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Medicare’s Recovery Audit Contractor program: RAC reviews and appeals

Haynes and Boone LLP
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USA
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June 3 2009

In order to ensure accurate payments under the Medicare fee-for-service program, the Centers for Medicare & Medicaid Services ("CMS") has implemented the Recovery Audit Contractor (RAC) program

ACOs face large start-up costs, uncertain savings and possible losses under proposed rules from CMS

Haynes and Boone LLP
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USA
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April 4 2011

Accountable Care Organizations (ACOs) will face large start-up costs under proposed rules issued on March 31, 2011 by the Centers for Medicare and Medicaid Services (CMS), with an uncertain outlook for savings and even possible losses

Office for Civil Rights announces fines for violations of HIPAA privacy rule

Haynes and Boone LLP
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USA
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March 15 2011

The Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services has recently announced two significant enforcement actions against health care providers for violating the HIPAA Privacy Rule

Criminal case against healthcare executive dismissed; government likely to continue aggressive enforcement efforts

Haynes and Boone LLP
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USA
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May 12 2011

A former GlaxoSmithKline attorney, Lauren Stevens, was acquitted on May 10 of all criminal charges stemming from her response to an FDA investigation

Will Pioneer ACOs come to the rescue, or is the government rearranging deck chairs on the Titanic?

Haynes and Boone LLP
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USA
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May 19 2011

The Centers for Medicare and Medicaid Services (CMS) announced the creation of so-called "Pioneer ACOs" on May 17 in an attempt to blun heavy criticism over the draft regulations on Accountable Care Organizations (ACOs) issued on March 31, 2011 (the "Draft Regulations"

Despite minor modifications in final rules, ACOs still face large start-up costs and uncertain savings

Haynes and Boone LLP
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USA
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October 28 2011

Under final rules issued by the Centers for Medicare and Medicaid Services, Accountable Care Organizations will continue to face large start-up costs and uncertain savings, despite a decreased regulatory scheme and increased financial incentives

Medicare EHR Incentive Program starts attestation phase: physicians and hospitals to share $27 billion beginning May 2011

Haynes and Boone LLP
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USA
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April 20 2011

On April 18, 2011, the Centers for Medicare and Medicaid Services (CMS) began the attestation phase under its $27 billion Medicare EHR Incentive Program

FTC orders Texas doctors' group to cease joint price negotiations with insurers

Haynes and Boone LLP
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USA
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May 13 2011

Southwest Health Alliance ("Southwest"), an independent practice association with approximately 900 member physicians, has agreed to a proposed order recently entered by the Federal Trade Commission ("FTC") settling charges that it engaged in anticompetitive conduct in its dealings with insurers and other payors for the provision of physician services (collectively, "insurers" or "payors"

Appeals court overturns $44 million judgment against Tuomey Hospital in important Stark Law case

Haynes and Boone LLP
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USA
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April 4 2012

The U.S. Fourth Circuit Court of Appeals has reversed a $44 million judgment against Tuomey Hospital in Sumter, South Carolina that arose from Tuomey’s employment arrangements with physicians that allegedly violated the federal Stark Law