News & Analysis as of

Appeals Compliance Medicare

Skadden, Arps, Slate, Meagher & Flom LLP

First Circuit Demands ‘But For’ Causation Between Alleged Kickback and Claim Submission

On February 18, 2025, a panel of the U.S. Court of Appeals for the First Circuit unanimously decided that in order to transform an Anti-Kickback Statute (AKS) violation into a false or fraudulent claim for purposes of False...more

Goldberg Segalla

CMS Issues Alert & WCMSA User Guide Update; Positive Changes Expedite Allocation Practice

Goldberg Segalla on

Beginning April 7, the Centers for Medicare & Medicaid Services (CMS) will eliminate its one-year waiting period for Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Amended Review requests. Instead, CMS will...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 30. News Briefs: August 2020

Report on Medicare Compliance 29, no. 30 (August 24, 2020) - A federal court on Aug. 17 blocked HHS from enforcing its revised definition of sex discrimination in Sec. 1557, which prohibits discrimination on the basis of...more

Health Care Compliance Association (HCCA)

[Event] Clinical Practice Compliance Conference - October 27th-29th, Nashville, TN

Our annual Clinical Practice Compliance Conference provides information about the latest government initiatives related to physicians and clinics. Unite with your colleagues to discuss strategies for facing compliance issues...more

King & Spalding

AseraCare Case Illustrates the Importance of Internal Compliance

King & Spalding on

On September 9, 2019, the Eleventh Circuit issued a highly anticipated opinion addressing the question of when Medicare claims for reimbursement (in this case, claims for hospice care) can be considered “false” under the...more

Baker Donelson

"The Stark Law has become a booby trap…" Says the Federal Appeals Court. Why Health Care Providers Should Heed the Warning

Baker Donelson on

After reading through the hundreds of pages of the District Court's and Appeals Court's decisions, including the recent Fourth Circuit Court of Appeals decision that was filed on July 2, 2015, one thing is certain: Mixing one...more

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