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Massachusetts Health Care Act Dies at the End of Legislative Session But Previews Sweeping Changes for the Health Care Industry

The Massachusetts legislative session officially closed on August 1, 2024 after an unusual half day extension. The 193rd legislative session left many omnibus bills unpassed, including S.B. 2881, “an Act enhancing the market...more

New Favorable OIG Advisory Opinion Allows Patient Assistant Programs Funded by Drug Manufacturers

The Office of Inspector General (OIG) recently issued a new favorable advisory opinion regarding patient assistance programs (PAP) for 12 specific disease funds. PAPs help patients pay high cost-sharing obligations for...more

FTC Finalizes Rule Against Employee Noncompetes

On April 23, 2024, the Federal Trade Commission (“FTC” or the “Commission”) voted to finalize a rule abolishing the vast majority of employee noncompetes across the United States (the “Noncompete Rule” or “Rule”). The FTC...more

Massachusetts: Proceed With Caution - New Vaccination Criteria for Hospitals and Other Licensed Health Facilities

Following public hearings and at least 78 public comments, at the end of October, hospitals and other facilities licensed by the Massachusetts Department of Public Health (DPH) will have new flexibility to require both flu...more

HHS OIG: New “General Compliance Program Guidance” Provides Voluntary Steps Towards Increased Effectiveness

In connection with the November 2023 Health Care Compliance Association’s (HCCA) Healthcare Enforcement Compliance Conference, and with acknowledgment by the Chief Counsel to the Inspector General, Rob DeConti, of the long...more

“Acute Hospital Care at Home”: Omnibus Bill Extends Flexibility Period to December 31, 2024

As part of the $1.7 million omnibus spending bill that became law December 29, 2022, the Centers for Medicare & Medicaid Services (CMS) extended, through December 31, 2024, the Acute Hospital Care at Home (H@H) initiative...more

Will CMS’s Proposed Rule on “Identified Overpayments” Increase Reverse FCA Cases?

On December 27, 2022, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule which, in part, seeks to amend the existing regulations for Medicare Parts A, B, C, and D regarding the standard for when an...more

Workplace Violence: CMS Warns of Violations of Hospital Conditions of Participation

Workplace violence has become one of the key management challenges and sources of enterprise risk for hospitals over the past several years. Threats from patients, visitors, and staff have increased, sometimes with tragic...more

CMS Extends Delayed Enforcement of the Good Faith Estimate

On Friday, December 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued an FAQ regarding the Good Faith Estimate (GFE) and Convening Provider/Facility requirements in the Federal No Surprises Act. The issued...more

Compliance Officers Lookout! DOJ and OIG Tag Team Corporate Integrity Agreements

The Office of Inspector General of the U.S. Department of the Health and Human Services (OIG) recently changed the language describing a compliance officer’s role in relation to other responsibilities he or she may have...more

Hurricane Ian: Public Assistance Funding Extended for Certain Health Care Facilities in Florida

Health care facilities and certain other nonprofits have new opportunities for Federal public assistance funds, but they must act quickly. On October 4, 2022, President Biden amended the Hurricane Ian Major Disaster...more

Postponement in the Massachusetts Patients First Act Penalties

On July 5, 2022, the Commonwealth of Massachusetts re-extended the implementation and enforcement date for the “Patients First Act”, sometimes referred to as the Massachusetts No Surprises Act, to January 1, 2025. As...more

Is Hospital Care at Home Here to Stay?

It has been almost two years since the Centers for Medicare & Medicaid Services (CMS) first issued blanket waivers of certain hospital conditions of participation allowing healthcare systems and hospitals to provide hospital...more

Innovative Revenue Streams for Academic Medical Centers: Reaching Beyond On-Site Patient Care

Academic Medical Centers (AMCs) are commonly known for providing communities across the globe with comprehensive patient care, extensive research programs, and educating our future healthcare providers. However, the high...more

Compliance Issues in Hospital and Health System Sports Sponsorships

Many hospital, health systems and other health care providers have seen benefits in sponsoring sports teams, stadiums and athletic tournaments. Considerations include general branding in the community, recruitment of staff or...more

Massachusetts DPH Delays Enforcement Penalties for State Surprise Billing Law

The Massachusetts Department of Public Health (DPH) has delayed the enforcement penalties for the new notice requirements under the “Patients First Law” until July 1, 2022. This news comes as a relief to the provider...more

Government Issues No Surprises Act Interim Final Rule with Comment Period (Part II)

On September 30, 2021, the U.S. Departments of Health and Human Services (HHS), Labor and Treasury (collectively, the Departments) along with the Office of Management and Budget released “Requirements Related to Surprise...more

Federal Government Publishes an Interim Final Rule (Part 1) Implementing the No Surprises Act

Over the last several years, both the federal government and a number of state legislatures have sought to find a solution to the billing by out-of-network providers, referred to as “Out of Network Billing” (OON Billing) and...more

Cardiac Medical Device Medicare Overpayment Self-Assessment – Methodology

More than 900 hospitals across the United States are approaching a Centers for Medicare & Medicaid Services (CMS)-imposed deadline to report overpayments from the removal (explant) of defective cardiac medical devices if...more

The President Issues an Order: Should I Stop Withholding Payroll Taxes?

On August 8, 2020 President Donald Trump issued four different executive actions in response to the breakdown in negotiations with congressional leaders over the next wave of economic stimulus programs designed to aid workers...more

COVID-19: States Protect Long-Term Care Facilities from Liability

COVID-19 has hit long-term care facilities very hard.  Every day brings reports of lethal outbreaks in such facilities and one-quarter or more of the reported COVID-19 related deaths in the United States have been connected...more

COVID-19: CMS Publishes Explanatory Guidance on Stark Blanket Waivers

As discussed in detail in a prior post, U.S. Health and Human Services Secretary Alex M. Azar II (the Secretary) issued blanket waivers of sanctions under the federal Physician Self-Referral Law (Section 1877 of the Act),...more

Massachusetts Governor Proposes Facility Fee Ban

Massachusetts Governor Charlie Baker has restarted the discussion on health care cost containment in the Commonwealth with a proposed bill that contains a raft of initiatives. This is the first in a series of blog posts to...more

Site-Neutral Hospitals Find Reprieve for their Outpatient Departments Through the Courts

On September 17, 2019, the D.C. District Court held that the Centers for Medicare & Medicaid Services (CMS) exceeded its statutory authority when it cut the payment rate for clinic services at off-campus provider-based...more

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