Click to view the WMV fileOn Monday, July 2, 2012, Epstein Becker Green conducted a webinar titled "Decision 2012: What’s In, What’s Out, and What’s Next?" examining the monumental decision (PDF) issued by the Supreme Court of the United States on the Patient Protection and Affordable Care Act.

This webinar analyzed the decision and its implications for the states, the

by Jay Gerzog, Dale Van Demark, Tamar Rosenberg, and Dawn Welch

Is it possible that the U.S. Department of the Treasury (“Treasury”) knows something we do not about the pending U.S. Supreme Court decision on PPACA?

Probably not, but that has not stopped the Treasury and Internal Revenue Service (“IRS”) from issuing

The federal rate review program requires that the Centers for Medicare & Medicaid Services establish state-specific thresholds for the following year’s rate review program by June 1. This year, only two states, Alaska and Wisconsin, submitted state-specific threshold proposals to the Center for Consumer Information and Insurance Oversight. Both of these requests were denied on June 1. This health reform alert provides a summary of the state-specific threshold guidance and proposals and discusses potential trends for rate review state-specific thresholds and the implications for federal rate review.
Continue Reading No Change in the 10 Percent Federal Rate Review Threshold

by Daniel E. Gospin and Amy F. Lerman

As part of continued efforts to expand the Medicare Recovery Audit Contractor (“RAC”) program, the Centers for Medicare & Medicaid Services announced in November 2011 the implementation of a demonstration project that will allow RACs to conduct prepayment reviews on certain types of Medicare claims that historically

by Joseph J. Kempf, Jr., and Jackie Selby

Evolving reimbursement models for health care providers (away from “fee for service” and toward “pay for performance” and risk sharing) raise interesting questions as to how such payments will be treated under the new medical loss ratio rules under the Patient Protection and Affordable Care Act. Some