News & Analysis as of

No False Claims Act Case Where There is No False Claim – DNJ Throws Out Qui Tam Action Against Genentech

Halloween has come and gone. The Drug and Device Law Little Dogs stayed in their costumes (Batgirl and a rabbi) long enough to be photographed for (unsuccessful) entries for a pet costume contest. There was ample candy –...more

CMS Adopts Changes to Medicare & Medicaid EHR Policies

The Centers for Medicare & Medicaid Services (CMS) has published a sweeping final rule with comment period that specifies the requirements that eligible professionals (EPs), eligible hospitals, and critical access hospitals...more

MedPAC Discusses Changes to Medicare Advantage Payment System

On October 8 and 9, 2015, the Medicare Payment Advisory Commission (MedPAC) held its second meeting of the 2015-2016 session. Commissioners met to examine ways to improve the Medicare Advantage (MA) payment system, including...more

GAO Releases Report on Initial Results of CMS’s Hospital Value-Based Purchasing Program

The U.S. Government and Accountability Office (GAO) issued an October 2015 report to congressional committees concluding that the initial results of the Hospital Value-Based Purchasing (HVBP) program show “no apparent shift”...more

2014 Medicare ACO Results Released: CMS Asserts Success but Few ACOs Receive Payments

The Centers for Medicare and Medicaid Services (CMS) released, on August 25, 2015, the quality and financial performance results for Medicare Accountable Care Organizations for 2014. CMS touted that Medicare ACOs continued to...more

CMS Continues Its Focus on Quality Initiatives with the FY 2016 IPPS Final Rule

On July 31, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a final rule (Final Rule) updating fiscal year (FY) 2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS)...more

CMS Issues Final FY 2016 Medicare IPPS/LTCH Rule

On July 31, 2015, the Centers for Medicare & Medicaid Services (CMS) released a major final rule to update the Medicare acute hospital inpatient prospective payment system (IPPS) and the long-term care hospital prospective...more

Health Care Update - August 2015

CMS Releases Final Payment Rules (IPPS, IRF, LTCHs, Hospice, and Psych): At the end of last week, the Centers for Medicare and Medicaid Services (CMS) released a set of final 2016 payment rules affecting acute care hospitals...more

Health Care Update - July 2015 #2

Congress Slowly Works on Budget Reconciliation; ACA Reform Proposals Still Up in the Air - The FY 2016 budget resolution, which was agreed to by Congress this past April, included broad reconciliation instructions...more

CMS Call: Medicare Acute Care Quality and Reporting Programs (May 12)

On May 12, 2015, CMS is hosting a call that will provide an overview of all Medicare hospital inpatient quality reporting and value-based purchasing programs. Specifically, the call will cover: the Hospital Inpatient Quality...more

CMS Proposes Updates to EHR Meaningful Use Rules

CMS published a proposed rule on April 15, 2015 that would modify the Medicare and Medicaid Electronic Health Record (EHR) Incentive program to reduce complexity, simplify reporting requirements, and align Stage 1 and Stage 2...more

MACRA’s Advancement of EHR Interoperability and Telehealth

This is the fourth and final post in our series on the Medicare Access and CHIP Reauthorization Act (MACRA). Pub.L. No. 114-10. We’ve previously covered the repeal of the Sustainable Growth Rate (SGR) in our April 20th post,...more

HHS Releases Two Healthcare Information Technology Proposed Rules

On March 20, 2015, CMS and the HHS Office of the National Coordinator for Health Information Technology (ONC) released proposed rules regarding Stage 3 of the Medicare and Medicaid Electronic Health Records (EHRs) Incentive...more

Health Update - February 2015

Cyber Risk Insurance Policies: What You Need to Know - Editor’s Note: As data breach incidents and related cyber risks continue to increase and gain publicity—and government agencies become more actively involved in...more

HIPAA and “Meaningful Use” Audits: Issues to Consider and How to Prepare

As more and more providers adopt electronic health records (“EHRs”) systems (and with new regulations concerning their required use for purposes of Medicare billing for chronic care management, their popularity can only...more

CMS, ONC Update Meaningful Use FAQ, Lay Groundwork for HIT Changes

CMS and the Office of the National Coordinator for Health IT (ONC) announced several policy developments last week relating to electronic health record (EHR) technology issues....more

Hospital Executive Pleads Guilty to False Meaningful Use Attestation for EHR Incentive Payments

The former CFO of Shelby Regional Medical Center, Joe White, pleaded guilty to knowingly making a false statement related to the hospital’s meaningful use of electronic health records (“EHR”). Shelby Regional had received...more

HHS Proposes Extension of Deadline for EHR Compliance

According to the federal government, over 370,000 providers have participated in the Medicare and Medicaid Electronic Health Record ("EHR") incentive program since its inception in 2011. However, providers nationwide continue...more

CMS Extends Deadline for 2013 Meaningful Use Attestations

CMS announced on Friday, February 7, 2014, that the agency is extending the deadline for eligible professionals (EPs) to attest as meaningful users of certified electronic health record (EHR) technology for the 2013 Medicare...more

CMS Extends 2013 Meaningful Use Attestation Deadline for Eligible Professionals

On Feb. 7, the Centers for Medicare & Medicaid Services (“CMS”) extended by one month the deadline for eligible professionals to attest to meaningful use for the 2013 Medicare EHR Incentive Program year. The deadline was...more

Privacy and Security Alert: January 9th, 2014

On December 5, 2013, the Office of Inspector General (OIG) reported on the Office for Civil Rights’ (OCR) compliance as of May 2011 with oversight and enforcement of the Security Rule and compliance with federal cybersecurity...more

CMS & OIG Final Rules Extend And Amend Protection For EHR Donations

Ordinarily, the donation of Electronic Health Record (EHR) technology, services or training to a provider would raise fraud and abuse concerns and potentially implicate the Stark law and Anti-kickback Statute. In order to...more

Final EHR Donation Rules Issued in Time for the New Year

On December 27, 2013, the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) issued final rules revising the Stark exception (42 CFR...more

The Long Sunset: EHR Donations May Continue Until 2021 (With a Few Changes)

Under long-awaited final rules recently published by the federal government, hospitals and other “protected donors” may continue to “donate” interoperable electronic health record items and services without incurring...more

CMS Extends Start Date for Stage 3 of Meaningful Use to 2017 Without Extending Timeline for When Providers Must Start Stage 2

The Centers for Medicare & Medicaid Services recently announced a revised timeline for the implementation of Stage 3 “meaningful use” measures for the Electronic Health Records Incentive Programs, but did not extend the...more

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