Medical providers, including individuals, physician groups, hospitals, surgery centers, health systems and other health care facilities, may be eligible for a portion of a $2.8 billion settlement reached by the Blue Cross...more
2/25/2025
/ Antitrust Division ,
Antitrust Litigation ,
Blue Cross ,
Blue Shield ,
Class Action ,
Competition ,
Compliance ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Facilities ,
Physicians ,
Settlement
On October 9, 2019, the Centers for Medicare and Medicaid Services (“CMS”) proposed sweeping changes to the federal Physician Self-Referral Law, commonly referred to as the Stark Law. While many of the changes reflect CMS’...more
12/30/2019
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Physician Compensation Arrangements ,
Physicians ,
Regulatory Reform ,
Regulatory Requirements ,
Rulemaking Process ,
Stark Law
Lawmakers in both the United States House and Senate are considering two proposals to address unexpected, patient medical bills from out-of-network providers. Often referred to as “surprise medical bills” or “balance...more
Several studies show that the total cost of losing an employee can range from tens of thousands of dollars to 150 percent of the employee’s annual salary. There are also the “soft costs” of losing an employee, including lost...more
If the 2017 healthcare environment could be summed up in one word, it would be “uncertainty.” With the largely unexpected election of Donald Trump as President, the multiple, unsuccessful attempts by the Republican controlled...more
12/18/2017
/ Affordable Care Act ,
Bundled Payments ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Opioid ,
Pain Management Clinics ,
Physicians ,
Trump Administration
The following is the third installment of a three-part series discussing important provisions in physician employment agreements.
When a physician leaves a medical practice, especially if the physician stays in the area to...more
The following is the second installment of a three-part series discussing important provisions in physician employment agreements.
When a physician leaves a medical practice, especially if the physician stays in the area...more
The following is the first installment of a three-part series discussing important provisions in physician employment agreements.
When a physician leaves a medical practice, especially if the physician stays in the area...more
Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more
12/12/2016
/ 60-Day Rule ,
Affordable Care Act ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Data Breach ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Fraud ,
HIPAA Breach ,
Hospitals ,
Implied Certification ,
Long Term Care Facilities ,
Medicaid ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
OIG ,
Overpayment Recovery Time Limits ,
PHI ,
Physicians ,
Popular ,
Premiums ,
Provider Payments ,
Quality Payment Program (QPP) ,
Trump Administration ,
Universal Health Services Inc v United States ex rel Escobar ,
Value-Based Payments
Since the enactment of the net investment income tax ("NIIT") in 2012, physicians and other taxpayers owning multiple business interests have had to make educated choices based upon accounting projections and SWAGS when...more
Driven by Federal Health Care Reform and a desire to remain independent of hospitals and health care systems, physician groups are actively exploring different collaborative and alignment options, including the formation of...more