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?
This week, the Ninth Circuit considers whether COVID-testing providers have a private right of action for reimbursement and considers a landlord’s standing to challenge a COVID-related eviction moratorium. SALOOJAS, INC....more
Walgreens Medicaid Fraud Case Kicked Back to Trial Court - On August 15, 2023, the US Court of Appeals for the Fourth Circuit issued an opinion reversing a district judge’s dismissal of False Claims Act (FCA) claims...more
In April 2022, CMS announced an initiative to pay for Medicare beneficiaries to receive free OTC COVID-19 test kits. Specifically, Medicare established a demonstration project to pay various eligible healthcare providers to...more
While social distancing restrictions associated with COVID-19 are on the wane, lawsuits seeking reimbursement for COVID-19 testing are on the rise. The issue is whether federal legislation passed at the onset of the Pandemic...more
Providers who rely on the Health Resources & Services Administration (“HRSA “) COVID-19 Uninsured Program (“UIP”) for reimbursements related to COVID-19 testing, treatment, and vaccine administration will no longer be...more
Have questions about the new Frequently Asked Questions for group health plans’ coverage of over-the-counter COVID-19 test kits? ...more
Following up on their earlier guidance the Departments of the Treasury, Labor, and Health and Human Services have issued an additional set of frequently asked questions and answers on the requirement to cover over-the-counter...more
On February 4, 2022, the U.S. Department of Labor (DOL), U.S. Department of the Treasury, and U.S. Department of Health and Human Services (HHS) issued subregulatory guidance that provides greater flexibility and clarifies a...more
Pursuant to recent federal guidance, group health plans and insurers must now cover over-the-counter COVID-19 tests without cost-sharing, prior authorization or other medical management requirements effective January 15,...more
As of January 15, 2022, fully-insured and self-insured group health plans are required to reimburse participants for the cost of purchasing over-the-counter (“OTC”) COVID-19 tests, even if such tests are purchased without the...more
Group health plans and health insurance issuers are now required to cover the cost of over-the-counter (OTC) COVID-19 diagnostic tests. Last week, the Departments of Labor, Health and Human Services, and the Treasury issued...more
SCOTUS Halts OSHA’s Vax-or-Test ETS (but Greenlights CMS Rule). On January 13, 2022, the Supreme Court of the United States stayed the Occupational Safety and Health Administration’s (OSHA) COVID-19 vaccination-or-testing...more
Earlier this week, the COVID-19 testing coverage mandate was significantly expanded pursuant to FAQs issued jointly by the Departments of Labor, Health and Human Services and the Treasury (collectively, the Departments). The...more
In light of the difficulty of test scheduling and concerns about costs to consumers, the Biden administration this week announced that the Department of Health and Human Services will require private health insurance and...more
On January 10, 2022, the U.S. Department of Health & Human Services, Department of Labor, and the Treasury (“Tri-Agencies”) published guidance about how health plans and health insurance issuers must reimburse OTC COVID-19...more
On December 2, 2021, President Joe Biden made comments announcing the White House’s plan for combating COVID-19 and the emerging new variant, Omicron. As part of the nine-step plan, President Biden announced an initiative...more
Effective May 28, 2021, Massachusetts employers are required to make paid leave time available to employees for COVID-related illnesses, quarantine, and vaccinations. Paid leave benefits are paid by the employer and then...more
This 24th edition of Unprecedented, our weekly update on COVID-19-related litigation, sees a flurry of activity around government restrictions on mass gatherings and business operations -- including a significant ruling from...more
On July 30, 2020, CMS and the CDC announced that health care providers can be reimbursed for counseling patients regarding the importance of self-isolation prior to the onset of symptoms at the time of COVID-19 testing. As...more
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), launched a COVID-19 Uninsured Program Portal. The new portal allows healthcare providers who have...more
Some health plans are trying to improperly reduce reimbursement owed to providers for services related to COVID-19 by unilaterally carving out those services from existing provider contracts – e.g., Aetna, certain Blues, etc....more
The Families First Coronavirus Response Act, enacted on March 18, 2020, appropriated $1 billion to reimburse providers for conducting COVID-19 testing for the uninsured. In addition, part of the $100 billion Provider Relief...more