Articles and Blogs

Health Provider News – May 17, 2019

[05/17/19]

Posted on May 17, 2019 in Health Law News

Published by: Hall Render

 NATIONAL States inch forward on nurse staffing laws Bill backed by generic drug companies gets PhRMA endorsement at Senate hearing As MACRA Implementation Turns 2, Industry Leaders Call for Change Best & worst states for physicians to practice, ranked by Medscape Some hospitals turn away ambulances when the patients are more likely to be poor,…Read More

The Supreme Court Announces a Presumption Against Class Arbitration

[05/15/19]

Posted on May 15, 2019 in HR Insights for Health Care

Published by: Hall Render

The Supreme Court of the United States announced a landmark ruling about arbitration clauses on April 24, 2019. In Lamps Plus, Inc. v. Varela, the high court held that an arbitration clause does not permit class arbitration without clearly and explicitly stating so. Chief Justice Roberts delivered the opinion of the Court, reasoning that “shifting…Read More

Countdown to Phase 3 Skilled Nursing Compliance Programs – Component #1 – Policies and Procedures

[05/15/19]

Posted on May 15, 2019 in Long-Term Care, Home Health & Hospice

Published by: Hall Render

This is the first in a series of articles discussing the countdown to Phase 3 skilled nursing home compliance programs. To view other articles in this series, click here. Beginning on November 28, 2019, surveyors will use the requirements detailed 42 C.F.R. Section 483.85, the Requirements for States and Long-Term Care Facilities (“Final Regulations”) by…Read More

Department of Justice Updates Compliance Program Guidance

[05/13/19]

Posted on May 13, 2019 in Health Law News

Published by: Hall Render

On April 30, 2019, the U.S. Department of Justice (“DOJ”) released an updated version of is guidance known as “The Evaluation of Corporate Compliance Programs” (“2019 Guidance Document”). This document provides actionable guidance for health care providers seeking to assess and enhance their compliance programs. The DOJ’s updates emphasize the government’s view that not only…Read More

Hall Render’s This Week in Washington – May 10, 2019

[05/10/19]

Posted on May 10, 2019 in Federal Advocacy

Published by: Hall Render

Addressing “Surprise” Medical Bills High Priority for Administration and Congress Yesterday, President Trump held an address at the White House where he emphasized that Congress should act to “hold insurance companies and hospitals totally accountable” for surprise medical bills. A surprise medical bill, more commonly known as balance billing, occurs when patients, through no fault…Read More

CMS Updates Preclusion List Requirements for Medicare Advantage and Part D

[05/10/19]

Posted on May 10, 2019 in Health Law News

Published by: Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) recently published a final rule (“Final Rule”) revising the procedures that CMS uses to administer its Preclusion List. As outlined below, CMS now requires Medicare Advantage, Medicare Part D and other designated plans to deny payment for items or services provided by or prescribed by a provider…Read More

Health Provider News – May 10, 2019

[05/10/19]

Posted on May 10, 2019 in Health Law News

Published by: Hall Render

NATIONAL Costs for the same medical procedures show wide variation between hospitals CBO: HHS’ rebate rule would boost federal spending by $177B, lead to higher Part D premiums Trump administration announces ‘conscience rule’ for health care providers CMS lays out strategy to foster medical innovation in Medicare CVS exec: ‘We don’t discount Amazon’ Hospitals add…Read More

CMS Announces New Primary Cares Initiative

[05/10/19]

Posted on May 10, 2019 in Health Law News

Published by: Hall Render

On April 22, 2019, the Centers for Medicare & Medicaid Services (“CMS”) announced a new set of value-based payment models for reimbursement of primary care services. CMS has coined the new models its “Primary Cares Initiative.” Although participation in the models is currently voluntary, CMS hopes the initiative will accelerate the nationwide transition of primary…Read More

Civil Investigative Demands: Broad, Unfair and Legal

[05/10/19]

Posted on May 10, 2019 in False Claims Act Defense

Published by: Hall Render

The U.S. government’s unilateral investigative powers under the False Claims Act were bolstered by a ruling from the U.S. District Court for the Eastern District of California last week. Ruling on a Petition for Summary Enforcement of a Civil Investigative Demand (“CID”), the court held: Settlement discussions with a person or entity involved in a…Read More

Is It Fee-for-Service or Managed Care? CMS Launches Direct Contracting Models

[05/10/19]

Posted on May 10, 2019 in Health Law News

Published by: Hall Render

In keeping with the trends of the commercial market, on April 22, 2019, the Centers for Medicare & Medicaid Services (“CMS”) announced opportunities to participate in new direct contracting models under Medicare’s Part A and Part B fee-for-service program. CMS intends to focus these models particularly on primary care coordination for medically complex and seriously…Read More