The Lead Off by Congress Congress enacted the bipartisan No Surprises Act (“NSA”) to end surprise medical bills for emergency services. Among various protections for patients, the NSA also provides for an independent dispute resolution (“IDR”) arbitration process to resolve payment disputes between providers and payors for out-of-network emergency services and certain services furnished by
A comprehensive legal resource page with original commentary and key takeaways on critical topics impacting our clients industries.
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule outlining a one-time lump sum payment of $9 billion dollars to be given to approximately 1,649 participating 340B hospitals.[
On April 5, 2023, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule for Medicare Advantage (“MA”) Plans, confirming that MA Plans must follow the 2-Midnight Rule, its case-by-case exception, the inpatient-only (“IPO”) list, as well as traditional Medicare coverage criteria.