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CMS proposes $7.5B OPPS increase, modifications to reimbursement for 340B-acquired drugs
CMS proposed to increase reimbursement under the OPPS and ASC PPS and to eliminate the inpatient-only list.
2021 Federal funding methodology for basic health programs finalized
CMS has finalized the methodology for funding payment amounts for states offering basic health plans for program year 2021.
Conviction of patient recruiter in Medicare kickback scheme affirmed
Appeals court upheld conviction of a patient recruiter in a Medicare kickback scheme, noting that there was not enough evidence to show the recruiter was a bona fide employee who would fall under the...
State FCA claims against manufacturer of replacement knee device dismissed; federal claims granted
Relators’ failed to sufficiently allege their claims against the manufacturer of replacement knee device under state FCAs. However, they sufficiently alleged their claims under federal FCA.
CMS issues Part C proposals following Supreme Court’s Allina Health decision
The proposals address concerns about the agency’s notice-and-comment rulemaking regarding treatment days for MA beneficiaries.