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  • GenomeDx Biosciences Corp., which markets a genomic test (Decipher®) intended to assess the aggressiveness of prostate cancer, has agreed to pay $1.99 million to the U.S. Department of Justice to resolve allegations that it violated the False Claims Act (31 U.S.C. §§ 3729 et seq.)(“FCA”) by submitting claims to Medicare for tests conducted to evaluate treatment options for men after prostate surgery. The government and a whistleblower alleged that between September 2015 and June 2017, GenomeDx knowingly submitted Medicare reimbursement claims for... More
  • The long-running saga of the Medicare appeals backlog added a new chapter that may give frustrated stakeholders a new remedy.[1]  On March 27, 2018, the United States Court of Appeals for the Fifth Circuit ruled that a home health agency may pursue a claim against the Secretary of HHS for failing to provide a hearing before an Administrative Law Judge within a reasonable time.  Family Rehabilitation, Incorporated v. Azar, No. 17-11337 (5th Cir., Mar. 27, 2018). In this case, Family Rehabilitation... More
  • This is the 7th and final installment in the Medicare Secondary Payer Compliance series. All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided. Medicare Secondary Payer Compliance: An Introduction (Part I) Medicare Secondary Payer Compliance: Conditional Payments (Part II) Medicare Secondary Payer Compliance: Group Health Plans (Part III) Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV) Medicare Secondary Payer Compliance: Providers (Part... More
  • This is part 6 of 7 in the Medicare Secondary Payer Compliance series. All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided. Medicare Secondary Payer Compliance: An Introduction (Part I) Medicare Secondary Payer Compliance: Conditional Payments (Part II) Medicare Secondary Payer Compliance: Group Health Plans (Part III) Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV) Medicare Secondary Payer Compliance: Providers (Part V) Medicare... More
  • This is part 5 of 7 in the Medicare Secondary Payer Compliance series. All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided. Medicare Secondary Payer Compliance: An Introduction (Part I) Medicare Secondary Payer Compliance: Conditional Payments (Part II) Medicare Secondary Payer Compliance: Group Health Plans (Part III) Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV) Medicare Secondary Payer Compliance: Providers (Part V) Medicare... More
  • This is part 4 of 7 in the Medicare Secondary Payer Compliance series. All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided. Medicare Secondary Payer Compliance: An Introduction (Part I) Medicare Secondary Payer Compliance: Conditional Payments (Part II) Medicare Secondary Payer Compliance: Group Health Plans (Part III) Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV) Medicare Secondary Payer Compliance: Providers (Part V) Medicare... More
  • This is part 3 of 7 in the Medicare Secondary Payer Compliance series. All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided. Medicare Secondary Payer Compliance: An Introduction (Part I) Medicare Secondary Payer Compliance: Conditional Payments (Part II) Medicare Secondary Payer Compliance: Group Health Plans (Part III) Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV) Medicare Secondary Payer Compliance: Providers (Part V) Medicare... More
  • This is part 2 of 7 in the Medicare Secondary Payer Compliance series. All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided. Medicare Secondary Payer Compliance: An Introduction (Part I) Medicare Secondary Payer Compliance: Conditional Payments (Part II) Medicare Secondary Payer Compliance: Group Health Plans (Part III) Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV) Medicare Secondary Payer Compliance: Providers (Part V) Medicare... More
  • All titles in this series can be viewed below. Subscribe to our blog to receive these future updates. Prior installments of this series can be accessed using the links provided. Medicare Secondary Payer Compliance: An Introduction (Part I) Medicare Secondary Payer Compliance: Conditional Payments (Part II) Medicare Secondary Payer Compliance: Group Health Plans (Part III) Medicare Secondary Payer Compliance: Non-Group Health Plans (NGHPs) (Part IV) Medicare Secondary Payer Compliance: Providers (Part V) Medicare Secondary Payer Compliance: The False Claims Act (FCA) for Providers (Part VI) Medicare Secondary... More
  • Congress is currently considering two bills that would dramatically alter the ways in which all federal agencies develop and publish rules. If enacted, both would create significant new obligations for agencies such as CMS and the FDA, expand the scope of judicial review of rules, and would increase the potential for political influence over the rulemaking process. Both bills passed the House on party-line votes, and are under consideration by the Senate. The first bill, H.R. 5, would overhaul multiple phases... More