News & Analysis as of

Reimbursements Physicians Healthcare

DLA Piper

Proposed CY 2026 Medicare Physician Fee Schedule Rule Signals Support for Digital Health Advancement

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On July 14, 2025, the Centers for Medicare and Medicaid Services (CMS) issued the calendar year (CY) 2026 Medicare Physician Fee Schedule (MPFS) Proposed Rule (Proposed Rule). This client alert focuses on the proposed...more

McDermott+

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

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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

Dentons

Ep. 59 – Treating Medicare Beneficiaries as a Cash-Based Practice

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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

J.S. Held

Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review

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In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround...more

Weber Gallagher Simpson Stapleton Fires &...

PA Supreme Court Approves OTC Supplements & CBD Oil for Workers’ Compensation

In a unanimous opinion issued today, the Pennsylvania Supreme Court has ruled that any item that is part of a health care provider’s treatment plan falls within the purview of medical services and the broad-encompassing...more

Lowenstein Sandler LLP

Virginia Hospital Indicted for Allegedly Turning a Blind Eye to Doctor’s Crimes

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In an unusual criminal prosecution, the Chesapeake Regional Medical Center (CRMC), a hospital in Chesapeake, Virginia, was indicted last week by a federal grand jury in Virginia for conspiring to defraud the United States and...more

Stikeman Elliott LLP

Federal Government Announces Policy on Canada Health Act Status of Payments to Regulated Healthcare Professionals Providing...

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Friday, the Federal Government issued correspondence to the provinces and territories regarding its newly introduced Canada Health Act Services Policy. As set out in this correspondence from the Minister of Health, the CHA...more

Davis Wright Tremaine LLP

COVID-19 Telehealth Flexibilities Extending and Enduring

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

Whiteford

Client Alert: Phoning It In: Congress Passes A Short Extension To Medicare Telehealth Flexibilities As 2025 Approaches

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With the end of 2024 and an expiration of applicable Medicare telehealth flexibilities approaching, Congress passed the American Relief Act of 2025, preserving applicable flexibilities for an additional three months, through...more

Baker Donelson

2025 Medicare Physician Fee Schedule: Payment and Overpayment Policies

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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

Nelson Mullins Riley & Scarborough LLP

Federal Regulatory Update: CMS Medicare Payment Changes & Congressional Next Steps

The Centers for Medicare & Medicaid Services (CMS) have released significant updates affecting Medicare payments for 2025. The changes, outlined in two final rules, will impact both physicians and hospitals, eliciting strong...more

Akerman LLP - Health Law Rx

Zafirov Decision Sets Stage for Appellate Showdown Over Constitutionality of FCA’s Qui Tam Provision

For the first time ever, a judge has ruled that the qui tam provision of the False Claims Act (FCA), which whistleblowers have used to recover $52 billion on behalf of the government since 1986, is unconstitutional....more

McDermott Will & Emery

Investing In a Healthier Future: The Investor’s Perspective On Value-Based Care

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In this session, McDermott Will & Emery Partner Joel Rush moderated a discussion exploring investors’ interests in, opinions on and strategies for entering the value-based care (VBC) market. The panel discussed factors taken...more

Sheppard Mullin Richter & Hampton LLP

Legislation Re-Introduced to Expand Access to Telehealth Under Medicare

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

Mintz - ML Strategies

Recent Developments in Massachusetts Health Policy

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Building on the momentum of early October hearings on the state’s growing health care expenditures, the Health Policy Commission (HPC), the Joint Committee on Health Care Financing, Governor Charlie Baker, and others spent...more

Foley & Lardner LLP

Navigating the Diagnostic Commercialization Process

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Guest Post By: Perry Dimas, Senior Vice President and General Manager for Premier Source, part of AmerisourceBergen The 2015 Business of Personalized Medicine Summit was an inspiring day with talented professionals. One...more

Foley & Lardner LLP

Telehealth Commercial Coverage and Parity Laws: Trends, Challenges and Opportunities

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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

Akerman LLP - Health Law Rx

Reimbursement Changes, Shift to Consumerism Discussed at Akerman Healthcare Briefing

Changing reimbursement models and a shift to consumerism were two of the hot topics discussed at Akerman LLP's recent Healthcare Briefing event titled "Financial and Corporate Implications of the Affordable Care Act: A Look...more

Troutman Pepper

Great Investment For Doctors: Joint Venture Pharmacies

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With reimbursement levels declining, health care organizations, including pharmacies and physicians, continue to look for ways to diversify their businesses. A very attractive vehicle for increasing revenues has been...more

BakerHostetler

2014 Physician Fee Schedule: Cuts and Quality and Data! Oh My!

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The Centers for Medicare and Medicaid Services (CMS) recently released the calendar year 2014 Physician Fee Schedule Proposed Rule (Proposed Rule)....more

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