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Showing 38 posts from 2016.

On December 7, 2016, the Office of Inspector General U.S. Department of Health and Human Services (the OIG) published in the Federal Register a final rule (Final Rule) that, among other things, adds three new safe harbors to the Anti-Kickback Statute, and expands the exceptions to the definition of "remuneration" that is prohibited under the Civil Monetary Penalties (CMP) statutes and regulations.  Read More ›

The unexpected election of Donald J. Trump on November 8, 2016 has introduced a significant level of uncertainty in the health care industry.  Both President-Elect Trump and Republican congressional leaders have emphasized the repeal and replacement of the Affordable Care Act (ACA) or some of its key provisions.  As a result, providers, payers, and patients now face the prospect of a dramatically altered health care landscape three years after the ACA's key provisions took effect. Read More ›

On November 2, 2016, the Centers for Medicare and Medicaid Services (CMS) released its interim final rule implementing Section 603 of the Bipartisan Budget Act of 2015 (Section 603) as part of the 2017 Outpatient Prospective Payment System (OPPS) rule.  Read More ›

On Friday, October 14, the Centers for Medicare and Medicaid Services (CMS) released the much anticipated Final Rule with comment period implementing the Medicare Access and CHIP Reauthorization Act (MACRA).  Read More ›

A recent California Court of Appeal decision addressing the statute of limitations created a potential pitfall for health care providers who rely on a plan’s voluntary internal appeals process for underpaid claims as a basis to delay filing formal legal action.  Read More ›

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