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CMS Proposes to Revamp Medicare Reimbursement for Evaluation and Management Services: Trading One Controversy for Another?

USA - August 3 2018 Evaluation and management (“E & M”) services furnished in offices or in outpatient settings account for approximately 20 percent of all Medicare Part…

The Sunshine Act also rises: one more chance for medical device manufacturers to prepare

USA - September 14 2012 The Physician Payment Sunshine Act, which was incorporated into Section 6002 of the Affordable Care Act, requires pharmaceutical, medical device, biological and medical supply manufacturers to file annual reports on payments to physicians and teaching hospitals.

Supreme Court opinion in Sebelius v. Auburn Regional Medical Center rejects a challenge by hospitals to Medicare's SSI fraction calculation

USA - January 24 2013 A unanimous Supreme Court has issued its opinion in Sebelius v. Auburn Regional Medical Center, No. 11-1231 (Jan. 22, 2013), rejecting a challenge by…

Stuart M. Gerson

OMHA’s Medicare Appellant Forum offers few meaningful answers for frustrated Medicare providers and suppliers

USA - March 3 2014 On February 12, 2014, the Office of Medicare Hearings and Appeals ("OMHA") hosted a Medicare Appellant Forum ("Forum") to address its current backlog…

Amy F. Lerman

OIG Issues a Final Rule Designed to Advance the Transition to Value-Based Care and Modernize the Regulatory Framework

USA - December 3 2020 On December 2, 2020, the Department of Health and Human Services ("HHS") Office of Inspector General ("OIG") and the Centers for Medicare & Medicaid…

David E. Matyas, Jason E. Christ, Anjali N.C. Downs, Karen Mandelbaum, Teresa A. Mason, Jennifer E. Michael, Victoria Vaskov Sheridan, Carrie Valiant, Lesley R. Yeung