Surprise Billing Comparison: What You Need to Know

The question is not if, but how: How will lawmakers tackle surprise billing? What started out as question for a small Senate working group in 2018 has turned into one of the major health priorities of both parties.

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McDermottPlus Check-Up: May 17, 2019

This Week’s Dose: Drug pricing remains in the spotlight, but lawmakers also introduced legislation focused on surprise billing and coinsurance.

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The First 100 Days: House Health Policy Recap

Let me count the ways to 100. 1. Affordable Care Act. 2. Insurance Expansion. 3. Drug Pricing. 4. Surprise Billing. 5… Ok, maybe let me count to four.

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+Success

McDermottPlus persuaded the Centers for Medicare and Medicaid Services (CMS) to revise Medicare laboratory “Date of Service” regulations.

Codes currently eligible for exception to DOS rule

+Success

McDermottPlus assessed the policy pathway and operational feasibility to scale up group prenatal care, and designed alternative payment models to facilitate implementation.

States that already have the CenteringPregnancy model of Group Prenatal Care

+Success

On behalf of a coalition of leading global manufacturers of blood glucose monitoring systems, McDermottPlus successfully advanced legislation intended to improve market access and patient choice under the Medicare Competitive Bidding Program.

Reduction in Medicare payment amount for diabetes test strips since 2012

+Insights

Upcoming Events

May 30

Webinar | Understanding Guidance on Hospital Co-Location Arrangements

Webinar

Join McDermottPlus and McDermott Will & Emery as the discuss and analyze the long-awaited CMS draft guidance addressing the use of shared space, staff and services by hospitals and other enrolled providers.

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Jun 27

You’re Invited: Hot Topics in Medicare Advantage Breakfast Discussion

The McDermott Building

McDermottPlus and McDermott Will & Emery invite you to join us on Thursday, June 27, 2019 at 8:45 AM for a breakfast discussion on hot topics in Medicare Advantage.

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Resource Centers

Dedicated resource libraries for clients and partner organizations.

Payment Innovation
Resource Center

A library of content about Medicare payment transformation initiatives. Includes original analysis, major regulations, agency guidance, program announcements and other primary source documents.

Diagnostics
Resource Center

A collection of primary source materials about laboratory diagnostics regulation and payment, including original analysis, Medicare rates, rulemakings, final determinations and other items of interest.

Prescription Drug
Resource Center

A collection of materials about prescription drug pricing initiatives and regulation from the Administration and Congress, original analysis, and other items of interest.

Insurance Coverage
Resource Center

A library of content about efforts to redesign health care insurance and coverage. Includes original analysis, major regulations, agency guidance, program announcements and other primary source documents.

Meet our Consultants

Deborah R. Godes


Advises clients on reimbursement and policy strategy.

Sheila Madhani


Advises clients on reimbursement policy strategy.

Paul Radensky, M.D.


A board certified internal medicine physician and lawyer who is recognized as a Medicare law and policy authority.

Eric Zimmerman


A recognized Medicare law and policy authority and registered lobbyist.

Christine Song


Analyzes quantitative data and evaluates the economic impact.

John Warren


A highly experienced Medicare veteran and former CMS director.

Mara McDermott


An accomplished health care executive with a deep understanding of federal health care law and policy.

Rachel Stauffer


A highly experienced government relations and legislative affairs strategist and advocate.

Rodney Whitlock, Ph.D.


An accomplished health care executive with more than two decades on the Hill specializing in rural health, the health care safety net and disability policy.

Katie Waldo


An experienced government relations strategist who helps clients navigate the complex issues surrounding Medicare, Medicaid and the healthcare marketplace.

Emma Zimmerman


A government relations professional and registered lobbyist who supports clients on a range of health policy issues.

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