On February 27, 2026, the Centers for Medicare & Medicaid Services (“CMS”) issued a six-month nationwide moratorium on several types of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) suppliers, banning new businesses from enrolling …..
CMS has finalized another significant round of updates to the hospital price transparency requirements, including adopting a revised standardized template that hospitals must use going forward. Although the new requirements were effective January 1, 2026, …..
As the Centers for Medicare & Medicaid Services (CMS) intensifies its push for greater transparency in healthcare pricing, providers nationwide are facing increased scrutiny and more stringent compliance demands under the guise of “Hospital Price …..
House Bill 492 – New Process for Appealing Medicaid MCOs’ Adverse Claim Determinations On June 7, 2017, Louisiana House Bill 492 (HB 492) was sent to the Governor for executive approval. This Bill establishes a …..
Quantification Required as Part of “Identifying” and Overpayment Six years after issuing its Proposed Rule, CMS released its final 60-Day Rule for reporting and returning overpayments. The Final 60-Day Rule is more industry-friendly, but still …..
CMS recently provided direction to A/B MACs and QICs regarding the scope of appellate review for redetermination (1st Level) and reconsideration (2nd Level) appeals of certain claims. Historically, MACs and QICs had discretion while conducting …..
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