LexisNexis® Legal Newsroom
Health Care Reform’s Impact on MA and PDP Plans

By Miki Kolton and Brendan Dunn, Attorneys, Greenberg Traurig, LLP President Barack Obama has now signed two separate bills that together will fundamentally transform our nation’s health care system. The Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care & Education...

Regional Health Care and Medicare Fraud Prevention Summit Conducted by Attorney General Holder and Secretary Sebelius

From the Department of Justice : WASHINGTON - Thursday, Attorney General Eric Holder and U. S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius kicked off the second in a series of daylong summits bringing together a wide array of federal, state and local partners, beneficiaries...

Introduction to the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010

By Timothy S. Jost, Robert L. Willett Family Professor of Law, Washington and Lee University School of Law The health care reform legislation adopted by Congress consists of the (originally) 2409 page Senate "Patient Protection and Affordable Care Act," (PPACA), signed into law by President...

Pre- and Post-Commencement of an Investigation of Health Care Compliance: Key Considerations for all Providers

By Gretchen Heinze Townshend and Elizabeth Bedore Campbell, Attorneys at Law Five health care fraud settlements in excess of $100 million were reported last year, with total recoveries from health care providers amounting to $2 billion. Providers need to understand that in today's regulatory...

Health Care Reform Event on martindale.com Connected

HEALTH CARE REFORM The Patient Protection and Affordable Care Act (PPACA) along with the Health Care and Education Reconciliation Act of 2010 is a product of the health care reform agenda of the Democratic 111th Congress and the Obama administration. The law includes a large number of health-related...

Podcast - Changes to Medicare and Medicaid by the Patient Protection and Affordable Care Act, with Mary Alice Jackson, Bradley Frigon and Stuart Zimring

On this edition, Mary Alice Jackson, Bradley Frigon and Stuart Zimring discuss how the new law changes Part D coverage and how Medicare premiums are determined, tax issues created by the act such as the new Medicare tax on individuals and Medicaid issues including how the act expands the number of people...

Williams Mullen Alert: CMS Issues Proposed Rule on 60-Day Reporting/Repayment Obligation for Overpayments to Medicare Providers

By Marcus C. Hewitt As part of 2010's Affordable Care Act, a new section was added to the Social Security Act (Section 1128J(d)), which requires providers to report and return any overpayments they receive from Medicare or Medicaid within 60 days (see http://www.ssa.gov/OP_Home/ssact/title11/1128J...

Cadwalader Client & Friends Memo: A 'Hat Trick' of Heightened False Claims Act Risks for Health Care Providers

Introduction At the risk of stating the obvious, fighting and prosecuting health care fraud are top priorities for the Federal Government, and the False Claims Act ("FCA") is its weapon of choice in the battle. In a speech in June, Stuart Delery, the Acting Assistant Attorney General for...

Norton Rose Fulbright: OIG Releases FY 2014Work Plan Summary

By Frederick Robinson , Megan Fanale Engel , Cori Annapolen Goldberg and Selina Coleman On January 31, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published its Work Plan for fiscal year 2014. The OIG announced that in the upcoming year, it will continue...

Williams Mullen: OIG Scrutiny of Hospital Outpatient Evaluation/Management Claims Billed to Medicare

By Marcus C. Hewitt H.H.S’s Office of Inspector General’s yearly work plan was issued on January 31, 2014, which included numerous new and ongoing reviews and activities by OIG for the coming year. Among the new projects, OIG will review Medicare payments to hospitals for outpatient evaluation...

Barnes & Thornburg LLP: OIG Work Plan 2014: Takeaways for Hospitals

By Gayland Hethcoat With the release of its work plan for fiscal year 2014 on Jan. 31, 2013, the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) has provided insight on the agency’s current enforcement priorities in Medicare, Medicaid, and other HHS programs...

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: ...

Steptoe & Johnson PLLC: False Billing Leads To Record Settlement In Medicare/Medicaid Fraud Case

The United States Attorney for the Southern District of West Virginia has announced a record $4.675 million settlement with a medical lab for false billings to Medicare and to West Virginia Medicaid. R. Booth Goodwin, of Charleston, WV, said in his press release that Calloway Laboratories of Woburn,...

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...

DLA Piper Health Systems Alert: MACRA: 3 Compliance Implications For Medicare Providers

By: Karen Nelson Much has been written about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its repeal of the Sustainable Growth Rate formula for physician compensation and the potential gainsharing safe harbor. But the Act also includes certain Medicare program integrity provisions...