Articles and Blogs

On July 17, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) published an updated Work Plan for Fiscal Year (“FY”) 2017 (“Work Plan”) that includes 14 added areas of planned or ongoing legal and investigative initiatives. OIG historically publishes the Work Plan annually, most recently in Fall 2016, and uses the…Read More

On June 29, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a favorable advisory opinion, Advisory Opinion 17-02, concerning a hospital (the “Hospital”) outpatient facility’s proposal to waive or reduce cost-sharing amounts owed by financially needy Medicare beneficiaries for items and services furnished in connection with a clinical research…Read More

On June 30, 2017, CMS published in the Federal Register a proposed rule (“Proposed Rule”) to update the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”) Quality Payment Program (“QPP”) for CY 2018 and future years. CMS has stated that it endeavors to increase flexibility, decrease administrative burden and overall simplify the QPP, particularly…Read More

On June 2, 2017, the Survey and Certification Group at the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum, “Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires’ Disease (LD)” (“S&C Memo”), requiring that facilities develop and follow policies and procedures that inhibit microbial growth in…Read More

Stark Reform Legislation Introduced and Advanced in the House On July 10, Reps. Marchant (R-TX) and Ron Kind (D-WI) reintroduced the Stark Administrative Simplification Act (H.R. 3173).  The bipartisan legislation would limit the penalties for technical violations of the Stark Law and create an expedited process for their resolution. The measure was introduced as a…Read More

This is another article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for States and Long-Term Care Facilities (“Final Regulations”) by the Centers for Medicare & Medicaid Services (“CMS”). BACKGROUND On September 28, 2016, CMS released a complete overhaul of Part 483…Read More

Many hospitals and health systems are using telehealth technologies to improve patient access (particularly in remote or rural locations), monitor and manage chronic conditions and generally deliver health care in a more timely and cost-efficient fashion. There are currently three general modalities of telehealth services. First, the asynchronous transmission of images, test results or other…Read More

In January of 2014, a relator filed suit against a Florida hospital system (“Health System”) under the False Claims Act. We originally reported on the suit against the Health System in this blog post. The suit garnered national attention based on the unique facts of the case. The suit involved a medical office building that was constructed…Read More

With employee health plan costs continuing to rise at an alarming rate, medium-sized employers are increasingly rejecting traditional insurance models built around a network of preferred providers and turning to a non-network model wherein the plan appoints a pricing consultant as a “Designated Decision Maker” (“DDM”) with discretionary and ultimate decision-making authority for determining the…Read More

All employers know that the U.S. Department of Labor (“DOL”) is the agency responsible for enforcement of the Fair Labor Standards Act – the federal law establishing minimum wage and overtime requirements for nearly every employer in the country. What you may not know is that the DOL can audit your workplace with or without notice. The…Read More