News & Analysis as of

Physicians Administrative Law Judge (ALJ)

Hendershot Cowart P.C.

CMS, Qlarant Scrutinizing Medicare Claims for Skin Substitute Treatments

Hendershot Cowart P.C. on

Our firm is seeing an uptick in Medicare demand letters for the recovery of overpayment for skin substitutes, such as WoundFixTM, Biobrane, Dermagraft®, AmnioBand®, or AlloPatch®, used in the treatment of wounds. CMS auditors...more

Husch Blackwell LLP

Hospice Audit Series | Welcome to the Party: Contractor Participation at ALJ Hearings

Husch Blackwell LLP on

Recently, there has been an uptick in contractor participation at the ALJ stage of hospice audit appeals. This development poses unique challenges and new advocacy opportunities for providers. In this episode, Husch...more

Husch Blackwell LLP

Hospice Audit Series: Insights for Winning at Administrative Law Judge (ALJ) Hearings, Part II

Husch Blackwell LLP on

In Part II of our two-part series on ALJ hearings, Husch Blackwell’s Meg Pekarske unpacks strategies for winning with colleagues Bryan Nowicki, Emily Solum and Erin Burns. They explore what it means to be well-prepared and...more

Husch Blackwell LLP

Hospice Audit Series: Insights for Winning at Administrative Law Judge (ALJ) Hearings, Part I

Husch Blackwell LLP on

In this two-part series, Husch Blackwell’s Meg Pekarske unpacks strategies for winning at ALJ hearings with colleagues Bryan Nowicki, Emily Solum and Erin Burns. They explore what it means to be well-prepared and who should...more

Husch Blackwell LLP

Hospice Audit Series: How are Hospices Faring at ALJ Hearings?

Husch Blackwell LLP on

After waiting years, hospices are getting their “day in court.” How are hospices faring? In this episode, Husch Blackwell’s Meg Pekarske is joined by colleagues Bryan Nowicki and Emily Park, who share insights on what it...more

Health Care Compliance Association (HCCA)

Provider Wins $2M Appeal at ALJ Over Modifier 25, Random Sample

Report on Medicare Compliance 30, no. 11 (March 22, 2021) - A cancer center has won its appeal of $2 million in Medicare claim denials in a case about modifier 25 and the extrapolation of an overpayment. Problems with the...more

Oberheiden P.C.

Is Your Medical License at Risk? What Doctors Need to Know about ALJ Hearings

Oberheiden P.C. on

As a doctor, allegations of medical malpractice or other unlawful or unethical conduct can have wide-ranging implications. In addition to facing civil liability and the prospect of a significant increase in your medical...more

Baker Donelson

HHS Memorandum Clarifies CMS Obligations Following Supreme Court Allina Decision

Baker Donelson on

In response to the disruptive Supreme Court decision on the impact and effect of administrative guidance, HHS has issued a memorandum suggesting that CMS's ability to enforce some of its payment policies may be limited by the...more

Bradley Arant Boult Cummings LLP

Alabama CON Report - September 2018

I. Certificate of Need Program - A. 2018-020, Ana Drive Operations, LLC d/b/a Hilltop at Glenwood I, Florence, AL: Proposes to convert sixteen(16) assisted living beds to sixteen (16) specialty care assisted living...more

Bradley Arant Boult Cummings LLP

Alabama CON Report - August 2018

I. SHPDA Administrative Report - The following project was approved by an Administrative Law Judge and no exceptions were filed. AL2018-005, Bay Eyes Surgery Center, Inc., Fairhope, AL: Proposes to add one (1) Class-C...more

Holland & Knight LLP

Recent Developments in Antitrust Scrutiny of Healthcare-Provider Transactions

Holland & Knight LLP on

As the trend of acquisitions of physician practices and mergers of hospitals continues, so does antitrust scrutiny of these deals. There was activity this week in three different proposed transactions that caught the...more

11 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide