News & Analysis as of

Health Care Providers

Quality Payment Program EHR Hardship Application Now Open

by Baker Ober Health Law on

The Quality Payment Program (QPP) hardship exception application is now open for those providers seeking a score adjustment related to their use of electronic health records (EHR). Providers who meet certain criteria can...more

Physicians Maintain High Standards

by Burr & Forman on

By the time this article goes to print, a lot could change, so there’s no apparent use in guessing what will come of the next Repeal and Replace efforts or what’s happening at Main Justice. Nobody knows. The only certainties...more

Uncertainty Surrounds Low Income Pool (LIP) Funding

The Centers for Medicare and Medicaid Services (CMS), in an August 3, 2017 letter to Florida’s Medicaid Director, approved a five-year extension of the State’s 1115 demonstration project, the Managed Medical Assistance...more

Alabama CON Report

I. For Informational Purposes Only - Contested Case - AL 2017-024, The Troy Hospital Health Care Authority d/b/a Troy Regional Medical Center, Troy, Alabama: Proposes to acquire, relocate and operate 18 geriatric...more

The Tennessee Health Services and Facilities Report - August 2017

by Burr & Forman on

The Tennessee Health Services and Development Agency ("HSDA") is responsible for regulating the health care industry in Tennessee through the Certificate of Need Program. A Certificate of Need ("CON") is a permit for the...more

Recent 11th Circuit Decision Is a Victory for Health Care Providers Challenging Insurer Reimbursement Decisions and a Reminder of...

by K&L Gates LLP on

The existence and scope of assignments of benefits from patients to health care providers continues to be critically important to a provider’s ability to challenge an insurer’s reimbursement decision under the Employee...more

AGG Food and Drug Newsletter - August 2017

by Arnall Golden Gregory LLP on

Arnall Golden Gregory LLP's Food and Drug Newsletter is a monthly update of legal and regulatory issues that affect the FDA-regulated community, including regular updates on legislative initiatives from AGG’s Washington, DC...more

District Court Finds Hospital’s Joint Venture Not “Per Se” Unlawful

On the eve of trial, and after years of litigation (including an appeal to the Sixth Circuit), all claims by Dayton, Ohio hospital The Medical Center at Elizabeth Place (“MCEP”) against Premier Health Partners (“Premier”)...more

Blog: OIG Releases August Work Plan Items

by Cooley LLP on

As we recently announced, the Office of Inspector General (OIG) is updating its Work Plan monthly rather than its previous twice-yearly publications. The August updates released this week include 4 new Work Plan items:...more

MACRA: Proposed Changes to the Merit-Based Incentive Payment System Track

by Polsinelli on

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule on the Medicare Quality Payment Program (QPP) in the Federal Register1 on June 30, 2017. This rule proposes the QPP program requirements for...more

Need OSHA Action On Ammonium Nitrate And Healthcare Workplace Violence, Government Monitor Urges

by Jackson Lewis P.C. on

Focus is needed on two safety and health priorities: healthcare workplace violence and high-risk facilities that handle hazardous substances such as ammonium nitrate, chief of the Government Accountability Office Gene L....more

Lawyers, Drugs, and Money – The Opioid Crisis Makes for Strange Bedfellows

by Arnall Golden Gregory LLP on

It seems that almost every day there is a new development in the government’s response to the opioid crisis or opioid emergency. But it’s not only the government and healthcare providers that are considering novel approaches....more

Maintaining Privilege for Quality Assurance Performance Improvement (QAPI) Documents and Reports

The Affordable Care Act (ACA), which was passed in 2010, provides authority for the Centers for Medicare & Medicaid Services (CMS) to establish and implement a Quality Assurance and Performance Improvement program for nursing...more

Tennessee Health Services and Facilities Report: August 2017 Newsletter

by Burr & Forman on

The Tennessee Health Services and Development Agency (“HSDA”) is responsible for regulating the health care industry in Tennessee through the Certificate of Need Program. A Certificate of Need (“CON”) is a permit for the...more

Polsinelli/TrBK Distress Indices Show Healthcare Distress at Record High

by Polsinelli on

We're pleased to announce the release of the Polsinelli|TrBK Distress Indices for the Second Quarter of 2017. Polsinelli, with data provided exclusively by TexHost, LLC d/b/a TrollerBk.com, publishes the Indices on a...more

340B Covered Entities Beware: CMS Proposes Drastic Drug Reimbursement Rate Cuts

by Polsinelli on

In its Outpatient Prospective Payment System proposed rule ("Proposed Rule"), CMS outlined a significant Medicare Part B payment reduction for separately payable, nonpassthrough drugs provided in the hospital outpatient...more

Federal Government to Target False EHR Incentive Payments

by Barley Snyder on

While health care reform remains bogged down, the federal government’s efforts to curtail fraud, waste and abuse in its health care programs fervently continues. Most recently, the U.S. Department of Health and Human...more

State Official Charged With Taking Bribes In Connection With $1 Billion Healthcare Fraud Scheme

by Arnall Golden Gregory LLP on

On July 22, 2016, the Department of Justice announced the indictment of the owner of more than 30 Miami-area skilled nursing and assisted living facilities, a hospital administrator, and a physician’s assistant in connection...more

California Hospitals Successfully Beat Back Medicaid Payment Cut

by King & Spalding on

Almost a decade ago, California submitted a State plan amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS) that would retroactively implement a ten-percent rate reduction in outpatient services provided to...more

EMTALA Settlement Highlights Continuing Challenges for Hospitals

After 30 years as a fixture in the federal healthcare regulatory landscape, the Emergency Medical Treatment and Labor Act—more commonly known as EMTALA—has been in the news again. In the past year, the U.S. Department of...more

Department of Justice Pilot Program Will Focus on Opioid Fraud and Abuse

by Arnall Golden Gregory LLP on

On August 2, 2017, Attorney General Jeff Sessions announced the formation of the Opioid Fraud and Abuse Detection Unit and a new Department of Justice (DOJ) data analytics program to combat opioid-related fraud and abuse. The...more

Ninth Circuit Raises Bar for Approving Changes in State Medicaid Reimbursement

by Perkins Coie on

The U.S. Court of Appeals for the Ninth Circuit Court raised the bar last week for what states must prove to establish that their Medicaid provider reimbursement rates are sufficient to ensure a robust network of providers...more

Patient Dies During Arbitration Agreement Rescission Period

by Faegre Baker Daniels on

What happens when a nursing home patient signs an arbitration agreement with a 30-day rescission, or cooling-off, period and then dies before the end of that period? Is the agreement enforceable because it wasn’t rescinded? ...more

Protecting Vulnerable Adults While Protecting Their Physicians – A Proposed Statutory Amendment

by Snell & Wilmer on

The Arizona Supreme Court’s recent decision in Delgado v. Manor Care of Tucson AZ, LLC, subjects health care providers to liability for ordinary negligence under the Adult Protective Services Act. This decision therefore...more

Health Alert (Australia) 14 August 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 10 August 2017 - Inquest into the Death of Stephen Herczeg 57/2016 (1808/2016) - The said Court finds that Stephen Herczeg aged 72...more

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