News & Analysis as of

Provider Payments Compliance

Foley & Lardner LLP

“Let’s Talk Compliance”: Medicare Advantage: Compliance Issues and Enforcement

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Editor’s Note: PYA and Foley & Lardner hosted the 6th Annual “Let’s Talk Compliance” two-day Virtual Conference on January 18 and 19, 2024. Panelists included Foley & Lardner attorneys and PYA experts. The event was hosted by...more

King & Spalding

Federal District Court Grants Injunction Barring CMS from Implementing New Policy on Medicaid Funding Designed to Prevent...

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On June 30, 2023, the United States District Court for the Eastern District of Texas (the Court) granted the State of Texas’ preliminary injunction motion, enjoining CMS from implementing and enforcing its Informational...more

Adams and Reese LLP

Payment Service Providers’ Valuable Data is Getting More Regulatory Attention

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The ways consumers make payments, including the data and technology associated with those payments, is becoming an increased focus of regulators. Financial institutions should carefully and thoroughly consider the recent...more

Foley & Lardner LLP

Let’s Talk Compliance Recap: Provider Relief Fund Reporting Requirements & Compliance Concerns

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In the latest installment of our “Let’s Talk Compliance” series, Foley & Lardner’s Alexis Bortniker and PYA’s Martie Ross answered numerous questions regarding Provider Relief Fund (PRF) reporting requirements. A recording of...more

Mitchell, Williams, Selig, Gates & Woodyard,...

"No Surprises Act" Compliance Tips For Group Health Plans and Health Insurance Issuers

On July 13th, group health plans and health insurance issuers subject to the Federal No Surprises Act (the “Act”) received the first phase of interim final rules promulgated under the Act (the “Rules”) and issued by the...more

Health Care Compliance Association (HCCA)

With Telehealth on OIG Work Plan, Beware Pitfalls; CMS Proposes HHA Telehealth Past PHE

Report on Medicare Compliance 29, no. 25 (July 13, 2020)  - When a physician’s telehealth visit with a Medicare patient on FaceTime cut out after five minutes, they shifted to an audio-only visit, with the physician and...more

Hinshaw & Culbertson - Health Care

Medicare Telehealth COVID-19 Waivers Expand Opportunities to Provide Telehealth Services to Medicare Beneficiaries

The Coronavirus Preparedness and Response Supplemental Appropriations Act (the "Act") includes a provision allowing the U.S. Department of Health and Human Services (HHS) to waive certain Medicare telehealth payment...more

Health Care Compliance Association (HCCA)

Payment Dispute Triggered First 2020 OCR Settlement

Report on Patient Privacy 20, no. 3 (March 2020) - A gastroenterologist in Utah who felt he was being held captive by an electronic health record (EHR) vendor found his 2013 complaint to the HHS Office for Civil Rights...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 7. News Briefs: February 2020 #4

Report on Medicare Compliance 29, no. 7 (February 24, 2020) -  Guardian Elder Care Holdings Inc., which operates more than 50 skilled nursing facilities (SNFs) in Pennsylvania, Ohio and West Virginia, and its related...more

Health Care Compliance Association (HCCA)

Observation Is Attracting Audit Attention; Hours Are a Risk, And Watch Out for the MOON

Report on Medicare Compliance 29, no. 5 (February 10, 2020) -  At least two Medicare administrative contractors (MACs) have set their sights on observation services, and there may be more to come. WPS is auditing...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 28, Number 44. News Briefs: December 2019

Report on Medicare Compliance 28, no. 44 (December 16, 2019) - ? Korunda Medical LLC, a Florida-based company that provides primary care and interventional pain management, has agreed to pay $85,000 to settle a potential...more

Health Care Compliance Association (HCCA)

As New SNF Payment System Takes Effect, CMS Will Monitor Changes in Therapy, Coding

Starting Oct. 1, per diem payments to skilled nursing facilities (SNFs) will be more generous on the first few days of a Medicare beneficiary’s stay, and then drop as the stay continues. That’s one of the changes under the...more

The Volkov Law Group

Focusing on “Payments” to Healthcare Professionals (Part I of III)

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The United States healthcare industry poses an infinite number of risks when it comes to interactions with healthcare professionals. Given the aggressive regulation and enforcement of prohibitions against kickbacks and...more

K&L Gates LLP

K&L Gates Triage: Triage in 2018: Health Care Topics to Watch in the New Year

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We expect 2018 to be another year of rapid change within the health care industry. In this episode, Mary Beth Johnston highlights some of the key topics that the health care practice group will monitor in the coming year,...more

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