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Legal + Compensation

Enrollment in Medicare Advantage has grown over the last 20 years following the Medicare Modernization Act of 2003, which renamed the program from private Medicare plans.

CMS finalized a rule Jan. 17 requiring certain payers to include a specific reason when denying requests, publicly report certain prior authorization metrics, and send decisions within 72 hours for urgent requests and seven calendar days for standard requests beginning…

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HHS' Office of Inspector General has determined that a consultant's proposed provision of gift cards to existing physician practice customers does not violate the federal Anti-Kickback Statute, according to an article by law firm Harris Beach published Jan. 18 on…

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