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McDermott+

September 2025 CPT Editorial Panel meeting: what’s on the agenda and why it matters

McDermott+ on

The American Medical Association (AMA) CPT®* Editorial Panel will convene in Chicago, Illinois, from September 18 to 20, 2025. The meeting agenda includes proposals to create new current procedural terminology (CPT) codes and...more

Bradley Arant Boult Cummings LLP

Third Circuit Finds Documentation Issues May Be “Material” under the FCA

Bradley Arant Boult Cummings LLP on

On August 25, 2023, the Third Circuit continued its trend of rulings unfavorable to FCA healthcare defendants in the latest appeal of U.S. ex rel. Druding et al. v. Care Alternatives et al., No. 22-1035, 2023 WL 5494333 (3d...more

Health Care Compliance Association (HCCA)

Enforcement actions relating to a lack of medical necessity

Health Care Compliance Association (HCCA) on

In a climate of shrinking margins, diminishing reimbursement, and frequent denials, healthcare organizations may make efforts to increase the volume of services they provide, especially those that are more profitable. Of...more

Pullman & Comley - Connecticut Health Law

Significant 2022 Connecticut Health Law Cases

Pullman & Comley - Connecticut Health Law on

Significant health care cases of 2022 included a surprise billing unfair trade practices case, a class action recognizing a patient’s constitutionally protected interest in their inpatient classification and a ruling...more

Akerman LLP - Health Law Rx

Federal Appeals Court Reverses Conviction of Mental Health Program Director

Akerman LLP - Health Law Rx on

In a recently released decision, the United States Court of Appeals for the Eleventh Circuit reversed the conviction of a former community mental health program director who was convicted after trial of conspiring to commit...more

Mintz - ML Strategies

Health Care Update - July 2015 #2

Mintz - ML Strategies on

Congress Slowly Works on Budget Reconciliation; ACA Reform Proposals Still Up in the Air - The FY 2016 budget resolution, which was agreed to by Congress this past April, included broad reconciliation instructions...more

BakerHostetler

CMS Releases CY 2016 OPPS Proposed Rule With Updates to Two-Midnight Rule and Other IPPS Proposals

BakerHostetler on

On July 1, 2015, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2016 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) payment system proposed rule that...more

Faegre Drinker Biddle & Reath LLP

Halifax Health Gets In More Hot Water

Faegre Drinker Biddle & Reath LLP on

You probably didn’t think Florida’s Halifax Health could make its situation any worse. After all, only two months ago Halifax agreed to pay $85 million to settle just the first half of a Medicare fraud case. That still...more

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