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Search OptionsHealth CareAetna Claims Victory in Four Year-Old Lawsuit Against Bay Area Surgical Management, LLC
Aetna has claimed victory in a four year-old lawsuit against Bay Area Surgical Management, LLC, after a civil jury hit the California medical group with a $37.4 million dollar judgment. The victory capped a month-long trial against 10 defendants, including surgical centers and the organization's… CMS Issues Final Rule: "Medicaid Program; Methods for Assuring Access to Covered Medicaid Services"
On November 2, 2015, the Centers for Medicare and Medicaid Services (“CMS”) issued a Final Rule titled “Medicaid Program; Methods for Assuring Access to Covered Medicaid Services” following the recent Supreme Court case, Armstrong v. Exceptional Child Care Center, where the Court held that a… Bipartisan Budget Act of 2015 Changes Reimbursement for Off-Campus Outpatient Departments
On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015 (Pub. Law 114-74) into law. The Act includes many provisions aimed to reduce federal debt, but only a few specifically affect health care. Perhaps one of the most significant health care implications involves a change in… International Pharmaceutical Company Pleads Guilty in Federal Court to Felony Criminal Charges
Warner Chilcott USA Sales, LLC, has agreed to plead guilty in federal court to felony criminal charges of paying kickbacks to physicians in return for prescribing seven of its drugs. The subsidiary of multibillion-dollar international pharmaceuticals company Allergan, was also accused of… CMS Issues Proposed Rule Revising the Long-Term Care Facility Medicare and Medicaid Participation Requirements
On July 16, 2015, CMS issued a proposed rule revising the Long-Term Care Facility Medicare and Medicaid participation requirements. These proposed revisions would serve as a widespread update to the participation requirements which have not been comprehensively reviewed and updated since 1991,… CMS Clarifies Access to Documentation as a Condition of Payment
Earlier this year, CMS published a Medicare notice titled Clarification of Ordering and Certifying Documentation Maintenance Requirements (Change Request 9112), which clarifies the term "access to documentation" in the Medicare Program Integrity Manual (Pub. 100-08, Chapter 15, Section 15.18). Under… No "Privilege Against Self-Incrimination" (Fifth Amendment) for Corporate Documents in a Fraud and Abuse Investigation
In a federal grand jury investigation into illegal physician kickbacks paid by a laboratory, Circuit Court Judge Cohen, writing for the U.S. Court of Appeals for the Third Circuit, affirmed the U.S. District Court for the District of New Jersey’s order of contempt against a physician and his… CMS Proposes Medicaid Managed Care Revisions
The Centers for Medicare & Medicaid Services (“CMS”) published its proposed rule to update its standards and requirements for Medicaid managed care plans. CMS notes that laws passed since the Medicaid managed care regulations were promulgated in 2002 have changed Medicaid to such an extent that the… ACO Final Rule Released
On June 4, 2015, the Centers for Medicare and Medicaid Services (“CMS”) issued a Final Rule for the “Medicare Shared Savings Program: Accountable Care Organizations.” The Final Rule follows the December 2014 Proposed Rule and the review of more than 270 public comments. The Medicare Shared Savings… Changes to Advanced Practice Nurse and Physician Assistant Laws
Utilization of advanced practice nurses, such as nurse practitioners, and physician assistants has been increasing over the past few years. Laws with respect to these health care providers have also changed, both on a Federal and State level. On May 4th, Governor Mike Pence signed into Indiana law… |
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