Health eSource February 2018

Featured Articles

Government Benefits

CMS Reshapes the Playing Field for Innovative Payment Models

Christopher Dean, Kristen Bohl and Catherine Martin, Baker Donelson, Baltimore, MD

The Centers for Medicare & Medicaid Services (CMS) continues to reshape the playing field of innovative payment models by cancelling proposed programs, limiting the scope of a mandatory, nation-wide program, and suggesting that different innovation programs would be released in 2018.

Health

Understanding, Avoiding and Navigating Third Party Pre-Payment Review Audits

Anthony S. Hearn, Ver Ploeg & Lumpkin, Miami, FL

The pre-payment review (PPR) audit can wreak havoc on a healthcare provider’s practice, creating cash flow shortfalls and other interruptions that negatively impact the delivery of care to patients.

Government Benefits

340B Drug Pricing Program: Uncertain Future and Need for More Guidance

Ayeisha A. Cox, Esq., DrFirst, Inc., Rockville, MD

The 340B Drug Pricing Program (Program) plays a key role in ensuring that low-income patients have access to essential health services and medications.

Government Benefits

Worksheet S-10 and Hospitals’ Uncompensated Care: A Moving Target That Is More Important Than Ever

Mark Polston and Elizabeth Swayne, King & Spalding, LLP, Washington, DC

Long-threatened in preamble language, the Centers for Medicare & Medicaid Services (CMS) has finally begun to include cost report Worksheet S-10 data in the calculation of hospitals’ Uncompensated Care (UCC) pool payments.

Government Benefits

Why Anti-Kickback Compliance Is Material to Federal Healthcare Payment

Scott C. Withrow, Esq., Withrow, McQuade & Olsen, LLP, Atlanta, GA

Since the Supreme Court’s 2016 unanimous decision on False Claims Act (FCA) materiality in Escobar, the government has successfully argued that compliance with the federal Anti-Kickback Statute (AKS) is material to federal healthcare payment.

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Health eSource February 2018

EMI, or How I Met the Section

Featured Articles

CMS Reshapes the Playing Field for Innovative Payment Models

Understanding, Avoiding and Navigating Third Party Pre-Payment Review Audits

340B Drug Pricing Program: Uncertain Future and Need for More Guidance

Worksheet S-10 and Hospitals’ Uncompensated Care: A Moving Target That Is More Important Than Ever

Why Anti-Kickback Compliance Is Material to Federal Healthcare Payment

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Renew Your ABA Membership

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Health eSource February 2018

EMI, or How I Met the Section

Featured Articles

CMS Reshapes the Playing Field for Innovative Payment Models

Understanding, Avoiding and Navigating Third Party Pre-Payment Review Audits

340B Drug Pricing Program: Uncertain Future and Need for More Guidance

Worksheet S-10 and Hospitals’ Uncompensated Care: A Moving Target That Is More Important Than Ever

Why Anti-Kickback Compliance Is Material to Federal Healthcare Payment

ABA Resources

The ABA

Connect