Blog - Archive for Health Care Law News

The HRSA COVID-19 Uninsured Program (UIP) has recently announced it will stop accepting claims for reimbursement due to the program’s lack of sufficient funds. This unexpected announcement has caused significant concern and confusion for businesses operating in this space, as it has historically been one of the primary and most reliable payors. As background, the Read more →

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The No Surprise Act (“NSA”) went into effect January 1, 2022, and impacts billing, and in particular balance billing, for emergency services as well as certain non-emergency services.  Generally speaking, a patient cannot be balance billed for emergency services.  Instead, the patient is only responsible for in-network cost share.  The NSA specifies how the insurers Read more →

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In a 2-1 Decision, the D.C. Circuit Court of Appeals reversed the district court’s order to HHS to clear the backlog of administrative appeals within four years. The appellate court found that the district court failed to adequately test HHS’s assertion that this mandate was impossible. After considering the merits of a group of hospitals Read more →

Tags : Medicare Claims

On August 14, 2017, CMS announced a significant change in its claims audit strategy for Medicare Administrative Contractors (MACs).  Under the new strategy — called Targeted Probe and Educate — MACs “will select claims for items/services that pose the greatest financial risk to the Medicare trust fund and/or those that have a high national error rate.”  Read more →

Tags : MACs , Medicare Audit , Medicare Claims

In a recent example of prosecutions of physicians for using adulterated or misbranded drugs and devices, a Tampa area oncologist was sentenced on August 7, 2017 to almost 6 years in prison for using unapproved, foreign-sourced chemotherapy drugs.  According to the Indictment, Dr. Norbergs ordered the drugs from foreign, unlicensed distributors for use in her Read more →

Tags : FDA , Health Care Fraud , misbranded drug , unapproved drug