As promised, our team has been studying the two final rules published by the Department of Health & Human Services (HHS) (one by the Office of Inspector General (OIG) and one by the Centers for Medicare & Medicaid Services...more
12/7/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
DMEPOS ,
Final Rules ,
Health Care Providers ,
OIG ,
Remuneration ,
Safe Harbors ,
Stark Law ,
Value-Based Care
Last week, the New York State Department of Financial Services released a proposed amendment to the regulations promulgated under the state’s Emergency Medical Services and Surprise Bills law (the SBL), which adds additional...more
10/14/2019
/ Amended Regulation ,
Consumer Protection Laws ,
Health Care Providers ,
Health Insurance ,
Medical Expenses ,
New Legislation ,
NYDFS ,
Out of Network Provider ,
Prior Express Consent ,
Proposed Regulation ,
State and Local Government ,
Surprise Medical Bills
News alert for all New Jersey health care providers! A new law went into effect yesterday (August 30, 2018) that changes billing requirements for out-of-network services in New Jersey. Known as the “Out-of-Network Consumer...more
Last week, Governor Andrew Cuomo unveiled his proposed $168 billion budget for fiscal year 2019, which proposes several changes to New York’s healthcare landscape. Among other things, the budget contains amendments that would...more
The Department of Health and Human Services Office of the Inspector General (OIG) has issued an Advisory Opinion (Opinion) in connection with a hospital’s gainsharing arrangement (Arrangement) with a designated group of...more
1/11/2018
/ Anti-Kickback Statute ,
Cherry Picking ,
Civil Monetary Penalty ,
Compensation ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Medicaid ,
Medical Reimbursement ,
Medicare ,
OIG ,
Physicians ,
Stark Law
A series of recoupment letters from the New York State Medicaid Fraud Control Unit (MFCU) to healthcare providers who have management or billing company arrangements based on a percentage of collections has prompted the...more
Last month the California legislature passed AB-72, which amends the Health & Safety Code to address reimbursement for out of network (OON) providers who provide services at in-network facilities, such as hospitals and...more
Just as the Centers for Medicare & Medicaid Services (CMS) began holding federal health care plans accountable for their provider network transparency obligations, the New Jersey legislature stalled in its bid to pass a law...more
Last year New York passed legislation known as the “Emergency Medical Services and Surprise Bills” law, a much-heralded consumer protection law primarily intended to guard against surprise bills for out of network (OON)...more