News & Analysis as of

Reimbursements Payment Systems

McDermott+

Inpatient Prospective Payment System (IPPS) Data Dashboard

McDermott+ on

Updated to include Medicare claims data thru Q4 2024. What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How have Medicare inpatient...more

A&O Shearman

PSR consolidated policy statement on APP scams reimbursement requirement

A&O Shearman on

The UK Payments Systems Regulator (PSR) has published a consolidated policy statement (PS25/5) concerning the authorised push payment (APP) fraud reimbursement requirement within the Faster Payments system, which came into...more

A&O Shearman

PSR update on impact of APP fraud reimbursement scheme

A&O Shearman on

The UK Payment Systems Regulator (PSR) has published an update on what it has seen since the implementation of its authorised push payment (APP) fraud reimbursement scheme in October 2024. The data covers UK payments made via...more

Proskauer - Health Care Law Brief

No Surprises Here!  Fifth Circuit Upholds QPA Calculations and Disclosure Requirements, but Sides with Providers on Payment...

The Fifth Circuit Court of Appeals has handed down a significant decision in response to a challenge from health care providers to the implementing regulations of the No Surprises Act (“NSA”). The Court upheld the...more

Hogan Lovells

UK APP fraud: What in-scope PSPs need to know about the new mandatory reimbursement regime

Hogan Lovells on

Over the past few years, the Payment Systems Regulator (PSR) and Bank of England (BoE) have published a huge number of consultations, guidance documents and specific directions outlining the requirements under the new regime...more

Alston & Bird

The UK Introduces a New Reimbursement and Compliance Monitoring Regime for Authorised Push Payment Scams

Alston & Bird on

Our UK Financial Services Group examine the UK’s new mandatory reimbursement rules that will require payment service providers (PSPs) to reimburse victims of scam transactions....more

A&O Shearman

UK Payment Systems Regulator Confirms Maximum Reimbursement Limit for Authorized Push Payment Scams Reimbursement

A&O Shearman on

On 25 September, the U.K. Payment Systems Regulator confirmed that the maximum reimbursement limit for victims of Faster Payments Authorized Push Payment scams will be £85,000. The PSR began consulting on reducing the...more

Hogan Lovells

APP fraud: UK PSR consults on reducing the maximum level of reimbursement

Hogan Lovells on

Following industry feedback - in particular prudential concerns for some smaller firms in the market – and work with the FCA, the Payment Systems Regulator (PSR) is consulting on a proposal to reduce the maximum level of...more

BCLP

Mandatory Reimbursement for App Fraud: What Payment Service Providers Need to Consider Ahead of Implementation

BCLP on

The controversial new requirement for all in-scope Payment Service Providers (“PSPs”) to reimburse victims of Authorised Push Payment (“APP”) fraud are due to be introduced from 7 October 2024. This is a significant change...more

King & Spalding

OIG Report Details Weaknesses in Enforcement of Two-Midnight Rule

King & Spalding on

CMS estimates that between 2017 and 2021, Medicare Part A improperly paid $23.9 billion for inpatient hospital stays, with $7.8 billion attributable to short stays that did not qualify for Medicare Part A. On June 13, 2024,...more

Hogan Lovells

APP fraud mandatory reimbursement: UK PSR consults on ‘key’ compliance and monitoring requirements

Hogan Lovells on

On 17 April 2024, the Payment Systems Regulator (PSR) published a consultation on the data and information that payment service providers (PSPs) will be required to provide to Pay.UK to enable it to monitor effectively...more

Skadden, Arps, Slate, Meagher & Flom LLP

New Rules To Tackle Authorised Push Payment Fraud

Authorised push payment (APP) fraud in the UK is the largest type of payment fraud, both in number of scams and value of losses. It involves a fraudster convincing someone to send a payment to a bank account that the...more

BCLP

Play Safe - How scam-proof are you in the new world of mandatory reimbursement for APP fraud?

BCLP on

Imagine this – a customer submits a payment instruction directing that all their life savings are transferred to a third-party account for the purposes of an investment. What do you do? While the scenario may appear...more

Hinshaw & Culbertson - Health Care

California Prohibits PBM Discriminatory Practices Against 340B Program Covered Entities and Contract Pharmacies

The 340B Drug Program requires pharmaceutical manufacturers participating in the Medicaid program to provide covered outpatient drugs at significantly reduced prices to certain health care organizations and programs, referred...more

Gardner Law

Compliance Considerations in High-Tech Healthcare

Gardner Law on

Cutting-edge technology is desirable to consumers for its ability to deliver innovative solutions, improved efficiency, enhanced user experiences, and the promise of staying ahead in an ever-evolving digital landscape. The...more

McDermott Will & Emery

Remote Monitoring and Digital Therapies: CMS Updates Coverage and Payment Policies

McDermott Will & Emery on

In recent years, the Centers for Medicare & Medicaid Services (CMS) has expanded payment for remote monitoring services in an effort to pay for non-face-to-face services that improve care coordination for Medicare...more

Hogan Lovells

APP fraud: UK PSR consults on specific direction to FPS participants on reimbursement requirement

Hogan Lovells on

The European Commission has just published its current thinking on green mergers. Recognizing that competition law must play its part in achieving the European Green Deal, the Commission sets the scene and explains how its...more

Verrill

CMS Proposes to Make Lump-Sum Payments to Hospitals for Underpayments for Drugs Purchased Through the 340B Program During...

Verrill on

Last week CMS issued its anticipated proposed rule to implement the Supreme Court’s decision last year which ruled that CMS’ reduction in Medicare payments for Part B outpatient drugs purchased through the 340B program...more

Hogan Lovells

APP fraud: UK PSR confirms introduction of ‘world first’ reimbursement requirement

Hogan Lovells on

The Payment Systems Regulator (PSR) has published a policy statement on its new reimbursement requirement to fight authorised push payment (APP) fraud. Subject to a few exceptions (eg removal of the minimum threshold for...more

Baker Donelson

Supreme Court Agrees to Hear Two Medicare Payment Cases Next Term with Significant Financial Implications for Hospitals

Baker Donelson on

On July 2, 2021, the U.S. Supreme Court granted petitions to hear two cases related to Medicare payments for health care providers. The Court will consider a hospital appeal of a Ninth Circuit decision that vacated part of a...more

King & Spalding

HHS Releases New Frequently Asked Questions Regarding CARES Act Provider Relief Funds - December 2020

King & Spalding on

This month, HHS released over twenty new and modified Frequently Asked Questions (FAQs) regarding payments distributed to providers via the CARES Act Provider Relief Fund. The FAQs cover a wide range of topics, including...more

Baker Donelson

CMS Issues Guidance for COVID-19 Treatments & Vaccines

Baker Donelson on

Over the past weeks, CMS has issued billing and coding guidance for newly authorized COVID-19 vaccines and treatments. This guidance information further implements policy and regulatory revisions made by CMS in the Interim...more

Davis Wright Tremaine LLP

2021 OPPS and ASC Payment System Final Rule: Change Is the Only Constant

On December 2, 2020, the Centers for Medicare & Medicaid Services (CMS) released the calendar year 2021 Final Rule implementing changes to the Medicare hospital Outpatient Prospective Payment System (OPPS) and Ambulatory...more

23 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