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Articles by Sean Cuddihy
Upcoming 12/31 Deadline To Comment On CMS And OIG Proposed Rule Changes Under The Stark Law And Anti-Kickback Statute - Food, Drugs
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Making The Granston Memo Work For FCA Defendants | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Health Care Suits at Center Stage in DOJ’s FCA Recovery Report for FY 2018 | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Blog Series Part 5: CMS Proposed Rule on Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Medicaid Fee-For-Service, and Medicaid Managed Care Programs for 2020 and 2021 | Sheppard Mullin Richter & Hampton LLP - J
As detailed in previous posts in this series, one major objective that the Centers for Medicare and Medicaid Services (“CMS”) addressed in a proposed rule issued November 1, 2018 (the “Proposed Rule”), was to implement new Social Security Act provisions that Congress added in the Bipartisan Budget Act of 2018 (“BBA”). One such provision will open fee-for-service Medicare data up to prescription drug benefit (“Part D”) plans.
OIG Report on Topical Compounded Drug Prescribing, Marketing and Billing Practices Signals Heightened Administrative and Enforcement Scrutiny | JD Supra
When commercially available medications’ standard dosage forms or amounts don’t quite fit a patient’s particular needs, the patient may benefit from customized compounded drugs. Medicare Part D, the prescription drug program, allows the private company sponsors that administer the benefit to cover compounded drugs under certain circumstances.[1] In recent years, Part D reimbursement to pharmacies for compounded drugs has increased significantly.
Blog Series Part 5: CMS Proposed Rule on Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Medicaid Fee-For-Service, and Medicaid Managed Care Programs for 2020 and 2021
As detailed in previous posts in this series, one major objective that the Centers for Medicare and Medicaid Services (“CMS”) addressed in a proposed rule issued November 1, 2018 (the “Proposed Rule”), was to implement new Social Security Act provisions that Congress added in the Bipartisan Budget Act of 2018 (“BBA”). One such provision will open fee-for-service Medicare data up to prescription drug benefit (“Part D”) plans.
Federal Regulatory Developments Brewing in Telehealth | JD Supra
Two federal agencies – the Centers for Medicare and Medicaid Services (“CMS”) and the Federal Communications Commission (“FCC”) – announced separate initiatives last week that stand to increase patient access to telehealth services. Proposed Medicare Physician Fee Schedule for Calendar Year 2019. The CY 2019 Medicare Physician Fee Schedule Proposed Rule (the “Proposed Rule”) was released for publication in the Federal Register on July 12, 2018.
CMS & FCC Initiatives to Improve Access to Telehealth
Two federal agencies – the Centers for Medicare and Medicaid Services (“CMS”) and the Federal Communications Commission (“FCC”) – announced separate initiatives last week that stand to increase patient access to telehealth services. Proposed Medicare Physician Fee Schedule for Calendar Year 2019. The CY 2019 Medicare Physician Fee Schedule Proposed Rule (the “Proposed Rule”) was released for publication in the Federal Register on July 12, 2018.
In Case Alleging Nationwide Pharmacy Fraud, Kmart Scores Narrow Settlement | JD Supra
As described in an April 17, 2018 article originally posted on the Sheppard Mullin Richter and Hampton, LLP False Claims Act Defense Blog, Kmart Corporation and the U.S. Department of Justice entered into a False Claims Act settlement agreement dated March 8, 2018, to end an investigation that was conducted jointly by the United States Attorney’s Office for the Eastern District of California and California’s Bureau of Medicaid Fraud and Elder Abuse.
In Case Alleging Nationwide Pharmacy Fraud, Kmart Scores Narrow Settlement
On Thursday, March 8, Kmart Corporation inked a settlement of a False Claims Act investigation[1] in which the qui tam relator initially alleged systematic pharmacy billing fraud across twenty-seven states for $525,000.[2] Brought by a pharmacist formerly employed at a Kmart in Lakeport, California, the original complaint alleged among other things that, instead of using a state-made drug utilization review alert system, Kmart relied on its own electronic systems that were not sufficiently...
The Harvard Crimson
The Harvard Law School crest is a glorification of and a memorial to one of the largest and most brutal slave owners in Massachusetts. But Isaac Royall, Jr., was more than simply a slave owner; he was complicit in torture and in a gruesome conflagration wherein 77 black human beings were burned alive. This fact and others were absent from The Crimson’s recent editorial, “Recognizing History”—an erasure of history that shows precisely why the seal must be changed.
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