Brian Lee on Health Care Providers

Potential Medicare Physician Fee Schedule Reform in the Last Weeks of the 118th Congress

A flurry of bills to reform the Medicare Physician Fee Schedule (PFS) faces the lame duck Congress. Our Health Care Group investigates how those reforms could take shape and which, if any, could find their way through the...more

12/5/2024 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare , Lame Duck Session , Legislative Agendas , Medicare , Physician Fee Schedule

Is Medicare Physician Fee Schedule Reform on the Horizon?

The decreasing value of Medicare reimbursements for physicians has caught the attention of a group of doctors in Congress. Our Heath Care Group explains how draft legislation would stabilize the Physician Fee Schedule (PFS)...more

10/31/2023 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Inpatient Prospective Payment System (IPPS) , Medicare , Physician Fee Schedule , Physicians

Provider Relief Fund Reconsideration Requests Nixed by Debt Limit Deal

Our Health Care Team eyes the abrupt end of payments to health care providers under the Provider Relief Fund. HRSA will no longer process or complete reconsideration requests....more

7/19/2023 / Health Care Providers , HRSA , Provider Relief Fund , Reporting Requirements

Provider Relief Fund Audit Season Is Here – Are You Ready?

Our Health Care Group analyzes why the Health Resources & Services Administration (HRSA) is flexing its auditing muscles and explores the implications for entities that received Provider Relief Funds and American Rescue Plan...more

6/5/2023 / American Rescue Plan Act of 2021 , Health Care Providers , HRSA , Provider Relief Fund , Reporting Requirements

The PRF Reporting Portal is Open – Key Takeaways from New Guidance

On June 30, 2021, the Health Resources and Services Administration (HRSA) opened the Provider Relief Fund (PRF) Reporting Portal, which providers who received PRF distributions will need to use to submit required information....more

7/6/2021 / Coronavirus/COVID-19 , Health Care Providers , HRSA , Provider Relief Fund , Reporting Requirements

Sequester Relief Extension Highlights Potential Reimbursement Cliff for Medicare Providers in 2022

Medicare providers face a nearly 10% reimbursement cut in 2022. Our Health Care Legislative & Public Policy Team does the math and explains how a combination of sequester cuts and expiring reimbursement support could bring a...more

4/23/2021 / Health Care Providers , Medicare , Provider Payments , Reimbursements , Sequestration

New Price Transparency Rules Finalized for Plans and COVID-19 Test Providers

As the hospital price transparency rule effective date approaches, the Administration has finalized new price transparency requirements for health plans and insurance issuers, as well as a requirement for COVID-19 test...more

11/13/2020 / Affordable Care Act , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Disclosure Requirements , Health Care Providers , Hospitals , Price Transparency , Virus Testing

HHS Announces $20 Billion Phase 3 General Distribution

Our Health Care Group reviews the nuances for eligibility and applying for the latest round of COVID-19 relief from the CARES Act’s Provider Relief Fund....more

10/5/2020 / CARES Act , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Health Care Providers , HRSA , Provider Relief Fund , Reporting Requirements

CMS Finalizes Price Transparency Hospital Requirements and Proposes Requirements for Health Plans

Our Health Care Group explains new rules (final and proposed) from the Centers for Medicare & Medicaid Services on pricing transparency for hospitals and cost-sharing information for health plans....more

11/18/2019 / Centers for Medicare & Medicaid Services (CMS) , Civil Monetary Penalty , Department of Health and Human Services (HHS) , Health Care Providers , PHSA

No Surprise, Congress Focuses on Surprise Billing

Despite partisan rancor in Congress over health care, one thing both parties agree on is that patients should not be surprised by an out-of-network health care bill. Our Employee Benefits & Executive Compensation and Health...more

6/10/2019 / Health Care Providers , Healthcare Costs , Hospitals , Out of Network Provider , Surprise Medical Bills

Updates on Biosimilar Reimbursement Pathways in the Face of a Changing Market

Though the biosimilars market has evolved, and more companies are seizing the opportunities, reimbursement regulations have been unclear at best. Our Health Care Group untangles the latest rules from the Centers for Medicare...more

1/25/2018 / Biosimilars , Centers for Medicare & Medicaid Services (CMS) , Food and Drug Administration (FDA) , Health Care Providers , Medicare , Medicare Part B , Medicare Part D , Pharmaceutical Industry , Prescription Drug Coverage , Prescription Drugs

Brian Lee

Alston & Bird

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