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Proposed Regulations in New York for ACO Certification Reflect Medicare Shared Savings Program Influence

The New York State Department of Health (“NYSDOH”) published proposed regulations (the “Proposed Regulations”) in October that establish standards for the issuance of certificates of authority to Accountable Care...more

ACO Fraud and Abuse Waivers Extended Through November 2, 2015

On October 17, 2014 the Centers for Medicare and Medicaid (CMS) and Office of Inspector General (OIG) within the Department of Health and Human Services published a continuation notice in the Federal Register extending the...more

IRS provides interim guidance for ACO participation in Medicare Shared Savings Programs and expands safe harbors for management...

On October 24, 2014, the IRS published Notice 2014-67, which expands the Revenue Procedure 97-13 safe harbors regarding management contracts and further provides interim guidance related to a health care organization’s...more

Internal Revenue Service Releases Interim Guidance Regarding Accountable Care Organizations' Use Of Tax-Exempt Bond-Financed...

On October 24, 2014, the Internal Revenue Service (IRS) released Notice 2014-67, which provides guidance for determining whether a state or local governmental entity or an organization described by Section 501(c)(3) of the...more

Monetizing Real Estate: A Method to Access Capital

The financial situation for hospitals and health care organizations remains challenging. The accrediting agencies, Moody’s, Fitch, and S&P all have negative outlooks for the hospital industry. Hospitals are facing numerous...more

IRS Releases Guidance on Private Business Use, and ACOs and Management Contracts

On October 25, 2014, the Internal Revenue Service (the IRS) released Notice 2014-67 that provides interim guidance on (i) participation in the Medicare Shared Savings Program through an accountable care organization (ACO) and...more

Health Law Pulse - October 2014 # 2

In This Issue: - OIG Releases Proposed Rule Revising the Anti-Kickback Statute Safe Harbors and Civil Monetary Penalty Rules ..AKS Safe Harbors ..Revisions to the Civil Monetary Penalty...more

Health Headlines: Also in the News - October 2014 #4

New Guidelines Released Concerning Treatment of Ebola Patients – In response to increasing concerns about the risk posed by Ebola to healthcare professionals, the Centers for Disease Control and Prevention (CDC) released new...more

Health Headlines: Also in the News - October 2014 #3

CMS Allocates Additional Support for ACOs – On October 15, 2014, CMS announced that it will allocate up to $114 million towards 75 ACOs in order to encourage development in areas lacking the care models. CMS said that the...more

Internal Revenue Service Releases Notice Liberalizing the Private Business Use

On October 24, 2014, the Internal Revenue Service (“IRS”) released Notice 2014-67 (the “Notice”), providing guidance with respect to Accountable Care Organizations and their use of tax-exempt bond financed projects. The...more

IRS Releases Favorable Private Business Use Rules for Facilities Financed With Tax-Exempt Bonds

On October 24, 2014, the IRS released Notice 2014-67, which establishes more favorable safe harbors for types of service contracts and other arrangements using property financed with tax-exempt bonds. The Notice also provides...more

Notice 2014-67 ?? Safe Harbors for ACOs and a New Management Contract Safe Harbor for Everyone

On Friday, Oct. 24, 2014, the Internal Revenue Service released interim guidance, Notice 2014-67, on whether a state or local government entity or an organization described in §501(c)(3) of the Internal Revenue Code of 1986,...more

IRS Releases Private Business Use Guidelines for ACO Participants

On Friday, October 24, 2014, the Internal Revenue Service (IRS) released Notice 2014-67, providing guidance regarding the circumstances under which participation by a hospital in an Accountable Care Organization (ACO) will...more

Fraud and Abuse Waivers for MSSP ACOs Extended Another Year

Fridays are for fraud and abuse news-related releases, yet again. Last Friday, the HHS Office of the Inspector General (OIG) released a notice (Notice) informing the public that it has delayed the release of a final rule...more

CMS and OIG Extend Interim Final Rule Regarding Waivers of Fraud and Abuse Laws For ACOs

On October 17, 2014, CMS and OIG jointly published a notice extending the effectiveness of a November 2011 interim final rule establishing waivers that protect qualifying accountable care organizations (ACOs) from liability...more

Hospital Conversion to For-Profit Status Improves Health (i.e., Financial Health)

For years the debate has raged: Does conversion of a nonprofit hospital to for-profit status result in a decline in clinical quality? An improvement? More efficient operations? A decrease in the volume of indigent and...more

Medicare Shared Saving Program Interim Final Rule Extended

On October 17, 2014, the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services, Office of Inspector General (OIG) published in the Federal Register (79 FR 62356 et seq) a notice...more

Pioneer ACOs: Slowed Health Spending, Improved Quality and More Drop Outs?

The Centers for Medicare and Medicaid Services (CMS) recently released second year results on its Pioneer Accountable Care Organization (ACO) program. The Pioneer ACO program is CMS’ ambitious foray into the ACO space and a...more

The New York State Department of Health Releases Long-Awaited Proposed Regulations Authorizing the Formation of ACOs

The long-awaited proposed regulations authorizing the formation of accountable care organizations (“ACOs”) in New York are finally here. Interested parties may comment on the proposal until December 1, 2014. The regulations...more

Colorado Supreme Court Protects Quality Management Privilege for CDPHE-Licensed Providers

Colorado hospitals and other licensed and certified health care facilities scored a significant victory on October 14, when the Colorado Supreme Court issued its en banc ruling in Simpson v. Cedar Springs Hospital, Inc. (2014...more

CMS Announces Program to Fund ACO Growth, Extends Fraud and Abuse Waivers

The Centers for Medicare & Medicaid Services (“CMS”) announced a new initiative, the ACO Investment Model, on October 15, 2014. Under the model, ACOs which are made up of “providers [who] lack adequate access to … capital”...more

Getting the Most Out of Physician Practice Acquisitions: Considerations for Converting Acquired Physician Practices into...

Hospitals acquiring physician practices need to balance competing considerations when determining how to fit them in the larger organization. Financial considerations weigh heavily, but so do considerations about finding some...more

Medicaid ACOs: States’ Answer to Escalating Costs?

States increasingly are experimenting with the use of Accountable Care Organizations (ACOs) in their Medicaid programs as a possible avenue to curb the escalating costs of providing care to expanding Medicaid populations....more

Perspectives - Trends and topics in not-for-profit management - September 2014

In this Issue: - Not-for-Profit Volunteers: HIPAA Compliance & Training - Not-for-Profit Spotlight: Project Sunshine - 10 Ways to Lose Your Not-for-Profit Status - Economic Development...more

An Ounce of Prevention in Health Care — The Importance of Periodic Corporate Audits

Most, if not all, health care providers operate their businesses in an entity form, such as a corporation or limited liability company (LLC). Many use multiple entities—for example, one entity to own the real estate (or a...more

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