Albert Shay

Albert Shay

Morgan Lewis

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Latest Publications


New Budget Bill May Signal End of Provider-Based Status

Hospitals that seek to establish provider-based OPDs should complete their work soon. A near-final discussion draft of a House budget bill, which the White House has apparently agreed to in principle, would end the...more

10/29/2015 - Billing Drug Pricing Federal Budget Health Care Providers Healthcare Hospitals Pending Legislation Section 340B

CMS Releases 2016 Physician Fee Schedule

Major changes to Stark law are ahead, including new exceptions for timeshare arrangements and employment of NPPs. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule on July 8 for the 2016...more

7/10/2015 - ACOs Alternative Payment Models (APM) Client Referrals CMS Comment Period Exceptions FQHC Healthcare Hospitals Medicaid Medicare Physician Fee Schedule Physicians Proposed Regulation Rural Health Care Providers Stark Law

The Three “Hows” Of Physician Compensation

New care delivery models and healthcare reimbursement trends are heating up the market for hospital employment of physicians yet again, but does a productivity-based compensation model still work in this environment?...more

3/18/2015 - Compensation Standards Fair Market Value Healthcare Hospitals Physician Medicare Reimbursements Physicians Stark Law

The OIG Work Plan: Does OIG Always Know Best?

Provider Compliance Departments routinely set audit priorities based, in part, on OIG’s Work Plan, but what should a provider do if it disagrees with a position that the OIG takes? Providers should be prepared to defend their...more

12/3/2014 - Audits Chief Compliance Officers Compliance Hospitals OIG Work Plans

HHS OIG Issues Revised Self-Disclosure Protocol

OIG touts substantial benefits of disclosing, provides greater detail for different types of disclosures, and captures 15 years of OIG Self-Disclosure Protocol experience....more

4/18/2013 - Anti-Kickback Statute Damages HHS OIG Self-Disclosure Requirements Stark Law

Protections to Be Extended for Electronic Health Record Donations

CMS and OIG issue similar proposed rules to modify the electronic health record exception and safe harbor. On April 10, the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) of...more

4/17/2013 - CMS EHR Final Rules OIG Proposed Amendments Safe Harbors

Final Sunshine Act Arrives: Now the Hard Part

The Centers for Medicare and Medicaid Services (CMS) issued the final regulations on the U.S. Sunshine Act on February 8, 2013. Transparency Reports and Reporting of Physician Ownership or Investment Interests, 78 Fed. Reg....more

3/8/2013 - Affordable Care Act CMS Healthcare Manufacturers Medical Devices Pharmaceutical Industry Physicians Reporting Requirements Sunshine Act

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