News & Analysis as of

Reimbursements Physicians Medicare

DLA Piper

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

DLA Piper on

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

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

Davis Wright Tremaine LLP

Navigating Aetna's Expanded Claim Edits: What Providers Need To Know and Do Before September 1, 2025

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

Dentons

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

Dentons on

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

Whiteford

Navigating Value-Based Care in Anesthesia: Enhancing Patient Outcomes Amid Legal Complexities

Whiteford on

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

Lowenstein Sandler LLP

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

Lowenstein Sandler LLP on

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

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

Whiteford on

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

Dinsmore & Shohl LLP

Medicare Telehealth Flexibilities Extended Through March 2025

Dinsmore & Shohl LLP on

Earlier this month, Dinsmore provided a notice to clients that several telehealth flexibilities for Medicare beneficiaries were set to expire on December 31. However, on December 20, Congress passed the American Relief Act,...more

Davis Wright Tremaine LLP

Effective Care: California Left Behind as Other States Expand Hospital at Home Programs

Hospital at Home (“HaH”) programs received renewed interest during the COVID-19 pandemic as a way to relieve hospital capacity issues and allow patients to receive effective care outside of the traditional hospital setting....more

Whiteford

Navigating New Medicare Overpayment Rules and Practical Tips to Comply

Whiteford on

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized the Medicare regulations interpreting the federal 60-day overpayment refund requirement (the Overpayment Statute) for Medicare Parts A and B as...more

Baker Donelson

2025 Medicare Physician Fee Schedule: Payment and Overpayment Policies

Baker Donelson on

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

Fox Rothschild LLP

CMS Proposed Rule Decreases Physician Payments, Expands Telehealth, and Much More

Fox Rothschild LLP on

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

Whiteford

California Department of Public Health's (CDPH) Limits On CRNA Scope of Practice Reminds Hospitals Nationwide to Revisit...

Whiteford on

The California Department of Public Health (CDPH) issued a letter on September 6, 2024, to all general acute care hospitals clarifying the scope of practice for Certified Registered Nurse Anesthetists (CRNAs) following...more

Dentons

Ep. 32 – An Easy Audit Tip to Help Avoid Overpayments

Dentons on

Looking for a simple, easy-to-implement way to lower your risk of overpayments? We have one on this week’s podcast!...more

McDermott Will & Emery

[Event] Physician Practice Management and ASC Symposium 2024 - May 15th - 16th, Nashville, TN

The Physician Practice Management (PPM) and ASC Symposium 2024 is the destination event for PPM and ASC industry leaders and health industry investors. Join us as we deliver actionable insights on the state of the market and...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

Baker Donelson

2024 Medicare Physician Fee Schedule Final Rule Extends COVID-19 Telehealth Policies and Includes Bonus Extension

Baker Donelson on

The CY 2024 Medicare Physician Fee Schedule Final Rule (Final Rule) implemented several statutory extensions to COVID-19 telehealth waivers and flexibilities, finalized proposed policies, and extended an important telehealth...more

McDermott+

Policy Update - CMS Releases CY 2024 Physician Fee Schedule Final Rule

McDermott+ on

On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | July 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for July 2023. We discuss several criminal and civil enforcement actions that involve violations of the False Claims Act...more

Benesch

Opportunities and Challenges for Office-Based Labs and Ambulatory Surgery Centers: Six Main Takeaways from the Benesch Healthcare+...

Benesch on

Six Main Takeaways from the Benesch Healthcare+ Nephrology & Dialysis Conference. Experts included Dapo Afolabi, M.D., President and CEO of Fort Worth Renal Group, Terry Litchfield, President of Access Solutions, Jason...more

McDermott Will & Emery

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

McDermott Will & Emery on

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

American Conference Institute (ACI)

[Event] 21st Annual Rx Drug Pricing Boot Camp - May 4th - 5th, New York City, NY

The American Conference Institute is hosting the 21st Annual Rx Drug Pricing Boot Camp in New York. With both federal and state law makers engaging in greater scrutiny of prescription drug pricing, now is the time when...more

Weintraub Tobin

Themes from American Health Law Association’s 2023 Institute on Medicare and Medicaid Payment Issues

Weintraub Tobin on

I am fresh back from Baltimore, Maryland, where I was on the faculty of AHLA’s annual Institute on Medicare and Medicaid Payment Issues. I have been on the faculty of this program for a dozen years, and am always thrilled to...more

53 Results
 / 
View per page
Page: of 3

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide