Aug 7, 2015 | Health Care
In April, the President signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which repealed and replaced the controversial Sustainable Growth Rate (SGR) formula. A lesser known, but nevertheless important, provision of MACRA requires...
Jun 22, 2015 | Health Care
In December, Chilivis Grubman attorney Scott Grubman issued a healthcare compliance alert regarding the electronic health records (EHR) meaningful use incentive payment program. That program, which began in 2009, provides financial incentives to providers who convert...
Jun 8, 2015 | Health Care
The U.S. Supreme Court on Monday declined to clarify the level of detail required to satisfy Rule 9 (b) in alleging claims under the False Claims Act when it declined to review the Eleventh Circuit decision in U.S. ex rel. Mastej v. Health Management Associates, Inc.,...
May 18, 2015 | Health Care
Several years ago, the federal government required states receiving Medicaid money (i.e., all of them) to institute the Recovery Audit Contractor, or “RAC,” program. A RAC is a private entity that contracts with a state to detect, and pursue recovery of, Medicaid...
May 6, 2015 | Health Care
Yesterday, as part of its continuing “data transparency initiative,” CMS released detailed data on over a billion prescriptions dispensed to Medicare beneficiaries in 2013 under the Medicare Part D Prescription Drug Program. That information is now publicly available...
Apr 29, 2015 | Health Care
As we all know, most medical care today is paid for by third-party insurance, and the physician usually sends the bill directly to the insurance company. However, it is very easy for there to be errors in these bills, either in individual bills or in series of bills....
