News & Analysis as of

Medical Reimbursement Reimbursements

Whiteford

Navigating New Medicare Overpayment Rules and Practical Tips to Comply

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On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized the Medicare regulations interpreting the federal 60-day overpayment refund requirement (the Overpayment Statute) for Medicare Parts A and B as...more

Baker Donelson

2025 Medicare Physician Fee Schedule: Payment and Overpayment Policies

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On December 9, 2024, the Centers for Medicare & Medicaid Services' (CMS's) Calendar Year 2025 Physician Fee Schedule Final Rule (the Final Rule) was published in the Federal Register. The Final Rule includes noteworthy...more

Nelson Mullins Riley & Scarborough LLP

Federal Regulatory Update: CMS Medicare Payment Changes & Congressional Next Steps

The Centers for Medicare & Medicaid Services (CMS) have released significant updates affecting Medicare payments for 2025. The changes, outlined in two final rules, will impact both physicians and hospitals, eliciting strong...more

Marshall Dennehey

Understanding Reimbursements for CPT Code 97039

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CPT code 97039 has been in a state of constant flux in Florida and recent rulings have created greater change. First, one must understand what 97039 is and its history. According to the American Medical Association (AMA), CPT...more

Saul Ewing LLP

Pennsylvania Expands Use and Reimbursement of Telemedicine and Bans Noncompete Agreements for Certain Health Care Practitioners

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In July 2024, Pennsylvania enacted two significant pieces of legislation relating to telemedicine and physician noncompetition agreements that will have a meaningful impact within the healthcare delivery system with the...more

Maynard Nexsen

A Primer on Health Reimbursement Arrangements

Maynard Nexsen on

During a time when recruiting and retaining qualified employees is becoming more and more difficult, it is crucial for employers to consider (or even reconsider) their benefits offerings and determine if there are any...more

Weber Gallagher Simpson Stapleton Fires &...

PA Insurer in Violation for Failure to Reimburse Claimant for Medical Marijuana

The Pennsylvania Commonwealth Court decided today that under the Commonwealth’s Medical Marijuana Act (“MMA”), Federal law and the Pennsylvania Workers' Compensation Act, it is not a violation of Federal Law prohibitions for...more

Chartwell Law

Pennsylvania Commonwealth Court Requires Reimbursement for Out-of-Pocket Medical Marijuana Payments

Chartwell Law on

The Pennsylvania Commonwealth Court issued a precedential decision today, requiring employers to reimburse for out-of-pocket medical marijuana expenses. Fegley v. Firestone Tire & Rubber (Workers’ Compensation Appeal Board)...more

Holland & Hart - The Benefits Dial

Born in the USA, but I’m a Cool Rockin’ Employee Not in the USA Now . . . Employer Considerations for U.S. Employees Living and...

If there is one long-term lesson that came out of the global pandemic, it is that employees are no longer tied to an office. Thanks to technology and almost two-years of successful remote working, employees have...more

Holland & Knight LLP

N.J. High Court Rules on Employer Obligations Under State Medical Marijuana Act

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Organizations in employee-friendly New Jersey have long been faced with a choice between compliance with permissive state marijuana regulations or with stricter federal mandates. The Supreme Court of New Jersey, in Hager v....more

Harris Beach PLLC

IRS Says COVID-19 PPE Expenses Are Deductible or Reimbursable Tax-Free

Harris Beach PLLC on

Just think of the many dollars you spend on face masks, hand sanitizers and sanitizing wipes to help you and your family prevent the spread of the coronavirus disease (COVID-19). It all adds up very quickly and can make a...more

Seyfarth Shaw LLP

San Francisco’s Stimulus: Employees Can Use Healthcare Funds During COVID-19

Seyfarth Shaw LLP on

Seyfarth Synopsis: On April 28, 2020, Mayor London Breed announced a plan to allow employees working in San Francisco to use funds from the Healthcare Security Ordinance (“HCSO”) contributions to buy “necessary expenditures,”...more

Foley & Lardner LLP

FQHCs: Four Reimbursement Traps for the Unwary

Foley & Lardner LLP on

This is the third article in our series addressing important topics for federally qualified health centers (FQHCs) and the providers who work with them. The first post in the series offered five tips for contracting with...more

Womble Bond Dickinson

South Carolina Expands Telemedicine to Physician Assistants, Advanced Practice Registered Nurses

Womble Bond Dickinson on

The practice of telemedicine continues to be one of the fastest-growing methods of delivering patient care, and recently legal changes passed by the South Carolina General Assembly will only increase the importance of...more

Dickinson Wright

As Telemedicine Soars, Reimbursement for Telemedicine Services Slowly Evolve

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The use of telemedicine has soared in recent years, as new technologies develop and consumer demand for instant access to healthcare increases. ...more

Foley & Lardner LLP

Top 5 Ways Telehealth Will Change Under the New Federal Funding Bill

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The telemedicine industry has been abuzz upon learning that provider-friendly legislation was included in the new federal Bipartisan Budget Act of 2018, signed into law by the President on February 9, 2018. But telehealth...more

Butler Snow LLP

Sixth Circuit Denies Seal of Approval for Unjustified Filings Under Seal

Butler Snow LLP on

Litigants and third parties subpoenaed to produce information in litigation who believe that information that they deem confidential will not ever become part of the public record so long as a discovery protective order is in...more

Faegre Drinker Biddle & Reath LLP

Site-Neutral Billing Exemptions

The Balanced Budget Bill Act of 2015 has a site-neutral billing provision relating to off-campus hospital outpatient departments (HOPDs). Those are facilities away from the hospital campus but certified as part of the...more

Stinson - Benefits Notes Blog

Time to Review Plan Subrogation Procedures, Part 2

I blogged a few days ago about the U.S. Supreme Court decision making it harder for plans to recover from a third-party settlement fund for the amount the plan paid when a participant is injured by that third-party. A recent...more

Foley & Lardner LLP

Telehealth Commercial Coverage and Parity Laws: Trends, Challenges and Opportunities

Foley & Lardner LLP on

There will always be differences among state laws on telehealth coverage, but what is remarkable is the rapidly increasing pace at which states have been adopting coverage statutes in the last few years, with currently 29...more

Benesch

Supreme Court Blocks Provider Challenges to Medicaid Program

Benesch on

On March 31, 2015, the Supreme Court issued the first of several expected decisions that will impact the healthcare industry this year, ruling that Medicaid providers have no constitutional or statutory right to challenge a...more

King & Spalding

Supreme Court Says Private Health Care Providers Cannot Sue to Force State of Idaho to Raise Its Medicaid Reimbursement Rates

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In Armstrong v. Exceptional Child Center, Inc., Case No. 14-15, issued March 31, 2015, the United States Supreme Court ruled that a group of private health care providers could not sue officials in Idaho’s Department of...more

Proskauer - Employee Benefits & Executive...

Eleventh Circuit Enforces Subrogation Clause

The Eleventh Circuit recently concluded that Robert Montanile, a welfare plan participant, could not avoid reimbursing the National Elevator Industry Health Benefit Plan for benefits it paid on his behalf after he recovered...more

BakerHostetler

Healthcare Providers Face Increasing Financial Pressure and Bankruptcy Risk

BakerHostetler on

The health of the healthcare industry can be summarized as follows: as go federal reimbursement rates, so goes the financial viability of healthcare providers, whether hospitals, nursing homes or medical practices. These...more

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