Archive
Medicare
No, You Can’t Just Not Take Medicare: What Every Chiropractor Needs to Know
A growing number of chiropractors are moving away from insurance panels in favor of cash-pay practice models built around direct-pay patient relationships. The appeal is understandable—simplified…
HHS Releases Final Part Two Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs
Summary of article from CMS Press Release: The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS), has released…
CMS Releases Proposed Rule on Anomalous DME Spending and MSSP Financial Calculations
Summary of article from American Hospital Association: The Centers for Medicare & Medicaid Services (CMS) released a proposed rule to address significant, anomalous, and highly suspect…
D.C. Circuit Holds 340B Program Does Not Prohibit Drug Manufacturers from Imposing Contract Pharmacy Restrictions
Summary of article from Foley Hoag LLP, by Patrick Brennan, Andrew London, Ross Margulies, Kian Azimpoor: On May 21, 2024, the U.S. Court of Appeals for…
Top Ten Health Law Myths
I have been practicing health law for more than 25 years and have had the benefit of working with a lot of healthcare providers. My clients…
The Shocking Truth About Neurostimulators and the Government’s Efforts to Recoup Payments
For much of the past decade, peripheral neurostimulator devices have been used liberally by some practitioners to treat chronic pain. In addition to pain relief, any…
New HHS Advisory Opinion Confirms Complete Federal Preemption for PREP Act Cases and Applicability of the Act’s Defenses in Non-Use Situations
Advisory Opinion 21-01 expands on the language of the amended Declaration to clarify that the PREP Act provides complete preemptive federal jurisdiction for cases in which…
HHS Issues Advisory Opinion on Contract Pharmacies Under the 340B Program
Many covered entities enter into written agreements with pharmacies (contract pharmacies) to distribute their covered outpatient drugs to the entities’ patients. The covered entity orders and…
CMS finalizes “reasonable and necessary” definition, expedited breakthrough device coverage process
On January 14, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule that, for the first time, adopts a regulatory standard for…
Texas, Pennsylvania hospitals lose lawsuit challenging Medicare payments
The hospitals said HHS wrongly calculated their Medicare disproportionate share hospital payments for fiscal year 2015, using the wrong data. As a result, the hospitals appealed…