis

Residents Can Be Hazardous to a Community Hospital's Medicare Health

Morgan Lewis on

Although Medicare graduate medical education reimbursement can be a helpful source of financing to facilitate resident training, many community hospitals have suffered a “gotcha” moment when trying to establish new programs....more

Obermayer Rebmann Maxwell & Hippel LLP

CMS Announces Launch of Open Payments Database: $3.5 Billion Paid to Physicians and Teaching Hospitals

The Open Payments database (the “Database”) is now live, and the first round of data is available to the public on the Centers for Medicare and Medicaid Services (“CMS”) website. This first round of data reflects “nearly 4.4...more

Foley Hoag LLP

The Physician Payment Sunshine Act Final Rule A Summary Of Key Provisions

Foley Hoag LLP on

On February 1, 2013, Centers for Medicare and Medicaid Services (CMS) published the long-awaited Physician Payment Sunshine Act (Sunshine Act) Final Rule, implementing Section 1128G of the Social Security Act. The...more

Womble Bond Dickinson

Healthcare Alert: Better Late than Never - The Sunshine Act Final Regulations are Finally Here!: Covered Recipients

Womble Bond Dickinson on

“Covered Recipients” - Physicians - The Final Rule retains the proposed definition of “physician” as meaning doctors of medicine and osteopathy, dentists, podiatrists, optometrists, and chiropractors, who are...more

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