LexisNexis® Legal Newsroom
Centers for Medicare & Medicaid Services to Release Proposed Rule Relating to Accountable Care Organizations (ACOs) in Medicare

The Centers for Medicare & Medicaid Services (CMS) is expected to release a proposed rule relating to Accountable Care Organizations (ACOs) in Medicare in the near future. In order to prepare for the release of this rule, we wanted to provide you with a broad review of the legislative authority and...

Williams Mullen Health Care Fraud and Abuse Alert: What CMS’s New Billing Requirement For ‘Incident To” Services Means For Medicare Providers

By Brian C. Vick In the final Medicare Physician Fee Schedule for 2014 (“2014 PFS”), CMS implemented a new condition of payment for “incident to” services that has significant fraud and abuse implications for any Medicare provider who relies on reimbursement revenue from these...

Norton Rose Fulbright: CMS Offers New Resources and Guidance on 2-Phase Approach to Sunshine Act Reporting

By: Benjamin Koplin , Selina Coleman and R. Jeffrey Layne The Centers for Medicare & Medicaid Services (CMS) has posted new resources to its "Open Payments" website to clarify its recently announced two-stage approach to registration and data submission. These resources include: ...

Williams Mullen: CMS Proposes Rule That Would Expand Its Authority To Audit Medicare Advantage Plans

By Brian C. Vick O n April 30, 2014, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule to update payment policies and rates for inpatient hospitals (the “Proposed Rule”) that includes a provision with significant future implications for sponsors...

Norton Rose Fulbright: Physicians Payments Sunshine Act Data 33 Percent Unpublishable, Penalties Next?

By Benjamin Koplin , Selina Coleman and R. Jeffrey Layne Despite extending the dispute-and-resolution deadline to account for the days that the Centers for Medicare & Medicaid Services (CMS) pulled down the reporting system, the public Physician Payments Sunshine Act website is still expected...

Norton Rose Fulbright: CMS Offers Settlement Of Inpatient RAC Denials

By Mark Faccenda On August 29, 2014, the Centers for Medicare and Medicaid Services (“ CMS ”) announced that certain providers with pending appeals of specified inpatient-status claims denied by Medicare contractors may elect to receive partial payment on those claims in exchange for the...

Barnes & Thornburg: CMS Releases Physician-Level Payment Data Totaling More Than $90 Billion in Medicare Reimbursements for 2013

By Jessica Talati On June 1, the Centers for Medicare & Medicaid Services (CMS) released its second annual installment of Medicare reimbursement data for physicians and other practitioners. The data set contains records for more than 950,000 practitioners who received a collective $90 billion...