Hospice Insights Podcast - Election Inspection: Be Proactive to Avoid Costly Election Statement Denials
(Podcast) California Employment News – Key Rules for California Employers: Business Expense Reimbursement
California Employment News – Key Rules for California Employers: Business Expense Reimbursement
AGG Talks: Home Health & Hospice - Reimbursement Audits and Appeals
Podcast: Direct Access Laboratory Testing: Reimbursement & Compliance – Diagnosing Health Care
Podcast: Owner's Outlook: Maximize and Safeguard Reimbursement Through Design - Diagnosing Health Care
HealthLaw HotSpot - A Look at Alternative Reimbursement Models in Value-Based Care
The Important and Thriving Role of Private Medical Practices
Value-Based Care and Its Impact on Providers
The Year Ahead: Litigation Hot Spots at a Glance
Teleworking: Amazing or amazingly complex?
(Video) Reimbursement of College Tuition and Fees After COVID-19
Value-based health care: compliance infrastructure
K&L Gates Triage: 340B Eligibility - Hospital Covered Entities
Value-based health care: fraud & abuse laws
Value-based health care: issues for pharmaceutical companies
Condo Water Invasion: Potential Medical Liability?
Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student Health claims. While the...more
The topic of “food as medicine” has gained increased attention recently, driven by a growing recognition of the role nutrition plays in preventing and managing chronic diseases. This article provides a high-level overview of...more
Cash-based practices, or providers who neither participate with nor bill insurers, are becoming increasingly common, especially in certain specialties such as primary care, women’s health, and mental health. While providers...more
On April 15, 2025, the Centers for Medicare & Medicaid Services (“CMS”) published the Contract Year 2026 Policy and Technical Changes Final Rule which amends the regulations governing various Medicare programs, including the...more
Value-based care (VBC) is a healthcare delivery model that prioritizes patient outcomes over the volume of services provided. This approach aims to enhance the quality of care while controlling costs by incentivizing...more
At the close of 2024, US Congress passed a short-term extension of Medicare telehealth flexibilities as part of the American Relief Act, 2025 (ARA). The Medicare telehealth waivers, originally enacted as part of the COVID-19...more
In the wake of an end of year filled with intense negotiations and political wrangling, Congress has successfully enacted the American Relief Act, 2025 ("the Budget Bill" or "legislation"), narrowly averting a government...more
On December 9, 2024, the Centers for Medicare & Medicaid Services' (CMS's) Calendar Year 2025 Physician Fee Schedule Final Rule (the Final Rule) was published in the Federal Register. The Final Rule includes noteworthy...more
CPT code 97039 has been in a state of constant flux in Florida and recent rulings have created greater change. First, one must understand what 97039 is and its history. According to the American Medical Association (AMA), CPT...more
The comment period for the CMS CY 2025 Physician Fee Schedule (PFS) Proposed Rule recently closed on Monday, September 9th. Based on previous years, the Final Rule can be expected as soon as early November, taking effect...more
Medical Device Manufacturer THD Pays $700,000 to Resolve FCA Allegations - On September 6, the US Attorney’s Office for the District of Maryland announced that THD America, Inc., and its parent company, THD SpA of Italy,...more
Earlier this year, we reported on the expected U.S. Food and Drug Administration (FDA) ruling concerning Laboratory Developed Tests (LDTs). The FDA has consistently shown a commitment to regulating LDTs. On May 6, 2024, the...more
Introduction - The Michigan Court of Appeals has concluded that for purposes of MCL 500.3157, providers of in-home healthcare services are not subject to reimbursement based on their charge description master or other...more
On June 8, 2023, the New York City Council passed a bill focused on healthcare accountability, with the goal of increasing access to healthcare services for New Yorkers. Entitled the Healthcare Accountability & Consumer...more
Many providers are not familiar with their obligations under the “60 Day Rule,” also known as Reverse False Claims liability, which can cause significant financial harm if providers fail to comply with these obligations....more
On June 15, 2022, after many years of ongoing litigation, the U.S. Supreme Court unanimously overturned a substantial Medicare Part B payment reduction to many 340B Program participating hospitals related to certain...more
Below are six reimbursement issues that health care providers should be on “high alert” for as the COVID-19 crisis persists. An increasing number of patients will be losing their health insurance coverage....more
When a law firm settles or resolves a personal injury claim on behalf of a client, the client’s health insurer has a right to be reimbursed for its past expenditures on the related injury. Reimbursement requests become...more
A bipartisan group of senators introduced legislation on October 30th designed to expand Medicare beneficiaries’ access to telehealth services. The bill is called the Creating Opportunities Now for Necessary and Effective...more
The use of telemedicine has soared in recent years, as new technologies develop and consumer demand for instant access to healthcare increases. ...more
Life Beyond FDA Clearance or Approval: The Reimbursement Challenge - To medical device manufacturers, winning premarket approval or 510(k) clearance from the U.S. Food and Drug Administration (FDA) is only half the battle....more
Personalized medicine can be described as the science of targeted therapies. Advances in diagnostic and molecular medicine have made it possible to more precisely identify alternative treatment options for patients based on...more
First Data Collection Period for Clinical Laboratories Is July 1, 2015 to December 31, 2015 - In the October 1, 2015 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule...more
There will always be differences among state laws on telehealth coverage, but what is remarkable is the rapidly increasing pace at which states have been adopting coverage statutes in the last few years, with currently 29...more
Editor's Overview - As the summer draws to a close, this month's Newsletter previews three cases that the U.S. Supreme Court already has agreed to hear that ought to be of particular interest to ERISA plan sponsors and...more