Health Updates

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Manatt on Health Reform: Weekly Highlights: November 2014 #2

With the conclusion of the midterm elections last week and open enrollment just around the corner, this week’s news highlights both renewed pledges from the opposition and a flurry of implementation activity in the states....more

Mainstream Wellness Program Challenged in EEOC v. Honeywell

Despite promulgating a paucity of guidance on what constitutes a “voluntary medical exam” under the Americans with Disabilities Act (“ADA”), on October 27, 2014, the U.S. Equal Employment Opportunity Commission (“EEOC”)...more

Health Update - November 2014

“Healthcare-Related” Calls: Ambiguity at the Intersection of HIPAA and TCPA - Editor’s Note: The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer...more

Orthopedic Patient Doesn’t Have a Leg to Stand On

It’s well known that Medicare, Medicaid and commercial insurers hate the ever-increasing trend of hospitals buying facilities and practices and then charging provider-based (i.e., higher) rates than the facilities and...more

Employment Law - November 2014

State Voters Pass Paid Sick Leave, Wage Increases - Why it matters: The polls have closed and the votes are in: The midterm elections will have a significant impact on employers across the country as voters in multiple...more

Liberia, Guinea, and Sierra Leone are Awarded Temporary Protected Status Designations

On November 20, 2014, the Secretary of Homeland Security announced that he would be designating Liberia, Guinea, and Sierra Leone for Temporary Protected Status (TPS) for 18 months, effective November 21, 2014 through May 20,...more

Liberia, Guinea, Sierra Leone Designated for Temporary Protected Status

Due to the outbreak of Ebola virus disease in West Africa, Secretary of Homeland Security Jeh Johnson announced the designation of Liberia, Guinea, and Sierra Leone for Temporary Protected Status (TPS) for 18 months,...more

D.C. Circuit Upholds Contraceptive Coverage Mandate

Last week, a unanimous three-judge panel of the D.C. Circuit upheld the religious accommodation to the Affordable Care Act’s (“ACA”) contraceptive coverage mandate (Priests for Life v. HHS, D.C. Cir. No. 13-5368, Nov. 14,...more

Manatt on Health Reform: Weekly Highlights: November 2014 #3

With the 2015 Open Enrollment Period (OEP) officially launched as of November 15, this week’s news highlights Marketplaces’ preparation for and tracking of outreach and enrollment – including 100,000 applications submitted on...more

DOL’s New Audit Focus? Health Plan Claims and Appeals and Hard to Value Assets

In recent talks and appearances, representatives of the U.S. Department of Labor have issued a warning about new areas of focus of DOL audits and enforcement actions. While there are a number of different enforcement...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

Mississippi CON Report - November 2014

In This Report: - I. October 2014 – Mississippi Certificate of Need Meeting - II. Certificate of Need Program Report – Filings/Reports Since September 2014 - Excerpt from October 2014 – Mississippi...more

HHS Issues Special HIPAA Guidance for Ebola Outbreak

The U.S. Department of Health and Human Services ("HHS"), Office for Civil Rights ("OCR"), released a bulletin last week addressing how covered entities (including certain health care providers and employer group health...more

Obama’s Executive Order, Its Impact on Health Care Costs, and the Constitutionality of Executive Orders

Pres. Barack Obama addressed the nation last night. He discussed his executive order that will delay deportations of up to 5 million migrants. What does an executive order on immigration have to do with Medicaid?...more

SuperVision Today - November 2014

Notes from the Chair and Executive Editor - Welcome to the fourth quarter edition of SuperVision Today, the quarterly e-newsletter published by Spilman's Labor & Employment Group. With the election results in,...more

Hospitals Should Be Aware of ACA Requirement to “Make Public” Their “Standard Charges”

A provision of the Affordable Care Act includes a requirement that hospitals disclose their standard charges to the public. 42 U.S.C. § 300gg-18(e) states that “[e]ach hospital operating within the United States shall for...more

DC Circuit Dismisses Appeal By Three Hospitals Challenging Subcontractor Status

On November 14, 2014, the United States Court of Appeals for the District of Columbia dismissed as moot an appeal by three hospitals affiliated with the University of Pittsburgh Medical Center. The hospitals had challenged...more

Vascular Solutions Inc. and its CEO Face Criminal Charges for Selling Unapproved Medical Devices

Last week, the Civil Division of the U.S. Department of Justice (DOJ) filed an indictment charging Vascular Solutions Inc. (VSI) and its CEO Howard Root with (1) selling medical devices without the approval of the U.S. Food...more

CMS Updates Manual Instructions to Implement CY 2014 MPFS Changes for Reimbursement of Investigational Devices and Related...

On November 6, 2014, CMS announced changes to its Medicare Benefit Policy Manual and Medicare Claims Processing Manual related to coverage of items and services in Category A and B Investigational Device Exemption (IDE)...more

HHS Extends November 17 Deadline to Submit Covered Lives Data under Reinsurance Program

The Health Care Reform Act created the transitional reinsurance program, which requires most self-insured health plans to make contributions to HHS for the 2014, 2015, and 2016 calendar years, in an attempt to stabilize...more

Just In Time for the Holidays: More Security Requirements From NIST

National Institute of Standards and Technology (NIST) has published draft recommendations aimed at securing the confidentiality of sensitive federal information located within non-federal entities’ information technology...more

Government turns up the heat with the False Claims Act – 5 action steps for healthcare providers

Forbes magazine has dubbed 2014 “The Year of the Whistleblower.” For healthcare providers, this designation has translated into millions of dollars in fines and penalties and the initiation of criminal investigations. ...more

CFO’s Thirst for Wine Club Invitation Costs Hospital Millions

You can’t make this stuff up. Last Monday a federal court in Rhode Island ordered two insurance companies to pay a $30 million claim by hospital management company Lifespan Corp. Lifespan filed the claim after being ordered...more

Insurance Antitrust Legal News - November 2014 - Volume 3 - Number 6

Plaintiff Files Third Amended Antitrust Claim Against Highmark - A long running antitrust dispute in Western Pennsylvania continued on October 1, when a Pennsylvania hotel (Cole’s Wexford Hotel) filed a third amended...more

Comments Sought by December 19th on the FDA's Proposed Criteria for "First Generic" Applications

This morning, the Food and Drug Administration (FDA) opened a public docket and requested comments on its proposed criteria for expedited review of "first generic" Abbreviated New Drug Applications (ANDAs). The comment period...more

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