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Healthcare Administrative Law Judge (ALJ)

Arnall Golden Gregory LLP

Healthcare Providers Could Finally Have Their Day in Court: Supreme Court Holds That Defendants Are Entitled to Jury Trials When...

On June 27, 2024, the Supreme Court of the United States released its opinion in SEC v. Jarkesy, a case involving a Securities and Exchange Commission (“SEC”) enforcement action for civil penalties against an investment...more

Wiley Rein LLP

Wiley Consumer Protection Download (September 11, 2023)

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Welcome to Wiley’s update on recent developments and what’s next in consumer protection at the Consumer Financial Protection Bureau (CFPB) and Federal Trade Commission (FTC). In this newsletter, we analyze recent regulatory...more

Health Care Compliance Association (HCCA)

Report on Patient Privacy Volume 22, Number 11. MD Anderson Won Against OCR, But Agency’s Response—Including on Fines—Keeps...

Report on Patient Privacy Volume 22, Number 11. (November 2022) Nearly five years passed from the time the University of Texas MD Anderson Cancer Center reported to the HHS Office for Civil Rights (OCR) that three...more

Arnall Golden Gregory LLP

Takeaways From AHLA’s Institute on Medicare and Medicaid Payment Issues

AGG Healthcare attorneys Lanchi Bombalier and Charmaine Mech recently attended the American Health Law Association (AHLA)’s Institute on Medicare and Medicaid Payment Issues in Baltimore, Maryland, from March 23-25, 2022. The...more

Seyfarth Shaw LLP

Antitrust Pitfalls: FTC Orders Unwinding of Two-Year-Old Acquisition

Seyfarth Shaw LLP on

In a unanimous Opinion and Final Order issued on November 1, 2019, the Federal Trade Commission (“FTC”) upheld an administrative law judge’s determination that the acquisition by one leading US supplier of lower-limb...more

Seyfarth Shaw LLP

Commission Decisions Confirm that Employers Must Take Action to Protect Employees from Workplace Violence

Seyfarth Shaw LLP on

Seyfarth Synopsis: In recent decisions—including Secretary of Labor v. Integra Health Management, Inc., No. 13-1124 (OSHRC Mar. 4, 2019)—the Occupational Safety and Health Review Commission (OSHRC) has upheld violations of...more

Mintz - Health Care Viewpoints

HHS Announces a “Settlement Express” Option for Medicare Appeals

HHS’s Office of Medicare Hearings and Appeals (OMHA) has long faced a backlog in Medicare appeals to Administrative Law Judges (ALJs). In an effort to address this backlog, OMHA established a Settlement Conference...more

Holland & Knight LLP

Recent Developments in Antitrust Scrutiny of Healthcare-Provider Transactions

Holland & Knight LLP on

As the trend of acquisitions of physician practices and mergers of hospitals continues, so does antitrust scrutiny of these deals. There was activity this week in three different proposed transactions that caught the...more

Robins Kaplan LLP

Your daily dose of financial news - The Brief – 9.9.16

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We’ve got a number for that Wells Fargo settlement/fine, and it’s a doozy: $185 million for illegal banking practices (including secretly issuing credit cards without customer consent, signing up customers for online banking...more

Polsinelli

HHS Proposes Rules to Eliminate Backlog … in 5 Years

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On June 28, 2016, the U.S. Department of Health and Human Services (HHS) released a series of regulatory changes in the Notice of Proposed Rule Making (NPRM) designed to curtail the massive backlog of Medicare claim appeals....more

Carlton Fields

Prevailing in an Era of Regulatory Enforcement – Balancing Risk and Compliance [Expect Focus – Vol. II, July 2016]

Carlton Fields on

IN THE SPOTLIGHT - - SEC Sanctions Unregistered EB-5 Investments Broker SECURITIES - - FINRA to Assess Member Firms’ Culture - SEC Seeks Fund Responses to Distribution-In-Guise Guidance ...more

Polsinelli

Four Key Takeaways on the Expansion of the Medicare Appeals Settlement Conference Project

Polsinelli on

On October 15, 2015, the Office of Medicare Hearings and Appeals (“OMHA”) conducted a teleconference to address Phase II of the Settlement Conference Facilitation (“SCF”) Pilot, effective October 1, 2015. SCF, launched in...more

Baker Donelson

OIG Hospital Compliance Audits: Is Your Number Up? Are You Ready?

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In its Work Plan for Fiscal Year 2012, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) announced it would begin reviews of Medicare payments to hospitals to determine compliance...more

Carlton Fields

EXPECT FOCUS: Onboard Technology, NAIC Cybersecurity, DOL, ACA Litigation, SEC Regulation (Vol. III, Summer 2015)

Carlton Fields on

In This Issue: IN THE SPOTLIGHT - - Your Data Breach Collided With My Personal Injury Coverage LIFE INSURANCE - - Phantom Injury Dooms “Shadow Insurance” Case - Latest NAIC Cybersecurity News ...more

Bradley Arant Boult Cummings LLP

Alabama CON Report

I. SHPDA Administrative Report - AL2015-022, Gulf Health Hospitals, d/b/a Thomas Hospital, Daphne, AL: Proposes to establish a freestanding emergency department (FED). The project was approved with stipulation of...more

Williams Mullen

Affirming the Need to Fix the Medicare Appeals Backlog: The AFIRM Act of 2015

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If you are one of the many health care providers wanting to appeal a Medicare contractor’s reimbursement decision, you may need to be prepared for a long wait. Over the last few years, the backlog of appeals to the...more

Bond Schoeneck & King PLLC

Health Law Wire: OMIG Standards for PRI Audits Held Arbitrary and Capricious (7/15)

The Office of the Medicaid Inspector General (OMIG) was recently given a set-back in its on-going audits of nursing home case mix submissions. These audits focus on “Patient Review Instruments” (PRIs) which form the basis of...more

Polsinelli

Senate Committee Passes Bill Addressing Medicare Appeals Inefficiencies

Polsinelli on

On June 3, 2015, the Senate Finance Committee passed an original bill that aims to streamline and improve the Medicare Audit and Appeals Process. The Medicare appeals process has recently faced scrutiny from industry leaders...more

Littler

NLRB Upholds Unilateral Changes in Negotiated Employee Benefits

Littler on

In an era when the National Labor Relations Board seldom finds actions by employers to be reasonable, that agency recently issued two decisions finding that a unilateral change in employee benefits provided under a collective...more

King & Spalding

OMHA Imposes 24-Month Stay for New ALJ Assignments; Announces Medicare Appellant Forum

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The Office of Medicare Hearings and Appeals (OMHA) has issued a Memorandum to OMHA Medicare appellants announcing a temporary stay, effective for cases filed on or after July 15, 2013, in the assignment of new requests for...more

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