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Maria E. Gonzalez Knavel

Foley & Lardner LLP

Articles

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Medicare issues final rules for hospital outpatient and ambulatory surgery center payment systems

USA - December 7 2012 On November 15, 2012, the Centers for Medicare and Medicaid Services published in the Federal Register final rules that would, among other things, update payment policies and rates under the Outpatient Prospective Payment System and the Ambulatory Surgery Center Payment System for Calendar Year 2013....

Judith A. Waltz, Jeffrey R. Bates, Donald H. Romano.

Introduction of the private-public partnership and the future of fraud claims

USA - July 30 2012 On July 26, 2012, the U.S. Department of Health and Human Services and the U.S. Attorney General’s Office announced that the federal government is creating a partnership with private payers and other state and private entities to attack health care fraud....

R. Michael Scarano Jr, Judith A. Waltz, Lisa M. Noller, Torrey K. Young.

Medicare program issues proposed rule for acute and long-term care hospital Inpatient Prospective Payment Systems for fiscal year 2013

USA - May 21 2012 On May 11, 2012, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register a proposed rule that would, among other things, update payment policies and rates for acute care hospitals paid under the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2013....

Jeffrey R. Bates, Donald H. Romano.

OIG and CMS focus on the identification and reduction of potential fraud and abuse in the Medicare Advantage Program

USA - February 29 2012 On February 24, 2012, the Department of Health and Human Services Office of the Inspector General (OIG) published the results of its study entitled “Medicare Advantage Organizations’ Identification of Potential Fraud and Abuse” (Study)....

R. Michael Scarano Jr, Judith A. Waltz, Jay Mark Waxman.

CMS announces Part B rebilling demonstration project

USA - 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....

Judith A. Waltz, Lawrence W. Vernaglia, Jeffrey R. Bates, Chris E. Rossman, Donald H. Romano.