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Health Insurance › Billing › Centers for Medicare & Medicaid Services (CMS)

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

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

Butler Snow LLP

Prior Authorization Reform in Healthcare: Winds of Change?

Butler Snow LLP on

Bob Dylan, winner of the Nobel Prize in Literature and one of the greatest American songwriters of all time, has effectively used wind as a metaphor in a number of songs he has written, each with its own distinct message....more

Robinson+Cole Health Law Diagnosis

OIG Issues Reports Reviewing Laboratory Billing Practices and Noting Increased Spending by Medicare Part B on Laboratory Tests

Robinson+Cole Health Law Diagnosis on

As the year comes to a close, the government has signaled a specific focus on clinical laboratories for 2023.  On December 6, 2022, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) issued...more

Winstead PC

[Webinar] Corinne Smith to Moderate CPE and CLE Credited Coding Webinar: "Changes to Outpatient Evaluation and Management (E/M)...

Winstead PC on

Is your practice ready for coming changes to E/M coding? The Centers for Medicare & Medicaid Services (CMS), Current Procedural Terminology (CPT) and American Medical Association (AMA) will implement significant changes to...more

Stinson LLP

2017 OPPS Final Rule: Payment to Off-Campus Provider-Based Departments

Stinson LLP on

On November 1, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the 2017 Medicare Outpatient Prospective Payment System (OPPS) Final Rule. One aspect of this rule is the implementation of payment decreases for...more

Foley Hoag LLP

New Rule Permits CMS to Revoke Medicare Billing Privileges for Providers/Suppliers with “Pattern or Practice” of Denied Claims

Foley Hoag LLP on

On December 5, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule titled “Requirements for Medicare Incentive Reward Program and Provider Enrollment” (“the Rule”). The Rule implemented several...more

Faegre Drinker Biddle & Reath LLP

Bundling Gains Momentum, Even as New Study Raises Questions

Faegre Drinker Biddle & Reath LLP on

Health care cost bundling—the aggregating of all the costs of an episode of medical care into a single bill—seems to be here to stay. After all, it’s the way most all other billing is done. When your car is serviced, you...more

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