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Physicians Medicaid Centers for Medicare & Medicaid Services (CMS)

Holland & Hart LLP

FMV for Provider Contracts: Regulatory Standards

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As a general rule, healthcare employers are required to pay employed physicians and other contracted providers fair market value (FMV) for their services, but many employers do not understand relevant regulatory standards. ...more

Alston & Bird

Health Care Week in Review: CMS Releases Final Medicare Prescription Payment Plan Part 2 Guidance

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Alston & Bird

Health Care Week in Review: CMS Issues Calendar Year 2025 Proposed Medicare Payment Rules for Physicians and Hospitals

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Epstein Becker & Green

CMS Finalizes Medicaid Access Rule: Significant Changes Ahead for HCBS Industry

On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) issued Ensuring Access to Medicaid Services, a final rule designed to address a range of barriers that Medicaid beneficiaries face in accessing home- and...more

ArentFox Schiff

Fast Five: Important Law and Policy Updates for US Health Care Transactions

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With the end of the first quarter of 2024, we highlight five developments, changes, or challenges that health systems, hospitals, nursing homes, clinics, physician practices, health insurers, and other health care providers,...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - May 9th - 10th, San Juan, Puerto Rico

Looking for compliance education and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance education on a wide variety of current and emerging topics...more

Hendershot Cowart P.C.

Doctors: Don’t Fall Victim To Telemedicine Fraud Schemes

Hendershot Cowart P.C. on

Telemedicine companies are supposed to facilitate medically necessary services to beneficiaries over the telephone via licensed medical professionals. In reality, however, many of these “telemedicine companies” are...more

American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

Cozen O'Connor

CMS Issues Final Rule Impacting Prior Authorization Process

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Last week CMS issued its final rule “CMS Interoperability and Prior Authorization” (CMS-0057-F), unchanged from its proposed rule in 2022, which addresses prior authorizations. Prior authorization, a “utilization management”...more

Epstein Becker & Green

HHS Publishes Proposed “Disincentives Rule” to Prevent Information Blocking by Health Care Providers

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The U.S. Department of Health and Human Services (HHS)—through the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC)—recently published a...more

McDermott+

The Comments are In! Responses to the Physician Fee Schedule Proposed Reg

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Time’s up and pencils down! Comments on the calendar year (CY) 2024 physician fee schedule (PFS) proposed reg were due earlier this week. Now, the Centers for Medicare & Medicaid Services (CMS) will have to review them and...more

McDermott+

The MIPS Effect: A Surprise Twist in Estimating Medicare Payments for Clinicians Next Year

McDermott+ on

As physician groups and other stakeholders work to finalize comment letters on the calendar year (CY) 2024 Physician Fee Schedule (PFS) proposed regulation by September 11, 2023, the Centers for Medicare & Medicaid Services...more

Health Care Compliance Association (HCCA)

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

Manatt, Phelps & Phillips, LLP

Proposed CY 2024 Medicare Physician Fee Schedule Extends Many Telehealth Flexibilities Through 2024

On July 13, the Centers for Medicare & Medicaid Services (CMS) released its annual proposed rule updating the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2024, which includes various proposed changes related...more

Health Care Compliance Association (HCCA)

News Briefs: July 2023

Report on Medicare Compliance Volume 32, no 25 (July 2023) Hospices in four states will face heightened oversight. “CMS is placing newly enrolling hospices located in Arizona, California, Nevada, and Texas in a provisional...more

Wilson Sonsini Goodrich & Rosati

CMS Proposes a Novel Replacement for Rescinded Pathway to Expedited Reimbursement of Breakthrough Devices

In November 2021, the Centers for Medicare & Medicaid Services (CMS) rescinded a short-lived program to expedite national Medicare coverage for innovative devices amid safety concerns for Medicare patients. CMS has strived...more

Epstein Becker & Green

CMS Announces the Making Care Primary Model, a Multistate Initiative to Strengthen Primary Care

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On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (CMMI), announced a new demonstration model under the authority of Section 1115A of the Social Security Act that...more

Weintraub Tobin

Themes from American Health Law Association’s 2023 Institute on Medicare and Medicaid Payment Issues

Weintraub Tobin on

I am fresh back from Baltimore, Maryland, where I was on the faculty of AHLA’s annual Institute on Medicare and Medicaid Payment Issues. I have been on the faculty of this program for a dozen years, and am always thrilled to...more

Bradley Arant Boult Cummings LLP

Key Insights from DOJ’s False Claims Act Statistics for Fiscal Year 2022

The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends. Although DOJ brought in the second-highest...more

Manatt, Phelps & Phillips, LLP

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 - January 2023

As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access...more

Fox Rothschild LLP

Five Differences Between the Federal Anti-Kickback Statute and the Federal Stark Law

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Physicians around the country are familiar with the Federal Anti-Kickback Statute (“AKS”) (42 U.S.C. § 1320a-7b(b)) and the Federal Physician Self-Referral Law, commonly referred to as the Stark Law (“Stark”) (42 U.S.C. §...more

Brownstein Hyatt Farber Schreck

Health Care in the FY 2023 Omnibus

On Dec. 23, 2022, President Joe Biden signed into law the fiscal year (FY) 2023 omnibus appropriations bill. The legislation was passed by the Senate (68-29) on Dec. 22 and the House (225-201-1) on Dec. 23. The bill provides...more

Epstein Becker & Green

2023 Physician Fee Schedule Final Rule Supports Health Equity Through Investments in Accountable Care Organizations

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The Centers for Medicare & Medicaid Services (CMS) recently issued its Medicare Physician Fee Schedule (PFS) final rule (the “final rule”), with most changes becoming effective January 1, 2023....more

Holland & Knight LLP

Holland & Knight Health Dose: October 11, 2022

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include ... ...more

Mintz - Health Care Viewpoints

California Passes New Law Requiring Physicians and their Employers to Notify Patients about the Open Payments Database

A new California law (AB 1278) will require physicians and their employers to provide patients with several forms of notices about the Open Payments database, starting January 1, 2023. The law is intended to increase...more

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