Articles and Blogs


Court Vacates 60-Day Rule for Medicare Advantage Plans, Creates Uncertainty for Same Rule Applicable to Medicare-Enrolled Providers


Posted on September 17, 2018 in Health Law News

Published by: Hall Render

Nearly a decade has passed since the U.S. Congress enacted the Patient Protection and Affordable Care Act (the “ACA”). Since March 2010, we have seen federal court rulings on numerous challenges to the ACA itself and the executive branch’s efforts to enforce the ACA. One such challenge resulted on September 7, 2018 in the... READ MORE

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OIG Final Rule Significantly Expands Exclusion Authority


Posted on January 19, 2017 in Health Law News

Published by: Hall Render

On January 12, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) published the “Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Exclusion Authorities” Final Rule (“Final Rule”) revising and expanding its authority to exclude individuals and entities from participation in federal health care programs.... READ MORE

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Section 1557: Federal Court Issues Nationwide Injunction Against HHS Sex Discrimination Rules


Posted on January 16, 2017 in Health Law News, HR Insights for Health Care

Published by: Hall Render

On December 31, 2016, a federal district court in Texas issued a preliminary injunction to prevent HHS from enforcing those few portions of the regulations implementing Section 1557 of the Affordable Care Act (“ACA”) that interpret the prohibition against “sex” discrimination to include discrimination on the basis of “gender identity” and “termination of pregnancy.”... READ MORE

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Discrimination in Federally Funded Health Care Programs – Part III: HHS New Regulations Regarding Equal Access for Individuals with Disability Under Section 1557 of the Affordable Care Act


Posted on August 2, 2016 in Health Law News

Published by: Hall Render

This is the third article in a series discussing the Department of Health and Human Services (“HHS”) Office of Civil Rights (“OCR”) final rule (“Final Rule”) implementing Section 1557 of the Patient Protection and Affordable Care Act (“ACA”). Failure to comply with the Final Rule can result in the loss of federal funding, and... READ MORE

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King v. Burwell – ACA Death Spiral Averted


Posted on June 26, 2015 in Health Law News

Published by: Hall Render

In an eagerly awaited, mightily impactful health care decision, King v. Burwell (U.S. No. 14-114 June 25, 2015), the Supreme Court of the United States (the “Supreme Court”) held that individuals eligible for tax credits to subsidize their purchase of health insurance in health care marketplaces created by the Affordable Care Act (“ACA”) may... READ MORE

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DOJ Intervenes in Retained Overpayment Suit


Posted on June 30, 2014 in False Claims Act Defense

Written by: Drew B. Howk

With the passing of the Affordable Care Act (“ACA”), False Claims Act (“FCA”) observers noted the imminent filing of cases alleging violations of the ACA’s amendments to the FCA or “reverse” false claims. Such claims are per se false claims under the FCA and arise when a government contractor or health care provider becomes aware... READ MORE

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This Week in Washington – November 8, 2013


Posted on November 8, 2013 in Federal Advocacy

Written by: John Williams

OMB Reviewing Final Rules on Anti-Kickback Statute, Stark Law Protections for EHR Deals Earlier this week, CMS and HHS sent two final rules to the White House Office of Management and Budget (“OMB”) that would extend safe harbor protections for arrangements that provide electronic health record (“EHR”) products to physicians until the end of... READ MORE

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Rebasing Has Arrived – CMS Publishes Home Health PPS 2014 Proposed Rule


Posted on July 2, 2013 in Long-Term Care, Home Health & Hospice

Written by: Robert W. Markette

On June 27, 2013, CMS released the proposed home health prospective payment rule (the “PPS Rule”) for calendar year 2014.  While refinements to the ICD-9-CM and discussions of ICD-10-CM implementation are of interest, the most notable change to the PPS Rule for 2014 is CMS’s long-awaited proposal for rebasing home health payments.  Once it... READ MORE

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CMS Comments on Compliance, QAPI Regulations


Posted on March 22, 2013 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

During yesterday’s Open Door Forum, Jeanette Kranacs, the Director of the Division of Institutional Post-Acute Care for the Centers for Medicare and Medicaid Services (“CMS”) commented that CMS will not be issuing instructions to surveyors on evaluating compliance and ethics programs until the regulations have been promulgated.  CMS was required to have final regulations and various tools in place as of... READ MORE

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