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Healthcare:  District courts lack jurisdiction to award a Medicare Provider (Doctor) injunctive relief until administrative remedies are exhausted

Healthcare:  District courts lack jurisdiction to award a Medicare Provider (Doctor) injunctive relief until administrative remedies are exhausted   Providers of medical services to Medicare recipients often must navigate claim denials in order to get paid.  Medicare contractors determine provider reimbursement eligibility based on several sources, including local coverage determinations...

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CMS Issues Proposed Rule to Empower Commercial Plans and States to Negotiate Payment for Innovative New Therapies Based on Patient Outcomes

CMS Issues Proposed Rule to Empower Commercial Plans and States to Negotiate Payment for Innovative New Therapies Based on Patient Outcomes Proposed rule updates provisions to promote value-based payment for prescription drugs The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to promote development of payment models...

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