The health care industry appears to have not seriously considered the possibility that Donald Trump would be elected President. While Mr. Trump campaigned on “repeal and replace” the Affordable Care Act (aka “Obamacare”), it is anything but clear what comes next. This edition of the Health Law Bulletin will at…
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare Sustainable Growth Rate (SGR) methodology for updates to the Physician Fee Schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two…
September 23, 2016: Following a two-day preliminary hearing, a Kern County Superior Court Judge dismissed all charges against a physician accused by the California Attorney General of Medi-Cal and Medicare fraud and related theft and tax offenses. Led by Steven Goldsobel, the firm fought a more than two-year long battle…
Federal Register, Volume 80 Issue 220 (Monday, November 16, 2015) Code of Federal Regulations Title 42: Public Health (Excerpted) View Article
The Medicare Access and CHIP Reauthorization Act (MACRA) makes two major changes in how Medicare will pay physicians and other clinicians. First, it implemented the so-called “Doc Fix.” That is, MACRA ended the flawed and much-maligned Sustainable Growth Rate (SGR) formula for determining Medicare payments and the annual ritual of…
Super Lawyers has selected Jeremy N. Miller of Miller Health Law Group as one of its 2016 Southern California Super Lawyers. Jeremy has made this list every year for the past 11 years. Super Lawyers is a rating service of outstanding lawyers from more than 70 practice areas who have…
Consider the following scenarios involving medically necessary services for Medicare or Medicaid patients: (1) a medical group learns that its outside billing service has incorrectly used the physician’s office site of service code when billing Medicare for hospital consults; (2) an imaging center finds out it did not have adequate…