Healthcare

News & Analysis as of

From Second and State: Capitol Wrap – Week of October 2014

As expected, this week blew through the Columbus Day holiday and into a flurry of legislative activity. Dozens of bills went back and forth between the chambers this week, and many have already landed on the governor’s desk....more

Front End Changes and, Again, More DIR Columns

Since the beginning of the Medicare Part D program, CMS has introduced many reporting mechanisms for trying to understand drug pricing, price concessions, and the cost of providing services to Part D members. The tool CMS...more

DOL Announces Delay to Home Care Worker Wage Regulations

Last October, the federal Department of Labor’s Wage and Hour Division sent shockwaves through the home health care industry by issuing final rules declaring most of its employees to be subject to FLSA minimum wage and...more

Health Care Reform Implementation Update

In the past week, CMS has released several advisories including updates to the rating system for nursing homes, premium and deductible information for Medicare Part B and Part D for 2015, Pioneer ACO results, payment dispute...more

This Hobby Lobby Proposal Is Much Mistaken

Suzanne Weakley, editor-in-chief of the CEB Business Law Practitioner, recently called my attention to this letter from six professors at U.C. Berkeley (Robert P. Bartlett III, Richard Buxbaum, Stavros Gadinis, Justin...more

Providers Challenge CMS's Non-Hospital Rotation Rules for GME and IME

Prior to the enactment of the Affordable Care Act (ACA), CMS required hospitals to comply with a number of exacting payment and documentation rules in order to include as part of their graduate medical education (GME) and...more

Eighth Circuit Says Termination Made to Lower Health Care Costs Constitutes Age Discrimination

Under the U.S. Supreme Court’s 1993 Hazen Paper decision, employers that select employees for layoff using the date of vesting of their pensions based on years of service are not discriminating on the basis of age, even if...more

Health Alert (Australia) - October 20, 2014

In This Issue: Judgements, Legislation, and Reports. Excerpt from Judgments: Commonwealth - 15 October 2014 - Gray v Richards [2014] HCA 40 - In 2003, a 10-year-old girl...more

OIG Proposed Anti-Kickback Safe Harbors and CMP Regulations: The End of Frustration or Just the Beginning?

On October 3, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published an unexpected, yet long-awaited, set of proposed rules that would add new anti-kickback law safe harbors,...more

‘Health Care’-Related Calls: Ambiguity at the Intersection of HIPAA and TCPA

The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer Protection Act (TCPA) for health care messages regulated under the Health Insurance Portability and...more

IRS Proposes Key Changes to Schedule H's Community Health Needs Assessment and Financial Assistance Policy Questionss

On October 8, 2014, the IRS released drafts of the 2014 Form 990, Schedule H and Instructions, proposing significant changes related to a hospital facility's compliance with Section 501(r) of the Internal Revenue Code. These...more

Hospital’s Extortion & Fraud Too Quick to Violate RICO

Danielle Bennion and her co-plaintiffs filed a RICO (Racketeer Influenced & Corrupt Practices Act) action alleging that Mountain View Hospital and co-defendants engaged in a plan of extortion and wire fraud for the purpose of...more

CMS Announces Program to Fund ACO Growth, Extends Fraud and Abuse Waivers

The Centers for Medicare & Medicaid Services (“CMS”) announced a new initiative, the ACO Investment Model, on October 15, 2014. Under the model, ACOs which are made up of “providers [who] lack adequate access to … capital”...more

Eggs in the workplace

Eggs – human eggs, aka ova – have been in the news this week. First, it was announced that Facebook and Apple will begin offering insurance coverage for female employees to freeze their eggs for later fertilization and...more

Mintz Levin Health Care Qui Tam Update - Recent Developments & Unsealed False Claims Act Cases: October 2014

Trends & Analysis - Between our last Qui Tam Update and the end of June, 65 health care–related qui tam cases were unsealed (28 in April, 18 in May, and 19 in June). Within those 65 cases...more

Critical Access Hospital Soothsayers and the 96-Hour Physician Certification Requirement

This year critical access hospitals (CAH) have struggled to implement procedures to comply with both the "two-midnight" rule and the 96-hour physician certification requirement. The combination of both puts physicians in a...more

CMS Reopens Application Period for Meaningful Use Hardship Exception

CMS Reopens Application Period for Meaningful Use Hardship Exception - the period during which certain eligible providers may request a hardship exception from qualifying as a Meaningful User under the Medicare EHR Incentive...more

Getting the Most Out of Physician Practice Acquisitions: Considerations for Converting Acquired Physician Practices into...

Hospitals acquiring physician practices need to balance competing considerations when determining how to fit them in the larger organization. Financial considerations weigh heavily, but so do considerations about finding some...more

Time to “Start Talking!” - Ohio Governor’s movement leads to new informed consent requirement

Citing that “most teens who abuse pain relievers say they get them from family and friends,” the use of prescription pain drugs continues to take center stage and has spurred an Ohio law requiring new procedures when...more

Protecting Healthcare and Other Employees From Ebola

News that a U.S. based health-care worker in Dallas has contracted Ebola while caring for a patient with the disease has raised questions about the protections that health care facilities and other employers must provide for...more

What Employers Can Learn from Physicians When It Comes to Administering the FMLA

Earlier this month, I took one for the team. And I survived. I had the privilege of presenting to a number of employers and health care providers at the annual “Impairment Without Disability” conference, an event...more

IPO Market at 9/30

Please see infographic below for more information. ...more

FTC Attacks Toothless Regulation of Dentists

Yesterday the United States Supreme Court heard argument in a case of national importance to health professions and the state boards that regulate them. The case, North Carolina Board of Dental Examiners v. FTC, addresses...more

CMS Proposes Revisions to Home Health Conditions of Participation

On October 9, 2014, CMS published in the Federal Register a Proposed Rule that would revise the home health Conditions of Participation (CoPs). The home health CoPs have not been updated since 1989. Although CMS previously...more

Device Advice: New Guidance From the FDA on Medical Devices and Cybersecurity

Are medical devices, subject to pre- and post-market regulatory controls, under increasing cybersecurity scrutiny? The FDA recently published recommendations for consideration of cybersecurity management in a product’s design...more

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