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Jury ruled in Tuomey Healthcare retrial that the hospital violated the Stark Law and False Claims Act
- King & Spalding LLP
- -
- USA
- -
- May 13 2013
On May 8, 2013, a jury concluded that Tuomey Healthcare System, Inc. (Tuomey), a community hospital in Sumter, S.C., violated the Stark Law for
CMS proposes additional incentives to reduce Medicare fraud including increase to reward for reporting fraud
- King & Spalding LLP
- -
- USA
- -
- April 29 2013
On April 24, 2013, CMS issued a proposed rule that would further incentivize Medicare beneficiaries and other individuals to report suspected
OIG concludes in nationwide review of drug that Herceptin has often been overbilled
- King & Spalding LLP
- -
- USA
- -
- January 28 2013
The HHS OIG has conducted a nationwide audit of the use and reimbursement of Herceptin (also known as trastuzumab), a Medicare-covered drug used to
Congressional Budget Office releases significantly higher estimate of sustainable growth rate calculated to include the final CY 2013 Physician Fee Schedule
- King & Spalding LLP
- -
- USA
- -
- November 26 2012
On November 1, 2012, CMS announced the Physician Fee Schedule rates for 2013, implementing a 26.5 percent rate reduction required under the sustainable growth rate (SGR) formula
Proposed settlement of Medicare class action could impact chronic care benefits
- King & Spalding LLP
- -
- USA
- -
- October 29 2012
On October 16, 2012, representatives of the parties in the nationwide class action lawsuit styled, Glenda Jimmo, et. al vs. Kathleen Sebelius filed a proposed legal settlement with the chief judge of the Federal District Court in Vermont in an effort to resolve the lawsuit
U.S. representative calls for federal investigation of hospital auditors
- King & Spalding LLP
- -
- USA
- -
- August 20 2012
U.S. Representative Dan Boren (D-OK) is calling for a federal investigation of CMS Recovery Audit Contractors (RACs) that audit hospitals' Medicare billing
FY 2013 final Medicare payment rules for inpatient acute care hospitals
- King & Spalding LLP
- -
- USA
- -
- August 6 2012
On August 1, 2012, CMS issued the final rule on Medicare hospital inpatient prospective payment systems for operating and capital-related costs of acute care hospitals for FY 2013
CMS solicits comments regarding patient inpatientoutpatient status for purposes of Medicare payment
- King & Spalding LLP
- -
- USA
- -
- July 23 2012
On July 6, 2012, CMS released the Hospital Outpatient Prospective Payment Proposed Rule (CMS-1589-P
CMS publishes final rule on reconsideration process for disallowances of claims for FFP under Medicaid and CHIP
- King & Spalding LLP
- -
- USA
- -
- June 4 2012
On May 29, 2012, CMS issued a final rule implementing a new reconsideration process for administrative review of disallowances of Federal Financial Participation under title XIX of the Social Security Act and extending the period states have to credit the federal government for identified but uncollected Medicaid overpayments
HHS files petition to Supreme Court on equitable tolling issue in Medicare reimbursement cases
- King & Spalding LLP
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- USA
- -
- April 23 2012
On April 13, 2012, Health and Human Services Secretary Kathleen Sebelius filed a petition for writ of certiorari with the U.S. Supreme Court requesting that the Court overturn the D.C. Circuit’s ruling that equitable tolling applies to the 180-day time limit for providers to file administrative appeals of final Medicare cost report payment determinations
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- Firm Name - King & Spalding LLP
- Author - Juliet M. McBride