Healthcare

News & Analysis as of

Recent OIG Audits of Home Health and Hospice Surveys May Signal Increased Scrutiny on Worker Qualifications

Recent audits by the Department of Health and Human Services Office of Inspector General (“OIG”) conclude that state survey agencies in a number of states and a leading national accrediting agency serving the home health and...more

New Developments on Interplay between Whistleblower Actions and Other Attacks on Hospital Discipline

Hospitals and their medical staffs may consider it time to dust off their bylaws, in consideration of a recent legal development in a peer review proceeding. Last year, the California Supreme Court held that Mark T....more

A Review of the Supreme Court’s 2014 - 2015 Term

During the United States Supreme Court’s 2014-2015 term, the Court departed from the pro-business reputation it had developed in labor and employment cases. This term, employees prevailed more often than not, including in...more

Recent DOJ and OIG Actions Show Growing Federal Scrutiny of Physician Financial Arrangements

Over the last month the Office of Inspector General (OIG) of the Department of Health and Human Services and the Department of Justice (DOJ) have each taken actions that suggest an increasing appetite to examine the financial...more

“Ain’t Wastin’ Time No More”* — Doctors, Vets, and Lawyers in the Antitrust Crosshairs

Supreme Court Decision in North Carolina State Board of Dental Examiners v. Federal Trade Commission Prompts Legal Challenges to State Professional Boards - Earlier this month a Texas federal district court judge granted a...more

Minnesota Joins 9-State Compact Expediting Telemedicine Across State Lines

Effective July 1, 2015, Minnesota will join the Interstate Medical Licensure Compact, a group attempting to expedite the licensing of physicians seeking to provide telemedicine services to patients located in other states....more

Health Care Update - June 2015 #4

In This Issue: - Pathway for Bipartisanship following King v. Burwell - Federal Regulatory Initiatives - Congressional Initiatives - Other Health Care News - Upcoming Congressional...more

FDA Provides 11th Hour Delay of Product Tracing Requirements for Pharmacies

On June 30, 2015, a mere day before the product tracing deadline for dispensers was to go into effect, FDA published a compliance policy guidance that delays enforcement of the applicable product tracing requirements until...more

US healthcare: payment-driven transformation ahead

Healthcare spending is forecast to increase from US$3 trillion in 2014 to US$5.2 trillion in 2023, reflecting a compound annual growth rate of 5.9 percent. US healthcare expenditures on a per capita basis are 1.9-2.6 times...more

CMS Issues Final Rule for Medicare Shared Savings Program

This month, the Centers for Medicare and Medicaid Services (“CMS”) issued a final rule (the “Final Rule”) regarding an update to the Medicare Shared Savings Program (the “Program”). The Final Rule will seek to enhance primary...more

Health Alert (Australia) - June 29, 2015

In This Issue: - Judgments; Legislation; and Reports. - Excerpt from Judgments: Australian Capital Territory (ACT). Medical Board of Australia v Hocking [2015] ACAT 44 - The ACT Civil and...more

Final Rule Will Give ACOs Participating in MSSP Access to More Data for More Beneficiaries

This is the third post in Health Care Law Today’s series on the final rule. This post addresses changes to sharing of beneficiary identifiable data. In its December 8, 2014 proposed rule revising the Medicare Shared...more

Progress in Medicare Takes Many Forms: Moving Ahead with Maintenance Care After Jimmo

Somehow, although certainly not from a clear reading of the Medicare statute, there was long a perceived rule that Medicare would only cover certain services if the patient was making measurable improvement. This created the...more

It's Time to Bill Medicare: Do You Know Where Your Physicians Are?

The Department of Health and Human Services Office of Inspector General (OIG) recently reported that Medicare contractors overpaid physicians $33.4 million in incorrectly coded physician services between January 2010 and...more

King v. Burwell – Supreme Court Upholds Premium Subsidies under Federally-Run Marketplaces; ACA Remains (Mostly) Unfazed

On June 25, 2015, the United States Supreme Court released its much anticipated King v. Burwell decision regarding the validity of premium assistance issued by Federally-run Marketplaces. Chief Justice Roberts, writing for...more

The Supreme Court Upholds The Availability Of Subsidies On The Federal Exchange—Where Do We Go From Here?

One of the most highly anticipated decisions of the term—at least among the Sheppard Mullin Healthcare team—was issued Thursday by the Supreme Court: King v. Burwell. Six of the justices, including Chief Justice Roberts,...more

CMS Pays $1.3 Billion to Hospitals for Settlements of Medicare Inpatient Appeals

On June 11, 2015, CMS announced that it had entered into settlements with over 1,900 hospitals for over 300,000 disputed inpatient billing claims. CMS updated its website dedicated to inpatient hospital reviews, noting that...more

Southern Spine Announces 2015 MDEA Honor for StabiLink® MIS Spinal Fixation System

Southern Spine announced recently that StabiLink® MIS Interlaminar Spinal Fixation System has been chosen as the Silver Winner in the Implant and Tissue Replacement category of the 18th Annual Medical Design Excellence Awards...more

Regulatory Capture Vitiates State Action Immunity

The Supreme Court has ruled that when an oversight mechanism created by a State —here a State Board — is under the control of those it was supposed to be regulating (sometimes referred to by economists as “regulatory...more

How Does the King v. Burwell Decision Affect the Affordable Care Act?

The Supreme Court handed the Obama administration a key victory this morning, upholding the tax credits that allow many low-income Americans to purchase health care insurance in states where the federal government is running...more

Expect Focus - ONLINE HEALTH CARE: NOT SO FAST Telemedicine Hits A Few Speed Bumps, Volume II, Spring 2015

In This Issue: - IN THE SPOTLIGHT • Risky Business: Common Cyber Security Risks, Expensive Consequences - LIFE INSURANCE • Ninth Circuit Finds Bonus Indexed Annuity Delivers Exactly...more

Under the Dome: Inside the Maine State House

Under the Dome: Inside the Maine State House provides a high-level overview of recent activity at the Maine State House. Legislature Plans Long Day - Early this past Wednesday morning, the Maine House and Senate...more

Massachusetts Health Care Regulatory Review – Opportunity for Industry Comment

Health care is big business in Massachusetts, and it is a highly regulated business. But Governor Charlie Baker hopes to simplify the Massachusetts regulatory regime. This past March, Governor Baker initiated a year-long...more

Crowdfunding and IP in Health and Biotech Start-ups (Part 2): The JOBS Act

Crowd Funding ImageThis is the second in a 3-part series about the use of crowdfunding in health and biotech start-ups. We started with the story of a tech start-up which set records for funding through a Kickstarter...more

Structuring Healthcare Provider Agreements for Compliance

On June 23rd, the Healthcare Law Blog discussed the Fraud Alert recently issued by the Office of Inspector General of the United States Department of Health and Human Services regarding physician compensation arrangements...more

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