News & Analysis as of

Billing

Baker Donelson

OIG Advisory Opinion 25-08: Unfavorable DME – Vendor Payment Arrangement

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On July 1, 2025, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion 25-08, an unfavorable opinion discussing a proposed arrangement in which a medical device company...more

Jones Day

Avianca: Second Court Adopts "Billing Date" Approach to Timely Performance of Unexpired Commercial Personal Property Leases in...

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In 1984 and 1994, Congress amended the Bankruptcy Code to add protections for commercial real property and equipment lessors. Those provisions—sections 365(d)(3) and section 365(d)(5), respectively—generally require a...more

ArentFox Schiff

Navigating OIG’s Advisory Opinion on Medical Device Billing Arrangements and Anti-Kickback Statute Risks

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On July 1, the US Department of Health and Human Services’ Office of Inspector General (OIG) released Advisory Opinion No. 25-08, issuing an unfavorable determination regarding a proposed arrangement in which a medical device...more

Husch Blackwell LLP

OIG Announces 2025 Work Plan Review: What Clinical Laboratories Need to Know About Medicare Payments for Diagnostic Lab Tests

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In June 2025, the U.S. Department of Health and Human Services Office of Inspector General (OIG) announced a new item in its Work Plan: “Medicare Payments for Clinical Diagnostic Laboratory Tests in 2024.” This annual review,...more

Patterson Belknap Webb & Tyler LLP

There’s no Escaping the Public Eye: Judge Figueredo Denies EscapeX IP’s Motion to Seal, and Orders Google’s Previously Sealed...

United States Magistrate Judge Figueredo recently denied Plaintiff EscapeX IP, LLC’s (“EscapeX”) efforts to seal its objections to billing records Defendant Google LLC (“Google”) had originally filed under seal in connection...more

Davis Wright Tremaine LLP

Two California Appellate Decisions Highlight Liability Risks Arising From Hospital "Conditions of Admission" Forms and Billing...

In the ever-evolving world of healthcare billing, two recent reported California appellate court decisions, Naranjo v. Doctors Medical Center of Modesto and Dameron Hospital Association v. Progressive Casualty Insurance...more

Marshall Dennehey

Commonwealth Court Rejects Insurer’s Reimbursement Claim Against Pharmacy in Billing Dispute

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Pioneer Construction Company, Inc., Eastern Alliance Insurance Company, and employers Alliance, Inc. v. Insight Pharmaceuticals, LLC d/b/a Insight Pharmacy; No. 867 C.D. 2022; filed May 12, 2025; Judge Covey - A workers’...more

Epiq

Managing Client Expectations in a Transforming Legal Market

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At the ALA National Conference in Nashville, a timely panel brought together operational leaders to explore the evolving expectations of law firm clients. The session, titled “Evolving Client Expectations,” featured senior...more

Hendershot Cowart P.C.

Legal Remedies for Physicians When Medical Billing Companies Fail to Perform

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For physicians with independent practices, engaging a third-party billing company to manage the billing process is an attractive option. Medical billing is increasingly complex and time consuming, and outsourcing that...more

ArentFox Schiff

Dispute Not Resolved: BCBSGA Sues Providers for Alleged Misuse of NSA Arbitration Process

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On May 27, Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSGA) filed a lawsuit in the Northern District of Georgia US District Court, alleging that a group of health care providers, along with their third-party...more

Mitratech Holdings, Inc

5 Signs Your Legal Billing Needs a Reset

Legal billing has always been complex, but over the past year, it has become even more critical for legal departments to manage with care. The Association of Corporate Counsel (ACC) reports that spending on outside...more

J.S. Held

All Is Not What It Seems, Or When Is A Dollar A Dime?

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Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - July 21st - 24th, Nashville, TN

Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more

Health Care Compliance Association (HCCA)

Top Healthcare Compliance Priorities for 2025

Recently Protiviti released an intriguing report: Top Compliance Priorities for U.S. Healthcare Organizations in 2025. In this podcast their Global Healthcare Compliance Leader, Leyla Erkan, CHC, CHP, CHRC, shares some of the...more

Esquire Deposition Solutions, LLC

Who Should Benefit from AI in Depositions: The Client, the Law Firm, or Both?

The American Bar Association’s suggestion last year that it would be ethically problematic for lawyers to charge high fees for formerly time-intensive work made easy by generative artificial intelligence has prompted an...more

McGuireWoods LLP

DOJ Targets Neurofeedback Billing in $15 Million Behavioral Health Fraud Case

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On March 6, 2025, federal prosecutors charged a Minnesota couple — Gabriel Adam Alexander Luthor and Elizabeth Christine Brown — with orchestrating a $15 million healthcare fraud scheme involving overbilling and submission of...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - June 9th - 12th, Pittsburgh, PA

Ideal for practitioners who want to build strong foundational knowledge of compliance program management in a healthcare setting and how to apply that knowledge in practice. Attendees will come away better prepared to...more

J.S. Held

Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review

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In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround...more

Tyson & Mendes LLP

Civil Procedure Updates to Know in New York for 2025

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In 2025, get ready for a whirlwind of updates across the state. From personal jurisdiction to discovery and beyond, some recent cases are shifting the landscape in New York. Read below to find out what happened and learn the...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Research Compliance Academy - March 24th - 27th, Chicago, IL

HCCA's Healthcare Research Compliance Academy is a three-and-a-half-day interactive educational program with a focus on the highly specialized and complex regulations and issues that affect research compliance professionals....more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - March 24th - 27th, Chicago, IL

Ideal for practitioners who want to build strong foundational knowledge of compliance program management in a healthcare setting and how to apply that knowledge in practice. Attendees will come away better prepared to...more

McDermott Will & Emery

OIG Nursing Facility Compliance Program Guidance: Renewed Focus on Fraud and Abuse

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The US Department of Health and Human Services Office of Inspector General’s (OIG’s) release of Nursing Facility Industry Segment-Specific Compliance Program Guidance (ICPG) for the first time since 2008 reemphasizes the...more

Bodman

Resolutions for Healthcare Providers: Part 2 of 2 – Compliance Plans, Risk Assessments, and Improved Workflows

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As the new year continues, it is useful to review your practice’s processes and policies to ensure that the practice operates with efficiency and remains compliant with ever-changing healthcare regulations....more

Pierce Atwood LLP

Latest Updates on Maine’s Net Energy Billing Program

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Recent decisions by the Maine Legislature and the Maine Public Utilities Commission (PUC) may affect participants in Maine’s Net Energy Billing (NEB) Program...more

Health Care Compliance Association (HCCA)

[Event] Research Compliance Conference - June 2nd - 4th, Orlando, FL

Get the latest insights in research compliance - The risks and challenges that come with clinical research are unique, as are the abundance of government regulations and enforcers that oversee them. HCCA’s Research...more

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