Articles Posted in Medicare/Medicaid

The Centers for Medicare and Medicaid Services (CMS) has issued two new proposed rules. First, CMS has issued a proposed rule for the 2021 Medicare Physician Fee Schedule (PFS Proposed Rule). The rule will be published on August 17, 2020. You can access the unpublished version here. Second, CMS issued a proposed rule for the […]

On April 26, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that its suspending its Advance Payment Program to Part B Suppliers, effective immediately. Additionally, CMS announced that it is reevaluating the amounts to be paid out under the Accelerated Payment Program. To date, CMS has paid out $40.4 billion in payments to […]

On April 15, 2020, the Department of Justice announced the following settlement agreements under the False Claims Act (FCA): The U.S. Attorney’s office for the Eastern District of Pennsylvania announced that a laboratory, pain clinic and two former executives agreed to pay $41 million dollars to resolve allegations under the FCA related to unnecessary Urine […]

The Center for Medicare & Medicaid Services (CMS) has announced that it is increasing payments under Medicare for high-throughput COVID-19 clinical diagnostic laboratory tests. Previously, Medicare Administrative Contractors were paying out $51 for these tests. Under the new payment policy, effective April 14, 2020, Medicare will pay $100 (nearly double the previous amount) for such […]

Today, the U.S. Department of Health and Human Services (“HHS”) announced that it would directly deposit $30 billion in funds into the accounts of providers/suppliers that billed Medicare fee-for-service claims last year.  This initial $30 billion is part of a $100 billion appropriation under the CARES Act that HHS will disburse through its grants from […]