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CMS publishes final rule implementing PPACA anti-fraud provisions, announces government’s enforcement efforts resulted in recovery of over $4 billion in FY 2010

USA - January 31 2011 On January 24, 2011, the U.S. Department of Health and Human Services (HHS) published rules implementing anti-fraud provisions of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act (PPACA) (the Final Rule).

Charles E. Smith

OMHA announces award of ECAPE contract

USA - April 20 2015 The Office of Medicare Hearing and Appeals (OMHA) announced April 14, 2015 that the development contract for the Electronic Case Adjudication and…

OIG issues unfavorable Advisory Opinion on proposal for exclusive laboratory services arrangements

USA - March 30 2015 On March 25, 2015, the U.S. HHS Office of Inspector General (OIG) released an unfavorable Advisory Opinion in which it found that it could potentially…

MedPAC recommends reduction in HOPD reimbursement

USA - January 17 2012 On January 12, 2012, the Medicare Payment Advisory Commission (MedPAC) recommended that reimbursement to hospital outpatient departments (HOPDs) for evaluation and management (E&M) services be reduced to equal payment for E&M services under the physician fee schedule (PFS).

OMB posts receipt of CMS proposed physician “sunshine” rule

USA - November 28 2011 On November 17, 2011, the White House Office of Management and Budget (the OMB) posted receipt of a CMS proposed rule titled “Transparency Reports and Reporting of Physician Ownership of Investment Interests (CMS-5060-P).” 

Seth H. Lundy