Litigation
H.R.3991 would amend the Social Security Act to remove the condition of payment but leave the condition of participation intact. A physician would not be required to state that the patient will be discharged or transferred in less than 96 hours in order for the CAH to be paid on that particular…
The AHA, several hospital associations (Greater New York, New York State, New Jersey and Pennsylvania) and four hospital systems today took the first steps to bring a federal court challenge to the Centers for Medicare & Medicaid Services’ two-midnight inpatient admissions criteria and related…
Delays of at least two years in granting an ALJ hearing for an appealed claim are not only unacceptable, they are a direct violation of Medicare statute that requires ALJs to issue a decision within 90 days of receiving the request for hearing.
This letter is in regards to Good Shepherd Health Care System’s recent experience with a qui tam fraud investigation under the False Claims Act.