wp horizontal light

No Surprises Act Update: New federal IDR Guidance released

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.

When a Provider Should Anticipate Large False Claim Act Penalties for Disregarding Compliance and Licensure Matters

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 Medicare programs.

Expertise