Healthcare

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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

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

Health Headlines: Also in the News - November 2014 #2

Dialysis Facility Compare Star Ratings and Data Release – CMS has finalized its methodology for its Dialysis Facility Compare Star Ratings program and expects to post ratings to Dialysis Facility Compare in January...more

Why Providers Should Think About the Impact of ICD-10 on Managed Care Reimbursement Now

ICD-10 implementation has been delayed by Medicare until October 2015. Many believe it may be delayed again and are putting off thinking about its impact until it is clear that the updated code set will be implemented by...more

Where All the Hospitals Are Above Average

According to the report, 1,224 hospitals are “top performers.” The report was released in Chicago – not Lake Wobegon – but the number of top performers represents about 37% of all hospitals in the sample, which consists of...more

MedPAC Considering Changes to Hospital Short-Stay Policies and Associated RAC Audits

Last week at its monthly meeting, the Medicare Payment Advisory Commission (MedPAC) discussed current issues with hospital short-stay policies. Specifically, MedPAC discussed the possibility of reducing the incentive to admit...more

Health Alert (Australia) - November 17, 2014

In This Issue: Judgments; Legislation; and Reports. Excerpt from Reports: American Medical Association (AmMA) - 10 November 2014 - New American Medical Association Policy Works to Protect Patient...more

The Game Plan for Health Care Enforcement: Office of Inspector General Releases 2015 Work Plan

The Office of Inspector General (“OIG”) within the federal Department of Health and Human Services (“HHS”) is charged with protecting the integrity of HHS programs by combating fraud, abuse and waste. On Halloween of 2014,...more

Behavioral Managed Care Organizations Do Not Have Unbridled Discretion – Providers Have Rights

Here is a common scenario: A behavioral healthcare provider has committed substantial resources into developing specialized behavioral healthcare services in the counties managed by a Managed Care Organization (“MCO”) under...more

Same Surgical Procedure Exception under 21 CFR 1271.15(b): FDA Raises More Questions Than it Answers Regarding the Scope of the...

The FDA has released a new draft guidance document for industry entitled “Same Surgical Procedure Exception under 21 CFR 1271.15(b): Questions and Answers Regarding the Scope of the Exception” (the Guidance Document), which...more

Post-Acute Care Summary Report - 2014: Benesch Health Care Market Intelligence

In this Issue: - Key Findings - Subsector Activity - Regulatory/Legal - Reimbursement - Excerpt from Key Findings: • The post-acute care (PAC) sector has seen an increase in mergers...more

Leading Private Equity Investment Themes Topic of Second Annual Health Care Investors Summit

With a keynote speech by Tenet Vice Chair Keith Pitts, and three panel discussions lead by investor representatives from Thomas Lee Partners, Riverside Partners, Nautic, and Welch Carson as well as provider and payer speakers...more

ACO Participation By Tax-Exempt Healthcare Organizations – Is Tax-Exempt Financing at Stake?

Does A Tax-Exempt Healthcare Organization’s Participation in an Accountable Care Organization (ACO) Adversely Affect Its Tax-Exempt Financing? IRS Notice 2014-67 Provides Guidance....more

HIPAA in the Time of Ebola

Ebola has recently been the source of much concern, and health care providers and hospitals are taking steps to prepare themselves for the possibility of treating patients with Ebola. In addition to all of the medical...more

Ebola or Not, Patient Privacy Must Be Protected: Office for Civil Rights Issues Bulletin on HIPAA Requirements in Emergency...

In the wake of the recent Ebola cases, the U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has issued a new bulletin reminding HIPAA-covered entities and their business associates that the...more

VA Health Reform: New Opportunities for Providers

The Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113-146) significantly expands access to health care services funded by the U.S. Department of Veterans Affairs (VA), creates new opportunities for...more

Impact of Midterm Elections on Health Care

The November 4 elections saw the Republican party win control of the U.S. Senate, increase its majority in the House of Representatives, and increase its majority of governorships....more

2014 Telemedicine Survey Executive Summary

Technology has influenced nearly every sector of the economy, and the health care industry is following suit. Among telemedicine’s many benefits are the potential to exponentially expand a provider’s geographic footprint, use...more

Special Edition Health Care Update - Elections Wrap Up, Lame Duck Preview, and a Changing Congress

In This Issue: - Impact of Midterm Elections - Lame Duck Preview - Ebola Epidemic and Lame Duck Response - Implementation of the Affordable Care Act - Other Federal Regulatory...more

HHS OIG Announces Information Security Initiatives in 2015 Work Plan

The 2015 Work Plan of the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) posted on Friday, October 31, 2014, includes initiatives focused on testing information security controls related to...more

SCOTUS to Review Subsidy Issue

On November 7, the U.S. Supreme Court announced it was going to review King v. Burwell. At issue in the case is whether Fourth Circuit correctly determined that the IRS did not exceed its authority when it released a rule in...more

The Government Is Going to Take My Money (and Other Medicaid Myths)

Due to ever-increasing nursing home costs, many clients have contacted us about Medicaid eligibility. Medicaid is a government program designed (in part) to pay the cost of nursing home care for those who need long-term care...more

Arrangements between Laboratories and Referring Physicians Involving “Registries”

The United States Office of Inspector General (“OIG”) recently issued a “Special Fraud Alert” focusing on two potentially illegal trends that it has detected in arrangements between laboratories and their referring...more

Iowa State Researcher Accused of Scientific Fraud

Here at Whistleblower Security, we’ve covered basically every type of fraud from phone fraud to check fraud to academic fraud to even food fraud. Now it’s time to talk about scientific fraud....more

Blog: Connecticut Court Holds HIPAA Does Not Preempt Common Law Claim for Breach of Confidentiality

The Connecticut Supreme Court held that the federal Health Insurance Portability and Accountability Act (HIPAA) does not bar individuals from bringing negligence and emotional distress claims under state common law for breach...more

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