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Medicare Access & CHIP Reauthorization Act of 20151 Six States and Various Religious Organizations File Suit to Invalidate the New Office of Civil Rights Anti-Discrimination Regulations
The Franciscan Alliance and Christian & Medical Dental Associations joined six states in a lawsuit filed against Health and Human Services (“HHS”) in a Texas federal court on August 23, 2016, challenging the regulations that the HHS’ Office of Civil Rights (“OCR”) finalized this past May (“Final… Forthcoming Changes to Nursing Facility Arbitration Agreements
On July 17, 2015, CMS released a proposed rule to revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. The proposed rule included a requirement regarding binding arbitration agreements. In the commentary CMS expressed concern that… Uncertainty of Indiana Medicaid Home Health Reimbursement
As many of you may know, the statewide home health reimbursement rates for Indiana Medicaid, are calculated based on the most recently completed Medicaid cost reports required from all home health providers billing Indiana Medicaid for services. (IHCP Bulletin 201625, May 17, 2016). As a result of… 15 Things to Know About the Proposed Changes to Off-Campus Provider-Based Department Reimbursement
The Balanced Budget Act of 2015 (“BBA”) passed on November 2, 2015 provides that, effective January 1, 2017, “applicable items and services” (other than items and services furnished by a dedicated emergency department) furnished by an off-campus outpatient department of a provider (“Off-Campus… HHS Office of Civil Rights Publishes Final Regulations Prohibiting Discrimination in Health Care Programs and Activities Receiving Federal Financial Assistance
The Health and Human Services’ Office of Civil Rights (“OCR”) recently published a final Regulation (“Regulation”) that implements the nondiscrimination requirements of Section 1557 of the Patient Protection and Affordable Care Act.[1] Beginning on July 18, 2016, discrimination in health care… The Yates Memo and Warner Chilcott – Fallout from the Trial
Following up on a previous client alert item, a federal jury recently found W. Carl Reichel, former president of Warner Chilcott, not guilty on June 17, 2016 of conspiring to pay kickbacks to doctors in exchange for writing prescriptions. The jury deliberated two days before delivering a not guilty… Indiana Boards to Adopt Rules to Align the Practice of Prescribing Controlled Substances to Patients with Chronic Pain
The Indiana General Assembly passed legislation during the 2015 General Session directing certain boards to establish protocols and standards for prescribing controlled substances for pain management treatment that “complement” existing rules for physicians.[1] Those boards include: the Board of… The Supreme Court Endorses "Implied Certification"
Hospitals which have discovered violations in their submissions for payment under Medicare and Medicaid may now pause before reporting the mistake and determine if the violation was “material” to the government’s conditions for payment. If the mistake was not material, then the False Claims Act… Aetna Claims Victory in Four Year-Old Lawsuit Against Bay Area Surgical Management, LLC
Aetna has claimed victory in a four year-old lawsuit against Bay Area Surgical Management, LLC, after a civil jury hit the California medical group with a $37.4 million dollar judgment. The victory capped a month-long trial against 10 defendants, including surgical centers and the organization's… CMS Issues Final Rule: "Medicaid Program; Methods for Assuring Access to Covered Medicaid Services"
On November 2, 2015, the Centers for Medicare and Medicaid Services (“CMS”) issued a Final Rule titled “Medicaid Program; Methods for Assuring Access to Covered Medicaid Services” following the recent Supreme Court case, Armstrong v. Exceptional Child Care Center, where the Court held that a… Bipartisan Budget Act of 2015 Changes Reimbursement for Off-Campus Outpatient Departments
On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015 (Pub. Law 114-74) into law. The Act includes many provisions aimed to reduce federal debt, but only a few specifically affect health care. Perhaps one of the most significant health care implications involves a change in… |
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