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House passes historic health care reform bill

Foley & Lardner LLP
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USA
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March 22 2010

After more than a year of negotiation, lobbying, and the highest political drama seen during the Obama administration, on Sunday, March 21, 2010, the U.S. House of Representatives passed two major pieces of legislation comprising an overhaul of the nation's health care system, on very tight margins and without any Republican support

Knowing retention of overpayments may now be a False Claims Act violation

Foley & Lardner LLP
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USA
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April 5 2010

Providers, suppliers, and Medicare and Medicaid managed care plans must now take much more expeditious action when they discover they have been overpaid by the Medicare or Medicaid programs

Health care reform legislation makes significant changes to Medicare reimbursement methods

Foley & Lardner LLP
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USA
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May 26 2010

On March 30, 2010, President Obama completed the enactment of federal health reform law by signing a package of reconciliation amendments to the Patient Protection and Affordable Care Act

CMS clarifies effective date of deemed compliance provisions: extra fraud, waste, and abuse training not required for Medicare providers

Foley & Lardner LLP
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USA
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May 11 2010

CMS has finally confirmed that Medicare Advantage and Part D plans should not be requiring special fraud, waste, and abuse (FWA) training for providers and suppliers (collectively, "providers") who enrolled in the Medicare program

PPACA will drive quality health care reform

Foley & Lardner LLP
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USA
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May 21 2010

Driven by years of widespread and highly publicized quality of care concerns and the pressing need to contain health care costs, the Patient Protection and Affordable Care Act (PPACA) contains numerous measures that seek to improve the quality of medical care while also lowering the rate of growth of health care expenditures

OIG raises concerns in management contracts for sleep labs and beyond

Foley & Lardner LLP
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USA
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November 22 2010

In two advisory opinions issued on October 28, 2010, the Department of Health & Human Services, Office of Inspector General (OIG) has fired a couple of shots across the bow at health care managers providing marketing services and also at the entire sleep lab industry

CMS letter recommends monthly screening of employees and contractors for federal health care program exclusions

Foley & Lardner LLP
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USA
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February 17 2010

Providers in many states should have received notices from state Medicaid agencies asking them to perform monthly checks of their employees and contractors to determine if they have been excluded from participation in federal health care programs

Backing up the wheelchair: CMS Proposed Rule withdraws, relaxes DMEPOS supplier standards

Foley & Lardner LLP
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USA
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April 5 2011

On April 4, 2011, CMS released a Proposed Rule revising and relaxing four of the 30 Medicare supplier standards applicable to suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS

CMS announces Part B rebilling demonstration project

Foley & Lardner LLP
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USA
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November 17 2011

On November 15, 2011, CMS announced a demonstration project whereby hospitals will be allowed to rebill under Part B, following a Recovery Audit Contractor (RAC) reopening and denial of inpatient hospital services, on the grounds that the services should have been furnished on an outpatient basis

The “3-Day DRG Payment Window”

Foley & Lardner LLP
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USA
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November 15 2011

On November 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for the 2012 Physician Fee Schedule, to be published in the Federal Register on November 28, 2011

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