Searching Content indexed under Healthcare by Steven Chananie ordered by Published Date Descending.
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Proposed And Expanded Disclosure Obligations For Hospitals Regarding Not Only Gross Charges, But Third Party Payor Pricing As Well
On July 29, 2019, CMS released its proposed outpatient prospective payment system ("OPPS") rule outlining a variety of changes it may implement for calendar year 2020.
United States
8 Aug 2019
Reimbursement For And Documentation Of Evaluation And Management Services: CMS Proposes Important Modifications
On July 12, 2018, the Centers for Medicare & Medicaid Services ("CMS") issued a proposed rule ("Proposed Rule") that would, among other changes:
United States
20 Aug 2018
The Enforcement Risks For Medicare Advantage Plans Continue: A New False Claims Act Settlement In Florida
Recent activities of the Department of Justice ("DOJ") and Qui Tam whistleblowers reveal that Medicare Advantage Plans remain at the forefront of investigations for violations of the federal False Claim Act...
United States
23 Jun 2017
Medicare Advantage Plans Under Fire: The Department Of Justice Files Complaints-In-Intervention
Despite the safeguards required by CMS, the DOJ alleges in both complaints that United failed to "look both ways" in submitting claims to CMS.
United States
5 Jun 2017
The Financial Impact of MACRA – Uncertainty Reigns In A Recent RAND Corporation Study
With all the talk of the Affordable Care Act's uncertain future, it is easy to forget about the Medicare Access and CHIP Reauthorization Act ("MACRA"), a bipartisan law passed by Congress in 2015...
United States
10 May 2017
Merger And Acquisition Activity In The Rehabilitation, Home Health And Hospice Sectors Increased In 2016, But Will This Trend Continue?
Since 2014, there has been a steady increase in mergers and acquisitions in the Rehabilitation sector, with a total of 40 deals announced in 2016.
United States
25 Apr 2017
The Siege Continues: The Justice Department Is Investigating Four Additional Medicare Advantage Plans
The FCA qui tam whistleblower lawsuit in the case of United States ex rel Benjamin Poehling v. United HealthGroup, Inc., et. al. was unsealed on February 15, 2017.
United States
30 Mar 2017
Medicaid Demonstration Waivers: A Shorter Path To Increasing State Control Over Healthcare Policy?
Seema Verma's nomination to head the Centers for Medicare and Medicaid Services (CMS) places Section 1115 Medicaid demonstration waivers into increasing spotlight.
United States
9 Jan 2017
The Overpayment Rule And The Implied False Claims Theory: "What You Don't Know Can Still Hurt You"
In 2010, the Affordable Care Act ("ACA") enacted new rules governing overpayments made by the Medicare and Medicaid programs.
United States
20 Jul 2016
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