Ober|Kaler

Charity's Patient Assistance Program Passes OIG Muster in Advisory Opinion 15-17

On December 28, 2015, the Department of Health and Human Services, Office of Inspector General (OIG) issued OIG Advisory Opinion 15-17, approving a charity’s proposal to unveil a new patient assistance program dedicated to…more
| Health, Nonprofit Law, Science, Computers, & Technology

OIG Issues (Another) Favorable Advisory Opinion Regarding Medigap/Preferred Hospital Network Arrangement in Advisory Opinion 16-01

On January 7, 2016, the Department of Health and Human Services, Office of Inspector General (OIG) issued Advisory Opinion 16-01, approving yet another insurer’s proposed contract with a preferred hospital network. The advisory…more
| Antitrust & Trade Regulation, Civil Procedure, Commercial Law & Contracts, Health, Insurance

Senate Considering Bill to Speed Medicare Claims Appeals

In early December of last year, Orrin Hatch (Senate Finance Committee Chairman, R-UT) and Ron Wyden (D-OR) introduced the Audit and Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (AFFIRM Act). The purpose of…more
| Elections & Politics, Health

Outliers: CMS Explains its Reasoning for FY2004 Fixed Loss Threshold Calculation

In accordance with the order issued by the D.C. Circuit in District Hospital Partners, LP v. Burwell and related cases, on January 22, CMS issued an explanation of the methodology it used to calculate the fixed-loss threshold…more
| Civil Procedure, Health

DMEPOS Prior Authorization Rules Expand

On December 30, 2015, CMS published a final rule entitled: "Medicare Program; Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies," implementing Section 1834(a)(15) of the…more
| Health

HHS Psychiatric Hospital Reimbursement Methodology Upheld

On December 29, 2015 the U.S. Court of Appeals for the District of Columbia rejected a challenge to a psychiatric hospital's pre-PPS Medicare reimbursement. Washington Regional Medicorp v. Burwell, No. 1:13-cv-00622 (D.C. Cir…more
| Administrative Law, Civil Procedure, Health

2-Midnight Rule Updates

- CMS Adopts Change to Benchmark and Shift in Enforcement - CMS Explains Reasoning Behind 0.2% Payment Reduction CMS has published discussions of the 2-midnight rule in two recent Federal Register publications. In the…more
| Health

CMS Changes to Cost Report and Appeal Rules Are Now in Effect

As part of the Outpatient Prospective Payment System (OPPS) final rule published in the Federal Register on November 13, 2015, CMS made noteworthy changes to the Medicare cost report and appeal rules. See 80 Fed. Reg. 70298…more
| Administrative Law, Civil Procedure, Health

WEBINAR: Creating Stable Security and Compliance Relationships Between Health Care Organizations and Vendors

The Omnibus Rule implementing the HITECH Act made several changes to the HIPAA Privacy and Security Rules that profoundly changed the dynamic between health care providers and vendors. In addition, the Breach Notification Rule…more
| Health, Privacy

WEBINAR: Protecting Your Patients, Workforce and Visitors from Workplace Violence and Active Shooters

The Ober|Kaler Health Care General Counsel Institute presented this webinar on key considerations for health care facilities in protecting patients, workers and visitors from workplace violence and active shooter situations…more
| Administrative Law, Health, Labor & Employment Law

WEBINAR: Cloud Computing & Health Care Organizations - Critical Privacy & Security Issues

More and more organizations are turning to the cloud because of how flexible and low-cost it is. As a result, many health care organizations are now using cloud-based servers to store patient information and are discovering new…more
| Privacy, Health, Science, Computers, & Technology

CMS Issues CY 2016 HHA PPS, Value-Based Purchasing and Quality Reporting Final Rule

On November 5th, CMS published the Final PPS Rule for Home Health Agencies (HHAs) for CY 2016. The rule implements annual changes to the PPS rates for HHAs and represents the third year in a four-year rebasing of the rates. In…more
| Health

Stark Updates Included in Final 2016 Physician Fee Schedule

With the final Medicare physician fee schedule (PFS) for 2016, the Centers for Medicare and Medicaid Services (CMS) has made a series of updates to the Stark physician self-referral regulations. The final rule is largely similar…more
| Health

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
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100 Light Street
Baltimore, MD 21202, United States

  • 410.685.1120
  • 410.547.0699

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100+ Attorneys

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