The following toolkits are made available to members of the Regulation,
Accreditation, and Payment Practice Group. If you have any comments or
suggestions on existing or potential toolkits, please email the
Practice Groups staff.
EMTALA Toolkit - Published on March 24, 2014
toolkit provides practitioners with an updated, comprehensive set of EMTALA
authorities, including, but not limited to, relevant statutory and regulatory
authorities, the Centers for Medicare & Medicaid Services' (CMS') interpretive
guidelines, and other U.S. Department of Health & Human Services, Office of
Inspector General (OIG) and CMS pronouncements related to EMTALA.
340B Toolkit - Published on June 10, 2014
is designed to assist health lawyers with understanding and researching 340B
Drug Pricing Program (340B Program) issues. Although the 340B Program was
established in 1992, the 340B Program has recently received increased attention
from stakeholders and policymakers, creating a new interest in understanding
340B Program eligibility and participation requirements. This Toolkit provides
the key statutes, regulations, policy guidance, case law, and forms necessary
for legal counsel to understand the 340B Program.
Graduate Medical Education and Indirect Medical Education Payments for
"Non-Provider" Site Training - Last updated on March 15, 2013
The updated version of the Graduate Medical Education (GME) and Indirect Medical
Education (IME) Toolkit addresses Medicare payments to hospitals when residents
provide services in "Non-Provider" site locations. This Toolkit includes
relevant statutes, regulations, program documents, administrative and court
decisions, links, and analyses related to Medicare GME and IME add-on payments
to hospitals that rotate residents through these "Non-Provider" settings.
Medicare and Medicaid Provider Enrollment Toolkit - Published
on March 5, 2013
This Toolkit is designed to assist health lawyers with
understanding and researching Medicare and Medicaid provider enrollment issues.
Diagnostic Testing Legal Issues Toolkit - Published on December
The Toolkit is designed to assist lawyers in advising clients
on diagnostic testing matters and in structuring diagnostic testing
arrangements.The RAP PG wishes to thank the Physician Organizations PG for
sharing this Toolkit with their members.
Provider-Based Status Toolkit - Last updated on January 11,
The Toolkit follows a logical progression, starting with a
discussion of why provider-based status is important, and continuing to a
checklist of requirements for provider-based status, and then continuing to more
complex issues, such as provider-based status for joint ventures, intersection
of provider-based rules with physician supervision requirements, and
Medicare Claims Appeals Toolkit - Published on March 18, 2010
The purpose of this toolkit is to provide a ready reference for the experienced
practitioner as well as a “primer” for the newcomer to the field of Medicare
claims appeals. With the implementation of the RAC process, providers are
expected to experience an increased volume of claims audits. Consequently, there
likely will be an increased volume in the Medicare Claims Appeals process, with
a greater number of health lawyers being asked to represent their clients in the
Medicare and Medicaid Research Toolkit - Published on March 24,
This toolkit has been designed to assist health lawyers with
researching complex Medicare and Medicaid issues. It is a web-enabled research
guide that helps practitioners: (1) organize reimbursement research; (2)
identify appropriate resources; and (3) carry out a successful and organized
CMS Hospital Surveys: The Legal Perspective - Published on
April 30, 2007
This toolkit contains valuable resources on hospital
surveys conducted by the Centers for Medicare & Medicaid Services.