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False Claims Act (FCA) Medicare Fee-for-Service

Foley & Lardner LLP

“Let’s Talk Compliance”: Medicare Advantage: Compliance Issues and Enforcement

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Editor’s Note: PYA and Foley & Lardner hosted the 6th Annual “Let’s Talk Compliance” two-day Virtual Conference on January 18 and 19, 2024. Panelists included Foley & Lardner attorneys and PYA experts. The event was hosted by...more

Proskauer - Health Care Law Brief

Medicare Advantage 2024 Rate Announcement – Further Impacts to Risk Adjustment

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Rate Announcement). This Rate...more

Foley & Lardner LLP

FCA Managed Care Case Update: A Court’s View of ICD Guidelines in Risk Adjustment Cases

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Addressing a recent motion to dismiss, the Northern District of California predominantly denied Kaiser Permanente’s (“Kaiser”) motion to dismiss the government’s complaint in United States ex rel. Osinek v. Permanente Medical...more

Foley & Lardner LLP

Managed Care & the FCA: Are Courts Getting It Right?

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Courts are grappling with unique questions in the context of managed care programs in False Claims Act (FCA) cases. But are they getting it right? Two questions trending in courts relate to: (1) materiality under the FCA when...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 42. News Briefs: November 2020 #2

Report on Medicare Compliance 29, no. 42 (November 23, 2020) - CMS said Nov. 16 that the Medicare fee-for-service improper payment rate dropped to 6.27% in FY 2020 from 7.25% last year, although CMS had to “modify”...more

Robinson & Cole LLP

Health Law Pulse - October 2015

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The Health Resources and Services Administration (HRSA) recently issued proposed omnibus guidance (Omnibus Guidance) interpreting various provisions of the 340B Drug Pricing Program (340B Program). The 340B Program allows...more

King & Spalding

Health Headlines: Also in the News - January 2015 #3

King & Spalding on

ALSO IN THE NEWS - HHS Publishes Goals on Alternative Payment Models with Continued Focus on Quality – In its continued efforts to base Medicare payments on quality over quantity, this morning HHS made public its goal...more

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