Blog - Archive for Medicare Reimbursement

In light of the expiration of the Public Health Emergency (PHE) effective May 11, 2023, many flexibilities adopted during the PHE by many federal and state payers as well as government regulators will terminate. Recently, DEA proposed permanent rules for the prescribing of controlled medications via telemedicine.  During the PHE, DEA suspended the requirement that Read more →

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CMS recently proposed a revision to the 60-day overpayment rule that would impact Medicare participating providers and entities. Generally speaking, a provider must return an overpayment within 60-days after the date on which the overpayment was identified.  A person has identified an overpayment when the person has, or should have through the exercise of reasonable Read more →

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Genetic testing, when medically necessary, can provide physicians with important information for the diagnosis, prevention, and treatment of numerous illnesses. It has become an extremely valuable tool in many fields of medicine and can play a significant role in the overall medical care that a patient receives. In recent years, genetic testing has become heavily Read more →

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The Families First Coronavirus Response Act (“FFCRA”), which was enacted in March of 2020, requires insurers to provide benefits without imposing any cost-sharing in connection with certain items and services related to the testing and treatment for COVID-19.  Curiously, the legislation is silent as to the concept that is well-known in the healthcare industry today Read more →

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After almost seven years of navigating the administrative appeals process, the Firm secured the complete dismissal of a $1,000,000 dollar Medicare overpayment for a South Florida physician.  Following the physician’s receipt of untimely overpayment demands, the Firm secured the reinstatement the provider’s appellate rights.  The gist of the overpayment demand was that the provider failed Read more →

Tags : Medicare Reimbursement