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Bridgette A. Keller


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CMS Proposes Changes to Medicare Advantage Program for CY 2020

USA - February 5 2019 CMS recently proposed several important changes for the Medicare Advantage ("MA") program that relate to payment, benefit design, and new actions to...

Xavier G. Hardy.

DOJ Follows Through on a 2018 New Years’ Resolution: Rein In Qui Tam Actions

USA - December 20 2018 Along with most of us, last January DOJ set its own goals for 2018: new policies related to False Claims Act (“FCA”) enforcement. One such...

Laurence J. Freedman.

OIG Says Proposed MCO Incentive Program Protected by AKS Safe Harbor

USA - November 19 2018 In its favorable Advisory Opinion 18-11, the OIG explains how a managed care organization’s proposed incentive program to pay network providers to...

The 2014 Overpayment Rule is Vacated: How We Got Here and Key Takeaways

USA - September 26 2018 Medicare Advantage Organizations (MAOs) have been hailing a federal judge’s recent ruling to vacate the 2014 Overpayment Rule. But, how did we get...

New Jersey Regulates Out-Of-Network Billing

USA - August 31 2018 News alert for all New Jersey health care providers! A new law went into effect yesterday (August 30, 2018) that changes billing requirements for...

Hope S. Foster, Nili S. Yolin.