Hospitals

News & Analysis as of

August Scam-of-the-Month Award

It turns out that back in 2011 the hospital sold the right to use its hospital billing codes to free-standing clinics. So under the arrangement, when the clinics sent bills, they were hospital bills rather than clinic bills...more

Week in Review

Significant electronic data breaches made headlines again this week. Supervalu announced that millions of customer credit card numbers were stolen at various stores. ...more

Alabama CON Report - August 2014

In This Report: - I. SHPDA Administrative Report - A. For Informational Purposes Only - II. Certificate of Need Program - A. Reconsideration on Home Health Batched Applications - B....more

Antitrust Considerations Surrounding Health Care Consolidation Among Hospitals and Physicians

The Affordable Care Act (“ACA”) has resuscitated the demand for hospital and health care provider mergers. The law explicitly encourages collaborative care—through, for example, financial incentives surrounding the creation...more

Massive Data Breach Affects 4.5 Million Patients in 29 States

Community Health Systems, Inc. (the “Company”), one of the largest hospital organizations in the country, announced via a public filing (Form 8K) made yesterday with the Securities and Exchange Commission (“Report”) that the...more

Class Action Plaintiffs Look to Fair Credit Reporting Act for Private Relief from Data Breaches Involving Health Information

A recent class action brought against the University of Miami (“University”) previews what could become an emerging trend among plaintiffs’ class action attorneys to seek damages for the unauthorized disclosure of personal...more

Hospital Operator Reports 4.5 Million Patients’ Data Stolen in Cyberattack

The Tennessee-based acute-care hospital chain Community Health Systems, Inc. (CHS), reported on August 18 that information on approximately 4.5 million patients was stolen from the company. CHS is one of the largest hospital...more

4.5 Million Patients’ Information Stolen by Hackers

Community Health Systems Inc. (“CHS”), a Tennessee-based hospital provider, has reported it was the target of data hackers who were able to obtain identification information belonging to approximately 4.5 million CHS...more

Who Audits the Auditors?

Since the advent of Medicare in 1965, hospitals have bemoaned the cost and burden of Medicare audits. The complaints increased when CMS hired private contractors for the audits. They became deafening in 2009 with the advent...more

New Jersey DCA Extends Deadline for Prescription Blanks

On February 18, 2014, the New Jersey Division of Consumer Affairs (the “DCA”) adopted new regulations which incorporate print-based security features into all New Jersey Prescription Blanks (NJPBs). The DCA has recently...more

Government Sues Hospital for Birthing Mama’s Babies

The Clinica de la Mama case could well serve as an instruction manual of what not to do to stay out of the government’s crosshairs. In this case, several hospitals entered into contracts for Clinica de la Mama to provide...more

Hospital Network Reports Large HIPAA Breach

Community Health Systems announced yesterday, August 18th, that hackers broke into its computers and stole data on 4.5 million patients. ...more

Acute Care Hospitals Settle FCA Lawsuits for $98 Million

Community Health Systems, Inc. (CHS) and Community Health Systems Professional Services Corporation, together a national owner and operator of acute care hospitals, and 119 of their hospitals, agreed to pay $98 million to...more

CMS Releases FY 2015 Hospital Inpatient Prospective Payment System (IPPS) Final Rule

On August 4, 2014, CMS released the annual Hospital Inpatient Prospective Payment System Final Rule for FY 2015 (the “Final Rule”) affecting discharges occurring on or after October 1, 2014. For inpatient acute care...more

New Federal Health Care Facility Regulations Could Mean More Construction Work

On April 16, 2014, the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, published proposed rules that would amend the fire safety standards for hospitals,...more

Unnecessary Surgeries Put Hospital in Three-Front War

When the government accuses a hospital of committing Medicare fraud by billing for unnecessary surgeries, the hospital has a real problem on its hands. It’s at war with the government, and that’s expensive, as well as...more

Pennsylvania Issues Regulations Under Excessive Overtime in Health Care Act

On July 19, 2014, the Pennsylvania Department of Labor and Industry published new regulations to implement certain provisions of the Prohibition of Excessive Overtime in Health Care Act, 43 P.S. §§ 932.1 to 932.6 (the "Act")....more

What’s Scarier than a Compliance Officer Turned Whistleblower? A Whole Association of Them

In U.S. ex rel. Corporate Compliance Assocs. v. N.Y. Society for the Relief of the Ruptured & Crippled the court ruled that the whistleblower failed to meet the False Claims Act’s requirement that allegations be described...more

Proskauer Obtains Dismissal of High-Stakes False Claims Act Suit

On August 7, 2014, Judge Castel of the Southern District of New York dismissed a False Claims Act (“FCA”) complaint that was based primarily on allegations that the defendant Hospital improperly focused on referral revenue in...more

Massachusetts Enforces Data Security Regulations Against Out-of-State Entity

On July 23, 2014, the Massachusetts Attorney General announced a consent judgment with an out-of-state Rhode Island hospital, Women & Infants Hospital of Rhode Island (“WIH” or the “Hospital”), resolving a lawsuit against WIH...more

CMS Publishes FY 2015 Final IPPS Rule

On August 4, 2014, CMS posted its final changes and updates to the Medicare Inpatient Prospective Payment System (IPPS) that apply for fiscal year (FY) 2015, effective October 1, 2014. Below are some of the highlights of the...more

Federal Prosecutors Bring Criminal Charges against Individual for Alleged HIPAA Violation

Federal prosecutors in the Eastern District of Texas recently brought criminal charges under the Health Insurance Portability and Accountability Act (“HIPAA”) against a former East Texas hospital employee. The former...more

Early Report on Value-Based Purchasing: Less to It Than Meets the Eye?

Medicare’s Value-Based Purchasing (VBP) program produced no improvement in either quality of care or patient satisfaction during its first nine months of operation. That’s the finding of a study led by Andrew Ryan, of the...more

Health Headlines: Also in the News - August 2014

Hospital IPPS Final Rule Not Yet Released – As of the time this edition of Health Headlines was sent to press, CMS has not yet released the hospital inpatient prospective payment system (IPPS) final rule for FY 2015....more

The Reformed Health Care Industry: Creative Structures and Alliances Can Yield Great Benefits, but Also Great Risks

Since the Affordable Care Act (the “ACA”) was enacted in 2010, the health care industry has been on the edge of its proverbial seat waiting to see which care delivery models are best suited to sustain all the changes: to...more

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