AGG Talks: Home Health & Hospice - Reimbursement Audits and Appeals
Podcast: Direct Access Laboratory Testing: Reimbursement & Compliance – Diagnosing Health Care
Podcast: Owner's Outlook: Maximize and Safeguard Reimbursement Through Design - Diagnosing Health Care
HealthLaw HotSpot - A Look at Alternative Reimbursement Models in Value-Based Care
The Important and Thriving Role of Private Medical Practices
Value-Based Care and Its Impact on Providers
The Year Ahead: Litigation Hot Spots at a Glance
Teleworking: Amazing or amazingly complex?
(Video) Reimbursement of College Tuition and Fees After COVID-19
Value-based health care: compliance infrastructure
K&L Gates Triage: 340B Eligibility - Hospital Covered Entities
Value-based health care: fraud & abuse laws
Value-based health care: issues for pharmaceutical companies
Condo Water Invasion: Potential Medical Liability?
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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