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Reimbursement Issues Worth Noting: Administrative Law and False Claims Act Implications
  • Epstein Becker Green
  • USA
  • October 1 2018

News of two distantly related reimbursement issues with administrative law and False Claims Act (“FCA”) implications is worth noting. OIG Study Raises

HHS-OIG Work Plan - Medicare Advantage
  • Epstein Becker Green
  • USA
  • September 24 2018

Providers, plans, and vendors that provide services under the Medicare Advantage program, should be aware that the Office of Inspector General (“OIG”)

California Court Endorses Percentage Billing Fees for Medi-Cal Providers
  • Buchalter
  • USA
  • April 9 2018

California's First District Court of Appeal ("Court of Appeal") has recognized that percentage-based billing arrangements do not violate California's

CFPB Requests Public Comments Regarding Its Use of Civil Investigative Demands
  • Troutman Sanders LLP
  • USA
  • January 25 2018

On January 24, the Consumer Financial Protection Bureau (CFPB) published a request for public comments on its use of Civil Investigative Demands or

OIG Report Highlights Impact of Improper Drug Classification
  • Arent Fox LLP
  • USA
  • January 12 2018

In late December 2017, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) released the findings of a report

Court Walks Back Ruling That Would Require Laboratories to Independently Verify Medical Necessity
  • Sidley Austin LLP
  • USA
  • December 15 2017

Clinical laboratories stand in a position of tension: although laboratory tests must be medically necessary to be reimbursable by federal healthcare

Health Law Update - June 15 ,2017
  • Baker & Hostetler LLP
  • USA
  • June 15 2017

Senate Republicans continue intra-party discussions on changes to House-passed legislation replacing the Affordable Care Act (ACA), but the lack of

Strategic Perspectives: Government Rekindles Concerns about CMS' MAO Overpayments
  • Pietragallo Gordon Alfano Bosick & Raspanti LLP
  • USA
  • May 22 2017

CMS estimated improper payments to Medicare Advantage Organizations (MAOs) to be 9.5 percent or $14.1 billion based on a national audit that reviewed

Avoiding Fraud and Abuse in Health Care Lending Arrangements
  • Epstein Becker Green
  • USA
  • May 10 2017

A recent settlement demonstrates the importance of compliant structuring of lending arrangements in the health care industry. The failure to consider

Additional Details Not Sufficient To Save Complaint From Public Disclosure Bar
  • Sidley Austin LLP
  • USA
  • March 27 2017

On March 22, 2017, the District Court for the Northern District of California dismissed a False Claims Act, 31 U.S.C...