Tag Archives: provider

CMS Recoupment Efforts Stopped by Court While Overpayment Appeals Are Pending

Overpayment
Providers and suppliers who have been assessed overpayments for Medicare services are entitled, by statute, to a stay of recoupment while the provider or supplier’s appeal is pending – but only at the first two levels of administrative appeal. If both appeals are unfavorable to the provider or supplier, the next step is an appeal … Continue reading this entry

Six Key Investment and Strategic Themes from Payer-Provider Convergence Deals

healthcare partnerships
At the 11th Annual Investment and M&A Opportunities in Healthcare conference in Nashville on June 6th, 2018,  a panel session moderated by Chris Donovan, partner in Foley’s Health Care Practice Group, addressed the topic of Payer-Provider Convergence. Additional panel participants included John Foley, Senior Vice President of Aurora Health Care and President of Wisconsin Collaborative … Continue reading this entry

Payor/Provider Convergence: Joint Venture Health Plans

Background Health Plans and health care providers are getting into each other’s business.  This payor/provider convergence has taken different forms.  Health systems have ventured into the health insurance business by acquiring or starting their own health plans and by establishing joint ventures with payors, to jointly own and operate a health plan.  Health plans have … Continue reading this entry