News & Analysis as of

NAIC Long-Term Care Innovation Subgroup Public Hearing

At the NAIC Summer 2016 National Meeting, the Long-Term Care Innovation (B) Subgroup held a public hearing as part of an initiative to address the challenges facing the private LTC market. With baby boomers retiring at a rate...more

Tennessee Health Services and Facilities Report: October 2016 Newsletter

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

Student Health Insurance Plans and the ACA: Agencies Provide Enforcement Relief that Allows Colleges and Universities to Continue...

Late last week, the Departments of Labor (“DOL”), Health and Human Services (“HHS”) and the Treasury (collectively, the “Agencies”) issued a very welcome FAQ that will allow higher education institutions to continue...more

Catching Up With the Times: CMS Reforms Long-Term Care Facility Requirements Part III

On October 4, the Centers for Medicare and Medicaid Services (CMS) published the biggest overhaul to federal long-term care regulations since 1991, and impacted facilities can immediately take steps to ensure they’re prepared...more

Tenet Healthcare Settles Fraud Case for $514 Million

If you work in compliance in the healthcare industry, you have a tough job. The number and variety of risks that healthcare providers face is daunting. The False Claims Act is a mighty weapon in the hands of federal...more

Requiring A Flu Shot Over Religious Objections: Risky Business

It’s flu season and many employers, particularly those in healthcare, want to require employees to be vaccinated to minimize the spread of illness. But what happens when an employee refuses on religious grounds?...more

St. Joseph Health Settles with OCR for $2.14 Million

The Office for Civil Rights (OCR) has announced that it has entered into a settlement with St. Joseph Health, which operates hospitals and nursing homes in California, Texas and New Mexico, for $2.14 million for alleged HIPAA...more

Catching Up With the Times: CMS Reforms Long-Term Care Facility Requirements - Part II

Following CMS publishing the biggest overhaul to federal long-term care regulations in 25 years, affected facilities must take steps to ensure they are prepared for the pending changes. On Oct. 4, CMS published the...more

Health Update - October 2016

Defining and Resolving the Provider Data Dilemma - Editor’s Note: Provider data drives the most fundamental processes in the healthcare system. Inaccurate provider data puts patient care and billions of dollars at risk....more

Burr Alert: Physicians, Surgery Centers and Taxes

Since the enactment of the net investment income tax ("NIIT") in 2012, physicians and other taxpayers owning multiple business interests have had to make educated choices based upon accounting projections and SWAGS when...more

Monster Movie Month: Episode III – Son of Frankenstein and Evolution From Yates Memo and FCPA Pilot Program

Welcome to my third installment in this month’s classic monster movie festival. This year I am revisiting the Frankenstein series. Today I want to explore the final movie where Boris Karloff starred as Frankenstein’s Monster;...more

CMS Finalizes Sweeping Changes to Medicare Physician Payments

The Centers for Medicare & Medicaid Services (CMS) on Oct. 14, 2016, released the highly anticipated Final Rule implementing the Medicare physician payment reforms enacted as part of the Medicare Access and CHIP...more

Third Circuit Delivers Resounding Victory for FTC in Pennsylvania Hospital Merger Case

On September 27, 2016, the U.S. Court of Appeals for the Third Circuit handed the Federal Trade Commission (FTC) a significant antitrust victory by granting its request for a preliminary injunction to stay the pending merger...more

Ten Things to Know About the CMS Long-Term Care Requirements Final Rule

Deadlines are looming to come into compliance with sweeping changes to the Centers for Medicare & Medicaid Services (CMS) requirements for long-term care facilities (LTC) participating in Medicare and Medicaid. The CMS final...more

DOJ-AmEx Case Could Have Ramifications for Health Care Providers

The U.S. Department of Justice's loss to American Express sends a message to health care providers: Steering, tiering, exclusive dealing and other contractual arrangements that appear to suppress competition in one part of...more

CMS Finalizes New Medicare Quality Payment Program: "Flexibility" and "Pick Your Pace" Key Themes

After receiving roughly 4,000 comments to its proposed rule, the Centers for Medicare and Medicaid Services (CMS) on October 14, 2016 released its final rule for implementing the Medicare Access and CHIP Reauthorization Act...more

MACRA Advances

Last year President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 ("MACRA"). MACRA implemented significant changes in how Medicare reimburses doctors. In particular, MACRA (i) ended the...more

U.S. Department of Education Issues Guidance on Student Medical Records

On September 14, 2016, the Department of Education (DOE) issued a “Dear Colleague Letter” to provide guidance on the application of the Family Educational Rights and Privacy Act (FERPA) to the disclosure of student medical...more

TCPA Health Care Exceptions Properly Applied In California

The Telephone Consumer Protection Act (“TCPA”) potentially touches just about every kind of business, including the business of selling prescription drugs. That is what the Northern District of California grappled with...more

The End of the Road for Hershey Medical Center's Merger: Parties Abandon Transaction After Third Circuit Rules That Hospital...

The decision serves as a reminder of the uphill battle that merging health care providers have faced since the FTC’s adoption of its current rigid market definition standard in 2007. The U.S. Court of Appeals for the...more

Surgeon General Notifies Employees of Breach

According to the Surgeon General of the United States, the personal information of current, former and retired employees of the United States Public Health Service Commissioned Corps and their dependents has been compromised....more

Administration Joins Courts In Prohibiting Arbitration In Nursing Home Admissions

Within the U.S. Government, the CFPB has gotten most of the attention for trying to regulate consumer arbitration. But this month, the Centers for Medicare & Medicaid Services (CMS) are bumping the CFPB out of the...more

The FDA Implements the Medicare Modernization Act: A New Role and a New Mission?

The Food and Drug Administration (FDA) has finally—after thirteen years—issued its final rule to amend its current regulations and implement the Medical Modernization Act governing how the American public get their generic...more

The Tech Industry’s Next Frontier?

Tongue-in-cheek references to Pokémon Go as a health App aside, maybe the tech industry is on to something. In the U.S., seven out of every ten deaths are due to chronic diseases, such as diabetes or heart disease. Perhaps...more

Fifth Circuit Affirms Order Compelling Arbitration Against Non-Signatories Based On “Intertwined Claims” Estoppel

A physician sued several healthcare entities for wrongful termination of employment, negligence, breach of contract, and tortious interference with at-will employment. While two of the defendants were signatories to...more

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