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On April 12, 2022, the Centers for Medicare & Medicaid Services (“CMS”) issued new guidance regarding the federal Independent Dispute Resolution (IDR) process, created under the No Surprises Act (NSA) to provide a mechanism for payers and providers to resolve disputes pertaining to the appropriate reimbursement amount for certain qualifying out-of-network claims.
In December 2021, the United States Court of Appeals for the Eleventh Circuit affirmed a civil penalty of nearly $1.2 million imposed on a hematology and oncology practice for violations of the Federal False Claims Act (“FCA”),[1] noting that the FCA violations were appropriate because the Florida-based medical practice submitted false information on claims to
On February 24, District Judge Jeremy D. Kernodle of the U.S. District Court of the Eastern District of Texas granted summary judgement in favor of Texas Medical Association. The plaintiffs successfully argued that provisions of the Departments of Health and Human Services, Labor and Treasury (the “Departments”) Interim Rule (“Rule”), pursuant to the No Surprises