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1 Mar 2023, 9:29 am
On January 30, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). [read post]
28 Feb 2023, 11:27 am
“Medicare will go bankrupt if fraudsters can knowingly defraud the government and escape liability. [read post]
28 Feb 2023, 8:12 am
The University of Pittsburgh Medical Center and the head of its cardiothoracic surgery department have agreed to pay $8.5 million to settle claims that they fraudulently billed Medicare and Medicaid for complex surgeries. [read post]
28 Feb 2023, 4:00 am
Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) issuing an interim final rule on November 5, 2021, shortcutting the full-blown notice and comment rulemaking process. [read post]
24 Feb 2023, 12:29 pm
Attorney’s Office for the Southern District of Texas announced on February 22 that Cornerstone Healthcare Group Holding Inc. and CHG Hospital Medical Center LLC. dba Cornerstone Hospital Medical Center will pay $21,637,512 to settle allegations that it improperly billed Medicare and violated the False Claims Act. [read post]
23 Feb 2023, 9:05 pm
HHS’s proposals included capping generic drugs at $2 for Medicare recipients, creating a payment process for drugs approved under accelerated approval process, and partnering with manufacturers to make gene and cell therapies more affordable. [read post]
23 Feb 2023, 6:38 pm
Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule on February 15, 2023 that would require Medicare-enrolled skilled nursing facilities (“SNFs”) and Medicaid-enrolled nursing facilities (“NFs”) to disclose additional ownership and management information to CMS and state Medicaid agencies. [read post]
23 Feb 2023, 8:39 am
Strategically centered in Washington, D.C., our Government Investigations & White Collar Litigation Department has been honored as a Law360 Practice Group of the Year and earned the trust of international companies and individuals through our representation in some of the most notable enforcement matters over the past decade. [read post]
23 Feb 2023, 5:00 am
Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. [read post]
23 Feb 2023, 4:00 am
On August 19, 2022 the Centers for Medicare and Medicaid Services announced plans to require nursing facilities to vaccinate most employees to continue to receive federal reimbursements. [read post]
22 Feb 2023, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs) and for audits conducted by the Office of Inspector General (OIG), effective for payment year 2018. [read post]
22 Feb 2023, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs) and for audits conducted by the Office of Inspector General (OIG), effective for payment year 2018. [read post]
22 Feb 2023, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs) and for audits conducted by the Office of Inspector General (OIG), effective for payment year 2018. [read post]
22 Feb 2023, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs) and for audits conducted by the Office of Inspector General (OIG), effective for payment year 2018. [read post]
22 Feb 2023, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs) and for audits conducted by the Office of Inspector General (OIG), effective for payment year 2018. [read post]
22 Feb 2023, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs) and for audits conducted by the Office of Inspector General (OIG), effective for payment year 2018. [read post]
22 Feb 2023, 7:17 am
The Centers for Medicare & Medicaid Services (CMS) recently issued a Medicare-related final rule invoking the agency’s statutory authority to promulgate retroactive rules after finding that failure to apply the final rule retroactively would be “contrary to the public interest. [read post]
21 Feb 2023, 4:02 pm
We have helped healthcare providers across the state renegotiate their contracts, navigate their complex provider-payer claims, and manage their revenue cycles.We apply a client-centered approach that’s practical, sophisticated, and aggressive. [read post]
20 Feb 2023, 5:00 am
CMS, the Centers for Medicare and Medicaid Services, issued a downloadable guidance on this topic. [read post]
19 Feb 2023, 7:23 pm
The facility must also have a transfer agreement with at least one Medicare-certified hospital that is designated as a level I or level II trauma center. [read post]
