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Centers for Medicare & Medicaid Services (CMS) Dispute Resolution

McDermott+

Breaking Down the New No Surprises Act FAQs Post-TMA III (June 2025 Update)

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UPDATE: On May 30, 2025, the Fifth Circuit granted the TMA III plaintiffs’ petition for rehearing en banc, which was previously filed on December 16, 2024. Of note, the Fifth Circuit’s mandate has not yet been issued, so as a...more

Jenner & Block

The Importance of Drafting Precise Earnout Provisions in M&A Transactions

Jenner & Block on

In spring 2019, Pacira Biosciences, Inc. (Pacira) acquired MyoScience, Inc. (MyoScience). At the time of the merger, MyoScience only had one product, called “iovera,” which is a handheld device used primarily for pain relief....more

McDermott+

Breaking Down the New No Surprises Act FAQs Post-TMA III

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On January 14, 2025, the US Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM), jointly issued Part 69 of a series of...more

McDermott+

No Surprises Act Implementation Under the Trump Administration

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The No Surprises Act, a law that ended the practice of “balance billing” by certain out-of-network providers, was enacted as part of the Consolidated Appropriations Act of 2021 on December 27, 2020. While the law passed...more

McDermott+

Regs Coming Through the End of the Year: Expect the Expected and the Unexpected

McDermott+ on

There could be an all-you-can-eat buffet of regs (and eggs) from now until the end of the year! As you may recall, a July 2024 Regs & Eggs blog post highlighted the spring 2024 “unified agenda” that listed all the regs...more

McDermott+

No Surprises Act Implementation Bumpy Period Reaches One-Year Mark

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We are now in September! And while many folks are thinking about how summer has come and gone so quickly, those following the No Surprises Act implementation process may also be wondering how a whole year has passed since the...more

King & Spalding

The Fifth Circuit Affirms Decision Vacating CMS Regulations Implementing the No Surprises Act IDR Process

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On August 2,2024, the Fifth Circuit affirmed the vacatur of federal rulemaking related to the No Surprises Act’s (NSA) Independent Dispute Resolution (IDR) process. The Court held that the No Surprises Act does not permit the...more

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | April 2024 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for April 2024. We discuss several US Department of Health and Human Services (HHS) agency actions, including the Calendar Year (CY) 2025...more

Hall Benefits Law

Federal Agencies Issue Final Rules on Federal IDR Process Administrative Fee and Certified Entity IDR Fee Ranges

Hall Benefits Law on

The Internal Revenue Service, Employee Benefits Security Administration, and the Centers for Medicare & Medicaid Services (collectively, “the Departments”) recently issued final rules concerning fees established by the No...more

American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

Holland & Knight LLP

Holland & Knight Health Dose: January 24, 2024

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

King & Spalding

CMS Makes Several Updates to the Federal Independent Dispute Resolution (IDR) Process

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Over the past month, CMS announced several updates to the Federal No Surprises Act IDR Process. On December 15, 2023, the Federal IDR portal was re-opened for all remaining disputes. The portal is now open for all disputes...more

McDermott+

Navigating the New IDR Batching Rules and Deadline Extensions

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If you have been following the implementation of the No Surprises Act independent dispute resolution (IDR) process, you have likely seen a bunch of new rules, guidance documents and deadline extensions come out recently and...more

McDermott+

McDermottPlus Check-Up: November 3, 2023

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CONGRESS - House Ways & Means Chair Smith, House Energy & Commerce Chair Rodgers and Senate Finance Ranking Member Crapo Call for Withdrawal of Nurse Staffing Mandate. Rep. Smith (R-MO), Rep. Rodgers (R-WA) and Sen. Crapo...more

ArentFox Schiff

No More Surprise Medical Bills: Providers Score Yet Another Victory as Texas Court Again Vacates Provisions of Biden...

ArentFox Schiff on

On August 24, 2023, health care providers in Texas scored yet another victory when a federal court vacated additional portions of the Biden Administration’s rulemaking under the federal No Surprises Act (the Act). This marked...more

Foley & Lardner LLP

The No Surprises Act: A District Court’s Decision Results in Federal IDR Outage

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Although the No Surprises Act was signed into law almost three years ago and has been in effect for the past year and a half, there have been numerous delays in implementation and execution due to the complexity of elements...more

Tucker Arensberg, P.C.

CMS Halts “No Surprises Act” Arbitration

Tucker Arensberg, P.C. on

CMS has halted the arbitration process for “Surprise Billing” established by the “No Surprises Act” for the second time, stating as follows...more

Husch Blackwell LLP

Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences

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Hospices have been the target of increased government scrutiny in 2023, and the Centers for Medicare and Medicaid Services (CMS) is planning to take further aim in 2024 through surveys. Join Husch Blackwell’s Meg Pekarske,...more

Venable LLP

A Proposed New Regulatory Environment for Medicare Hospice Providers: Application of the 36-Month Rule, Increasing Enrollment...

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On July 10, 2023, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) that would (i) include hospices in the 36-month rule ownership transfer restrictions that currently exist for home...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - May 2023

The May Monthly Minute examines a recent Seventh Circuit decision upholding unambiguous plan language against class action attack, the status of the federal IDR process under the No Surprises Act, and the DOL’s recent...more

Foley & Lardner LLP

Key Takeaways from the Foley/PYA “Let’s Talk Compliance” 2-Day Virtual Conference

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Session #1: State of the Healthcare Industry Effective Compliance Plans and Enforcement Trends - In their discussion of compliance program effectiveness and enforcement, attorneys Kolarik and Waltz and Ms. Sumner...more

Holland & Knight LLP

Holland & Knight Health Dose: December 6, 2022

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include: -...more

Hogan Lovells

340B Program: HRSA Proposes to Modify Administrative Dispute Resolution Process

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On November 30, 2022, the Health Resources and Services Administration (HRSA) published a proposed rule (Proposed Rule) in the Federal Register that proposes to introduce several changes to the current administrative dispute...more

Holland & Knight LLP

Holland & Knight Health Dose: November 29, 2022

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include . . ....more

Maynard Nexsen

No Surprises Act Updates – New Final Rule, CMS Resources and New FAQs

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On August 19, 2022, the United States Department of Health and Human Services, Department of Labor, and Department of the Treasury (the Departments) published a new final rule (Final Rule) under the federal No Surprises Act,...more

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