Medicaid, Billing, Health Care Providers

This Week in 340B: July 2 – 8, 2024

McDermott Will & Emery on 7/10/2024

Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more

[Virtual Event] Behavioral health compliance through deterrence - March 9th, 12:00 pm - 1:30 pm CT

Health Care Compliance Association (HCCA) on 3/1/2023

Learning objectives: - If presented with the opportunity to open a behavioral health company and the offer sounds too good to be true, it most likely is. - Do not sign documents if they are blank or you are being...more

CMS Audits: Part 1 The ABCs of Medicare and Medicaid Claims Audits: Understanding the Audit Contractors

Bass, Berry & Sims PLC on 2/15/2023

Because Medicare and Medicaid claims audit requests can look like routine billing-related correspondence, they can be easy to miss, leading to expensive and potentially catastrophic consequences. Providers, therefore, should...more

Another Win for Providers: Texas Federal District Court Again Vacates Independent Dispute Resolution Rule for the No Surprises Act

Sheppard Mullin Richter & Hampton LLP on 2/13/2023

On February 6, 2023, the United States District Court for the Eastern District of Texas ruled in favor of the Texas Medical Association and vacated portions of the final rule adopted in August 2022 (the “August 2022 Final...more

Knowing IS the Battle: Supreme Court to Address the FCA’s Scienter Standard

McCarter & English Blog: Government Contracts... on 2/3/2023

Scenario 1: A pharmacy chain hires a value consultant to review its Medicare and Medicaid billing practices for ways to optimize the coding of drug reimbursements to maximize profits. Drugs that had historically been charged...more

[Event] Research Compliance Conference - June 8th - 10th, Anaheim, CA

Health Care Compliance Association (HCCA) on 2/17/2022

Hear about the latest in research compliance - Do you want to learn… - How to prepare for upcoming changes in Medicaid? - Ways to build and maintain a better research compliance work plan for your program? - How...more

Federal Government Targets Providers Administering Amniotic Injections

Oberheiden P.C. on 10/26/2021

The federal government has recently made clear its intention to go after healthcare providers who provide amniotic injections to certain Medicare and Medicaid recipients. Over recent years, the federal government has...more

The No Surprises Act: A Look at the First Round of Federal Regulations on Surprise Billing

Epstein Becker & Green on 7/14/2021

On July 13, 2021, the Biden administration (“Administration”) officially published the “Requirements Related to Surprise Billing; Part I”—its first regulatory response to the enactment of the No Surprises Act (“NSA”)—as an...more

340B in 2021: What Covered Entities and Their Partners Need to Know Now

McDermott Will & Emery on 3/31/2021

Since March 2010, increased growth in the 340B Program has been accompanied by increased scrutiny from state and federal governments and conflicts between various 340B Program stakeholders. A transition in U.S. Department of...more

[Webinar] 340B in 2021: What Covered Entities and Their Partners Need to Know Now - March 18th, 2:00 pm - 3:00 pm ET

McDermott Will & Emery on 3/16/2021

This must-attend webinar will give 340B covered entities and their partners up-to-the-minute insights into the most pressing issues affecting their business today and the trends that will shape the market tomorrow. Our...more

Telemedicine-Medicaid Billing and Compliance: Not Just a Matter of Picking Up the Phone

Pullman & Comley, LLC on 5/4/2020

What should new and old Connecticut telemedicine and telehealth providers know about billing for Connecticut Medicaid services now that Connecticut’s Governor Ned Lamont again has expanded the ability of providers to offer...more

Reimbursement for Remote Patient Monitoring Services in 2019

Dorsey & Whitney LLP on 9/23/2019

Medicare reimbursement for remote patient monitoring has taken a number of steps forward throughout this year. New and proposed rules from the Centers for Medicare and Medicaid Services both expand the billing options...more

Health Care MarketTrends - September 2019, Issue 2

Foley & Lardner LLP on 9/17/2019

Welcome to Foley & Lardner LLP’s Health Care MarketTrends. In this issue, we examine private equity investment in specialty areas of the health care industry, specifically dermatology and orthopedics....more

Tennessee Nursing Home Chain Reaches “Largest Worthless Services Resolution in Tennessee’s History”

Bass, Berry & Sims PLC on 3/7/2019

Government Settles with Several Entities, Individuals - Last week, Vanguard Healthcare and related entities reached a settlement with the Department of Justice (DOJ) for the stated amount of more than $18 million to settle...more

K&L Gates Triage: 340B Update: State Medicaid 340B Billing Requirements

K&L Gates LLP on 4/25/2018

In the midst of the ongoing federal conversation surrounding the 340B Drug Pricing Program, individual states are implementing a number of regulatory efforts related to the 340B Program at an increasingly fast pace. These...more

California Court Endorses Percentage Billing Fees for Medi-Cal Providers

Buchalter on 4/9/2018

California’s First District Court of Appeal (“Court of Appeal”) has recognized that percentage-based billing arrangements do not violate California’s Medi-Cal laws and that the California Department of Health Care Services...more

The State AG Report Weekly Update

Cozen O'Connor on 3/16/2018

Consumer Protection- Arizona Attorney General Announces Settlement with Auto Manufacturer Over Alleged Ignition Switch Defects- Arizona AG Mark Brnovich reached a settlement with auto manufacturer General Motors LLC...more

New SAMHSA Rule: Permissible Part 2 Substance Abuse Disclosures to Subcontractors

Baker Donelson on 1/19/2018

On January 3, 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a final rule to revise 42 CFR Part 2, the federal regulations governing confidentiality of certain substance abuse patients'...more

Fast Alert: OIG Calls For Reevaluation Of Medicare Therapy Billing

Baker Donelson on 10/6/2015

On September 30, 2015, the Office of Inspector General (OIG) published a report titled, "The Medicare System For Skilled Nursing Facilities Needs To Be Evaluated" in response to growing concerns over Medicare's payment system...more

FCA 60-Day Repayment Provision Runs from Discovery of Potential Overpayment

Holland & Knight LLP on 8/12/2015

The U.S. District Court for the Southern District of New York issued the first decision directly addressing when an overpayment is “identified” for purposes of starting the 60-day repayment clock under the federal False...more

Can My Hospital Bill Medicare for Telehealth Chronic Care Management?

Foley & Lardner LLP on 7/15/2015

CMS just introduced proposed rules to clarify the requirements and payment opportunities when hospitals want to bill Medicare for Chronic Care Management (“CCM”) services. CCM is an exciting service covered by Medicare...more

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