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Adobe PDFProposed Changes to Medicare Hospital Inpatient Prospective Payment System (IPPS) for Federal Fiscal Year (FFY) 2015
Powers Pyles Sutter Verville PC;
Legal Alert/Article
June 11, 2014, previously published on May 16, 2014
The following outlines the changes to the acute-care hospital IPPS proposed by the Centers for Medicare and Medicaid Services (CMS) for FFY 2015. The proposed rule was published in the Federal Register on May 15. Comments are due June 30. The tables and data files for the proposed FFY 2015 IPPS...


Adobe PDFSignificant Disclosure of Medicare Physician Payment Data; Separating Fact from Fiction
Powers Pyles Sutter Verville PC;
Legal Alert/Article
April 25, 2014, previously published on April 11, 2014
A remarkable amount of data on Medicare physician billing was released for the first time to the public on Wednesday, April 9. The information, contained in over nine million records, reveals what the government insurance program paid physicians in 2012. Released to foster transparency in the...


HTMLMedicare Delays Provider ALJ Hearings for 2 Years
Powers Pyles Sutter Verville PC;
Legal Alert/Article
February 13, 2014, previously published on February 7, 2014
The Office of Medicare Hearings and Appeals (OMHA) recently issued a letter suspending most ALJ appeals for at least 24 months. The administrative appeals process for Medicare claims has been groaning under the number of appeals passing through the system for quite some time. In the past year or...


Adobe PDFWhat Went Wrong at Tuomey Healthcare System
Mark R. Fitzgerald; Powers Pyles Sutter & Verville, PC;
Legal Alert/Article
October 17, 2013, previously published on October 11, 2013
In a decision dated September 30, 2013, the U.S. District Court for South Carolina entered judgment against Tuomey Healthcare System (“Tuomey”) for a total of $237.5 million for violating the Stark law and the False Claims Act (“FCA”).  The judgment is the latest landmark in...


Adobe PDFOctober 1, 2013: Health Insurance Exchanges Open
Powers Pyles Sutter Verville PC;
Legal Alert/Article
October 10, 2013
The key provisions of the Affordable Care Act (“ACA”) are slated to go into effect this week. On Tuesday, October 1, states and the U.S. Department of Health and Human Services (“HHS”) will open their Health Insurance Exchanges, otherwise known as...