News & Analysis as of

Billing Healthcare Facilities

Baker Donelson

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

Baker Donelson on

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

J.S. Held

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

J.S. Held on

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

Clark Hill PLC

[Webinar] Telehealth Awareness Week - September 18th, 1:00 pm - 2:00 pm ET

Clark Hill PLC on

Join us for an insightful webinar as we delve into the ever-evolving landscape of telehealth in 2024. In this session, Carrie Foote and Paul Schmeltzer will explore the latest trends shaping telehealth, including advancements...more

Epstein Becker & Green

Navigating the New New York Department of Health Regulation on Facility Fees

Epstein Becker & Green on

Beginning June 21, 2023, New York State (NYS) Public Health Law (PHL) Section 2830 requires hospitals and healthcare professionals to provide written notice to patients before the patient is charged a facility fee....more

McDermott Will & Emery

Departments Release Update on No Surprises Act Independent Dispute Resolution Process

On April 27, 2023, The Departments of Health and Human Services (HHS), Labor, and the Treasury (the Departments) released a status update on the Federal Independent Dispute Resolution (IDR) Process, which covers the period...more

Health Care Compliance Association (HCCA)

[Event] 27th Annual Compliance Institute - April 23rd - 26th, Anaheim, CA

For over two and a half decades, the Compliance Institute (CI), has been HCCA’s primary educational and networking event for healthcare compliance professionals, offering attendees the latest in real-world compliance issues,...more

Proskauer - Health Care Law Brief

The Saga of the No Surprises Act Continues to be … Surprising

We previously noted that the regulations implementing the No Surprises Act (“NSA”) appeared to be inconsistent with the NSA because they seemed to establish the qualifying payment amount (“QPA”) as the appropriate payment...more

Goodwin

California Physicians Allege PE-Backed Provider Violates Corporate Practice Law

Goodwin on

On December 20, 2021, a group of emergency medicine physicians in California filed suit against a private equity-backed health care services company, claiming that (among other things), the company has run afoul of the...more

Tucker Arensberg, P.C.

2022 Medicare Rules for Facility-Based Split/Shared Visits

Tucker Arensberg, P.C. on

There has been much discussion and controversy over the new CMS position on billing for split/shared services in facility settings. As originally proposed, and starting in January 2022, if the service was shared among...more

Bass, Berry & Sims PLC

OIG Permits Physician-Employer to Retain Profits from Anesthesia Services Provided by CRNA in Physician Office and ASC

Bass, Berry & Sims PLC on

A pain management practice that employs a certified registered nurse anesthetist (CRNA) to provide anesthesia services in both an office location and an ambulatory surgery center (ASC) owned, in part, by the physician-owner...more

Cozen O'Connor

HHS, Treasury And Labor Release First Set Of Surprise Billing Rules

Cozen O'Connor on

The United States Departments of Health and Human Services, Treasury and Labor released interim final rules (“Rules”) regarding the “No Surprises Act” (“Act”) yesterday. The Rules are effective beginning on January 1, 2022....more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 25th Annual Compliance Institute - April 19th - 22nd, 9:30 am - 4:35 pm CDT

The Compliance Institute is celebrating 25 years! Join us for the Compliance Institute's 25th anniversary, April 19-22, 2021. This year, HCCA is excited to celebrate over two decades of compliance excellence with our...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2020 Virtual Regional Healthcare Compliance Conference - Louisville, KY - October 30th, 8:25 am - 4:30 pm EDT

Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2020 Virtual Regional Healthcare Compliance Conference - Louisville, KY - October 30th, 8:25 am - 4:30 pm EDT

Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more

Snell & Wilmer

The Supreme Court of Arizona Holds That Hospitals May Not Use Liens Against Third-Party Tortfeasors to Balance Bill Medicaid...

Snell & Wilmer on

On March 9, 2020, the Supreme Court of Arizona issued its ruling in Ansley, et al. v. Banner Health Network, et al., 2020 WL 1126300 (2020), finding that hospitals may not utilize Arizona Revised Statutes § § 33-931(A) and...more

Mintz - Health Care Viewpoints

New Jersey Regulates Out-Of-Network Billing

News alert for all New Jersey health care providers! A new law went into effect yesterday (August 30, 2018) that changes billing requirements for out-of-network services in New Jersey. Known as the “Out-of-Network Consumer...more

Nossaman LLP

Is Your Surgery Center Ready for California’s Surprise Medical Billing Law?

Nossaman LLP on

A new California law (AB 72) limits the amount that out-of-network surgeons and other health care professionals may bill patients for covered non-emergency services provided at a contracted facility, such as an ambulatory...more

Hogan Lovells

"Double Dip" Effectively Approved by Center for Medicare and Medicaid Services

Hogan Lovells on

Last week the Centers for Medicare and Medicaid Services (CMS) issued Release No. 104 to Manufacturers and Release No. 180, which invalidated earlier agency releases addressing the treatment under the Medicaid drug rebate...more

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