MiraMed Ajuba

April 11, 2018   Committees of the House and Senate have introduced a wave of legislation to address the opioid crisis, including more than 30 bills related to Medicare and Medicaid coverage and payment.   Highlights of the Opioid Crisis Response Act of 2018, introduced by the Senate Health, Education, Labor and Pensions Committee, include enhancing state prescription drug monitoring programs (PDMPs), which have shown value in identifying and reducing “doctor shopping” and other practices related to opioid misuse and abuse;…

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April 4, 2018   The controversial Recovery Audit Program of the Centers for Medicare and Medicaid Services had garnered criticism from the American Hospital Association and other groups for its role in generating a huge backlog of appeals that can take months, if not years, to resolve, straining hospitals’ financial resources in the process.  A 2017 study published in the Journal of Hospital Medicine found that the appeals process for denied claims can drag on for more than four years.   The AHA sued HHS in 2012, claiming that…

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