Health Care Providers

News & Analysis as of

Illinois Supreme Court Holds Fees and Costs Not Deductible From Health Care Lien

Yesterday, a unanimous Illinois Supreme Court resolved an important question for the health care industry. In an unanimous opinion by Justice Mary Jane Theis, the Court held in McVey v. M.L.K. Enterprises, LLC that a health...more

Health Alert (Australia) - May 25, 2015

In This Issue: Judgments; Legislation; and Reports & Publications. Excerpt from Reports: Australian Medical Association (AMA) - 19 May 2015 - $19 billion pharmacy deal sign of skewed health...more

DOL Publishes New FMLA Forms -- Good Through May 2018

Those sneaky little rascals! While the rest of us were enjoying our Memorial Day holiday, those crazy kids over at the Department of Labor were still working away. This time, they were busy posting the new model FMLA notices...more

California Supreme Court Agrees to Consider Whether California Health Care Workers Can Lawfully Waive a Second Lunch Period.

This week, the California Supreme Court agreed to review the decision in Gerard v. Orange Coast Memorial Center, No. G048039 (February 10, 2015), where the California Court of Appeal partially invalidated the Industrial...more

Hospitals Rally to Defend 340B

A consortium of hospitals from across the country has delivered a letter to Congressional leaders, urging them to preserve the federal 340B program in its present form. Neither the content nor the timing of the letter was...more

Managing Institutional Risk: Fraud-Proofing Your Organization

In this presentation: - Top 5 Fraud and Abuse Risks Facing Health Systems - Results of Enforcement Action - Top 5 Steps Health Systems Can Take To Minimize Fraud & Abuse Risk - Non-Compliant...more

Legislation Proposed In New Jersey to Alert Patients to Out-of-Network Costs

On May 14, 2015, four New Jersey legislators introduced the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the "Legislation"). If enacted, the Legislation would increase health care...more

State Regulatory Scheme Offering Antitrust Immunity to Healthcare Collaborations Creates Tension Between Federal and State...

On April 22, 2015, the Federal Trade Commission submitted a public letter to the New York State Department of Health (DOH) expressing “strong concerns” over state regulations offering to provide antitrust immunity to certain...more

Outpatient Ancillary Services: Creative Structures for Competing Into the Future

In this presentation: - Introduction - Why Ancillary Services Transactions Are Being Done - Conversion to Provider-Based or Under Arrangement - An Illustration - Some Medicare...more

Health Care Update - May 2015 #3

In This Issue: - 21st Century Cures Markup; Full Committee to Take Up this Week - Senate Finance Committee Solicits Health Bills for Upcoming Markup - Implementation of the Affordable Care Act - Federal...more

CMS Proposes Final Meaningful Use Objectives and Measures in EHR incentive programs Stage 3 Proposed Rule

On March 30, 2015, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) setting forth meaningful use criteria for Stage 3 of the Medicare and Medicaid Electronic Health Record Incentive...more

ONC Releases Updated Guide to Privacy and Security of Electronic Health Information

The Office of the National Coordinator for Health Information Technology (“ONC”) of the U.S. Department of Health and Human Services (“HHS”) recently released Version 2.0 of the Guide to Privacy and Security of Electronic...more

Also In the News - Data, Privacy, & Security Practice Report - May 2015

ONC Releases Updated Guide To Privacy And Security of Electronic Health Information ? The Office of the National Coordinator for Health Information Technology (“ONC”) recently released Version 2.0 of the Guide to Privacy and...more

Recent Lawsuit Underscores Critical Lessons for Purchasers of Cyber Insurance

Columbia Casualty Company v. Cottage Health Systems, No. 2:15-cv-03432, was filed on May 7, 2015 in the Central District of California. Cottage Health is one of the first cases nationwide—if not the first case—in which the...more

GAO Report on Oversight of Medicaid Payments to Hospitals

The Government Accountability Office (GAO) has released a report entitled “Medicaid: CMS Oversight of Provider Payments Is Hampered by Limited Data and Unclear Policy.” The report examines how state Medicaid payments to...more

Comingling of employee and patient data compromises employer’s HIPAA defense to employee’s claim of discharge for union activity

An administrative law judge (ALJ) of the National Labor Relations Board has concluded that a health care employer’s use of its medical records software to store employee contact information allowed an employee to access that...more

CMS Call on Hospice Quality Reporting (June 17)

CMS is hosting a June 17, 2015 provider call to discuss the Hospice Quality Reporting Program and the new Hospice Item Set (HIS) Manual (V1.02). The target audience includes quality staff at Medicare-certified hospice...more

OIG Issues Compliance Guidance for Healthcare Governing Boards

Members of healthcare governing boards now have direction from the OIG as to what is expected of them as they oversee the regulatory compliance of their organizations. And the good news is that the board members don’t have to...more

Religious Freedom and the Affordable Care Act

The fascinating interplay that weaves between the First and Fifth Amendments to the U.S. Constitution, the Religious Freedom Restoration Act (RFRA) and the Patient Protection and Affordable Care Act (ACA) continues to march...more

DOJ Pursuing Therapy Providers Under the FCA

As most recently spotlighted by the Department of Justice’s intervention in whistleblower claims against ManorCare, DOJ is increasing its enforcement of the False Claims Act (FCA) against therapy providers. In particular, DOJ...more

OCR Launches Phase 2 HIPAA Audit Program with Pre-Audit Screening Surveys

Health Insurance Portability and Accountability Act of 1996 (HIPAA) covered entities have reported that the U.S. Department of Health and Human Services Office for Civil Rights (OCR) recently sent pre-audit screening surveys...more

CMS Announces Next Generation ACO with Increased Risk and Reward

On March 10, 2015, the Centers for Medicare & Medicaid Services announced its “Next Generation ACO Model,” which CMS hopes will provide more experienced accountable care organizations an opportunity to assume higher levels of...more

CMS Changes Medicare Prescriber Enrollment Requirements

On May 6, 2015, CMS issued interim final rules relating to Medicare Part D beneficiary access to Part D drugs. Through the rules, CMS announced updates regarding the impending prescriber enroll or opt-out effective date,...more

IREG Update

Commercial Accountable Care Organizations - Models of health care delivery are evolving on many fronts, driven by the overriding goals of lowering the cost of health care and increasing its quality. Traditional private...more

New Data on Part D Prescription Drugs Available

On April 30, 2015, the Centers for Medicare & Medicaid Services (CMS) made available a dataset that provides detailed information on medications that physicians and other healthcare providers prescribed under the Medicare...more

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