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Health Law News

No Surprise Here…the Debate Continues on Surprise Billing

[08/28/19]

Posted on August 28, 2019 in Health Law News

Published by: Hall Render

It is no surprise that state and federal legislators are taking action to address the issue of unexpected medical bills, otherwise known in the health care industry as “surprise billing.” Surprise billing generally occurs when a patient receives care at an out-of-network facility (often emergency care) or from an out-of-network provider at an in-network... READ MORE

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Appropriate Use Criteria for Advanced Diagnostic Imaging – Testing Period Begins Soon!

[08/26/19]

Posted on August 26, 2019 in Health Law News

Published by: Hall Render

In late July 2019, CMS issued claims processing requirements for the educational and operations testing period for appropriate use criteria (“AUC”) related claims for advanced diagnostic imaging. Advanced imaging includes CT, PET, nuclear medicine, and MRI. The testing period begins January 1, 2020. The CMS Program Transmittal can be found here. Background The Protecting... READ MORE

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Health Provider News – August 23, 2019

[08/23/19]

Posted on August 23, 2019 in Health Law News

Published by: Hall Render

NATIONAL CMS proposes 2020 rate for total knee arthroplasty News report on healthcare billing fraud prompts senators’ call for federal action More than 50% of healthcare providers not compliant with HIPAA right of access 12 healthcare companies that are the highest-paying employers in their state CMS brings controversial star ratings system to ACA plans... READ MORE

HHS Receives Thousands of Comments on Proposed Reversal of Certain Discrimination Protections

[08/20/19]

Posted on August 20, 2019 in Health Law News

Published by: Hall Render

On June 14, 2019, the U.S. Department of Health and Human Services (“HHS”) published in the Federal Register a proposal to revise certain civil rights anti-discrimination regulations implementing and enforcing Section 1557 of the Affordable Care Act (“ACA”) (“Section 1557 Rule”) that HHS believes are inconsistent with pre-existing civil rights statutes and likely unlawful... READ MORE

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CMS Finalizes Changes for Low Wage Hospitals and Rural Floor

[08/19/19]

Posted on August 19, 2019 in Health Law News

Published by: Hall Render

On August 16, 2019, the Federal Fiscal Year (“FFY”) 2020 Medicare Inpatient Prospective Payment System (“IPPS”) final rule (“IPPS Final Rule”) was published in the Federal Register. In the IPPS Final Rule, the Centers for Medicare & Medicaid Services (“CMS”) finalized several changes announced in the proposed rule, including several changes to address disparities between high... READ MORE

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A New Option for Grant Noncompliance: OIG Releases Grantee Self-Disclosure Program

[08/16/19]

Posted on August 16, 2019 in Health Law News

Published by: Hall Render

On July 11, 2019, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) released the new Grant Self-Disclosure Program Guidance (“Grant Guidance”) for HHS grant recipients and subrecipients. Through the Grant Guidance, OIG provides new self-reporting options for HHS grant recipients and subrecipients who determine that they... READ MORE

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Health Provider News – August 16, 2019

[08/16/19]

Posted on August 16, 2019 in Health Law News

Published by: Hall Render

 NATIONAL Allscripts agrees to $145M HIPAA, kickback settlement GAO: PBMs passed on nearly all Part D rebates to plans in 2016 Reduce burnout by putting more doctors in leadership roles: Physicians Foundation Appeals court revives changes to Medicaid DSH payment rules 3 more healthcare organizations notify patients of AMCA data breach, bringing total affected... READ MORE

Stakeholders Asked and CMS Listened – Agency Proposes to Modify Stark Law Advisory Opinion Process

[08/13/19]

Posted on August 13, 2019 in Health Law News

Published by: Hall Render

In the recently issued Physician Fee Schedule Proposed Rule for Calendar Year 2020, the Centers for Medicare & Medicaid Services (“CMS”) proposed several revisions to its Stark Law advisory opinion process. These proposed revisions follow CMS’s receipt of several stakeholder comments in response to its Request for Information Regarding the Physician Self-Referral Law published... READ MORE

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Court Takes Broad View of Medicare DSH Eligibility for § 1115 Waiver Program Days

[08/09/19]

Posted on August 9, 2019 in Health Law News

Published by: Hall Render

Recently, the D.C. District Court ruled that HHS must include certain waiver programs in its Medicare disproportionate share calculations. This is a significant ruling because many states have experimented with different ways to provide health care to low-income populations. As a result, hospitals serving these populations may be entitled to increased payments.[1] Background Under... READ MORE

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Health Provider News – August 9, 2019

[08/09/19]

Posted on August 9, 2019 in Health Law News

Published by: Hall Render

NATIONAL Best patient experience innovations at 17 health systems DaVita, Fresenius Broke Kickback Rules, Whistleblower Says CMS Finalizes Medicare Pay Increase for Rural Hospital Workers 4 major questions on HHS and FDA’s drug importation action plan New CMS Pilot Program Gives Physicians Claims Data Access HHS Designates $20 Million for New Rural Residency Programs... READ MORE