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Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

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Thought Leadership

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Thought Leadership Spotlight

Healthcare Transactions: Year in Review 2018Last year, CVS Health Corp. (NYSE: CVS) announced it would purchase health insurer Aetna Inc. (NYSE: AET) for $67.5 billion, a transaction that would be one of the biggest healthcare mergers in the past decade. The transaction raises an intriguing question: is this the beginning of a transformational shift in healthcare?

Recently, members of our healthcare group authored the Healthcare Transactions: Year in Review outlining 2017 M&A activity and drivers in the following hot healthcare sectors:

• Managed Care
• Hospitals
• Post-Acute Care—Home Health & Hospice
• Ambulatory Surgery Centers (ASCs)
• Healthcare Information Technology (HIT)
• Behavioral Health
• Physician Practice Management

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Matt Curley and Brian Roark Provide Insight on Hospital Fraud & Abuse Enforcement for Becker's Hospital Review

Publications

August 12, 2013

Bass, Berry & Sims attorneys Matt Curley and Brian Roark provided an overview of trends related to hospital fraud and abuse enforcement in a recent article published by Becker's Hospital Review. The article, titled "7 Notable Developments in Hospital Fraud & Abuse Enforcement," discusses the following trends in hospital enforcement:

  1. The government's increased willingness to bring claims alleging unnecessary care; 
  2. The government's scrutiny of the medical need for and hospitals' billing of certain medical procedures; 
  3. Increased awards for whistleblowers reporting Medicare fraud; 
  4. The increased need for hospital peer-reviews in addition to internal reviews; 
  5. The increased number of Stark and AKS cases centered around physician employment arrangements; 
  6. The applicability of Stark to Medicaid claims; and 
  7. The increased focus on holding individuals and entities criminally liable for healthcare fraud.

To read the article in its entirety, please click here.


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