Healthcare Law Blog

SEPTEMBER 28, 2023

The Centers for Medicare & Medicaid Services (“CMS”) released the final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”) on January 30, 2023. This bargain is codified in the statutory mandate of 42 U.S.C. 1395w-23(a)(1)(C)(i) “to ensure actuarial equivalence.”

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Healthcare Law Blog

JANUARY 26, 2023

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients.

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Hall Render

FEBRUARY 14, 2023

billion in overpayments from MAOs for payment years 2011 through 2017. billion in overpayments from MAOs for payment years 2011 through 2017. On January 31, 2023, CMS will begin releasing the results of RADV audits and overpayment demands for payment years 2011 through 2017.

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Med-Net Compliance

JUNE 15, 2022

California Attorney General Rob Bonta announced a settlement against a Southern California doctor for submitting false claims to Medicare and Medi-Cal between the years of 2011 and 2018 for drugs, procedures, services, and tests that were never administered to patients. two whistleblowers were the doctor’s former?medical

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Health Care Law Brief

AUGUST 26, 2022

The Centers for Medicare & Medicaid Services (“ CMS ”) recently published the proposed 2023 Physician Fee Schedule (“ PFS ”), which contains several important changes affecting Accountable Care Organizations (“ ACOs ”) that participate in the Medicare Shared Savings Program (“ MSSP ”), including a new Advanced Incentive Program.

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Health Law Advisor

AUGUST 10, 2023

Medical Device Data Systems Prior to FDA’s Mobile Medical App Guidance, this topic was addressed by FDA when it created the category of Medical Device Data Systems (“MDDS”). Although that regulation was published in 2011, FDA still uses it as the foundation for determining whether an organization qualifies as an MDDS manufacturer.

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Drug & Device Law

JANUARY 30, 2023

280 (1995), decision that he joined in 1995 He joined a decision that found no preemption by virtue of a governmental decision not to regulate in Myrick and did not object to boilerplate description of obstacle preemption as an accepted preemption category Then in the 5-4 Geier v. Bartlett , 570 U.S. Levine , 555 U.S. citation in PLIVA, Inc.

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FDA Fraud Governance Medicare 72