Small Business Securities Bulletin: SEC Adopts Long-Awaited Crowdfunding Rules

A periodic bulletin keeping small businesses informed about current developments in securities law and related matters. By way of background, pursuant to Section 5 of the Securities Act of 1933 (Securities Act) and state…more
| Communications & Media Law, Finance & Banking, Securities Law

Congress Enacts "Provider-Based" Surprise

Hospitals have long tried to expand their footprints by developing, or in many instances acquiring, physician practices and other medical operations to provide services beyond the immediate vicinity of the hospital’s campus. The…more
| Health

CMS Issues CY 2016 Final Rule for Hospital Outpatient and Ambulatory Surgical Center Policy and Payment Changes

On October 30, 2015, CMS issued its final policy changes, quality provisions and payment rates for the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for…more
| Health

CMS Proposes Significant Revisions to Hospital Discharge Planning Process: How Patient Choice May be Impacted

On November 3, 2015, CMS released a proposed rule revising existing discharge planning requirements for hospitals, critical access hospitals (CAHs) and home health agencies (HHA). CMS stated impetus for doing so is to both…more
| Health

Court Upholds HHA Face-to-Face Narrative Requirement

The Medicare statute requires that home health agency (HHA) patients must be homebound and in need of skilled nursing or therapy services in order to receive Medicare HHA services. 42 U.S.C. § 1395f(a)(2)(C). Historically, this…more
| Administrative Law, Civil Procedure, Health

OIG Approves Health System's Complimentary Transportation Program

Recognizing that a narrowly tailored complimentary transportation program may pose minimal risk of fraud and abuse, the OIG posted favorable Advisory Opinion No. 15-13 on October 21, 2015. The Opinion approves an integrated…more
| Health

Limited Modifications in Final ACO Fraud and Abuse Waivers Most Notably Include Cut of Gainsharing CMP Waiver

Nearly four years after publishing their joint interim final rule with comment period, effective November 2, 2011 (IFC), the OIG and CMS (Agencies) have finalized the waivers of various fraud and abuse laws in the context of…more
| Administrative Law, Business Organizations, Health

Not Just A Union Issue: NLRB Decision Changing the Test For Joint Employer Status Affects Non-Union Employers, Too

As the National Labor Relations Board (the "Board"), traditionally the arbiter of all issues involving labor and unions, continues to broaden its reach into the world of non-union employers, it has begun to dismantle decades-old…more
| Franchise Law, Labor & Employment Law

Challenges to Medicare's Outlier Payment Rules - the Secretary Largely Prevails

As we reported in an earlier Payment Matters article, the United States Court of Appeals for the District of Columbia Circuit handed hospitals a partial victory on May 19, 2015, in their challenge to Medicare outlier payments…more
| Administrative Law, Civil Procedure, Health

The Bad Debt Moratorium Requires a Flexible Approach to Evaluating "Reasonable Collection Efforts"

On September 10, 2015, District Judge Randolph D. Moss of the U.S. District Court for the District of Columbia issued an opinion in Mountain States Health Alliance v. Burwell (Mountain States) involving Section 310 of the…more
| Administrative Law, Civil Procedure, Health

OIG Pushes OCR to Step Up HIPAA Enforcement

In two recent reports, each with a specific focus, the OIG strongly recommended that the Office for Civil Rights (OCR) step up its HIPAA oversight and enforcement activities. One report assessed the OCR’s oversight of covered…more
| Consumer Protection, Health, Privacy, Science, Computers, & Technology

CMS Takes First Step to Reduce Payments for Clinical Laboratory Tests

CMS recently published a proposed rule that would substantially revise the methodology used to pay for clinical laboratory tests that continue to be compensated separately by Medicare. Medicare Program; Medicare Clinical…more
| Health, Science, Computers, & Technology

Physician Payment: CMS Seeks Suggestions for SGR, PQRS, Meaningful Use and VBM Replacement

CMS would like your help in developing the replacement to the Sustainable Growth Rate adjustment (SGR). But you need to act quickly because CMS' cutoff date for your suggestions is October 31, 2015…more
| Health

Board of Physician Reporting Requirements of Physician Privilege and Employment Changes

Attached is an annotated version of a letter I sent to the Board of Physicians (Board) regarding its proposed new regulations on mandatory hospital (and other healthcare facilities) reporting of any changes in privileges and…more
| Administrative Law, Health

Uncertainty Continues for Two-Midnight Rule's Payment Reduction

In Shands Jacksonville v. Burwell [PDF], No. CV 14-1477, 2015 WL 5579653, (D.D.C. Sept. 21, 2015), the United States District Court for the District of Columbia gave the Secretary of the Department of Health and Human Services…more
| Administrative Law, Civil Procedure, Health
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100 Light Street
Baltimore, MD 21202, United States

  • 410.685.1120
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100+ Attorneys

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