News & Analysis as of

Medicare Shared Saving Program Interim Final Rule Extended

On October 17, 2014, the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services, Office of Inspector General (OIG) published in the Federal Register (79 FR 62356 et seq) a notice...more

North Carolina Legislative Report

The General Assembly adjourned “sine die” on Wednesday, August 20. During the interim, the MVA Public Affairs Legislative Report on North Carolina will be distributed biweekly to keep you up to date on the latest legislative...more

Blog: Business Forward Hosts HHS’s Director of Private Sector Engagement for a Discussion on Health Care for Small Businesses

On Wednesday, October 15, 2014, Business Forward hosted a discussion with Rhett Buttle, the Director of Private Sector Engagement at the U.S. Department of Health and Human Services (HHS). Mr. Buttle began by providing...more

Health Headlines: Also in the News - October 2014 #2

CMS Announces Changes to the Nursing Home Quality Rating System – On October 6, 2014, CMS announced upcoming changes to the nursing home five-star quality rating system. The changes include revising the scoring methodology...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

Health & Human Services, Office of Inspector General, Proposes New Fraud and Abuse Rules

The U.S. Department of Health & Human Services, Office of Inspector General (OIG) published 79 Fed. Reg. 59717 on October 3, 2014. This proposed rule has the potential to have an impact on a broad array of financial...more

Seniors Needn’t Drive into the City to Get Overcharged!

Remember when you had to drive into the city to get overcharged? Those days are over. According to a report issued Wednesday by the Office of Inspector General of Health & Human Services, Medicare patients pay two to six...more

Skilled Nursing Facility Reaches Largest Failure of Care Settlement in DOJ History

On Friday October 10, 2014, the Department of Justice (DOJ) and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) jointly announced a $38 million settlement with a skilled nursing facility...more

OIG Releases New Proposals on Anti-kickback Statute Safe Harbors, Exceptions to the CMP Law and the Gainsharing Prohibition

On October 3, 2014, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a long-awaited proposed rule for implementing amendments to safe harbors under the Anti-kickback Statute and...more

HHS Proposes New Safe Harbor Rules, Revises Others

Last week the Department of Health & Human Services ("HHS") issued a proposed rule amending the safe harbor regulations promulgated under the federal Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b). The proposed rule would...more

CMS Offers To Settle All Acute Care Inpatient Claim RAC Appeals

CMS is offering to pay hospitals 68 percent of the allowable amount for all claims that are currently on appeal. Specifically, CMS is offering to settle "inpatient status" claims at 68 percent of the "net paid amount" within...more

OIG Issues Proposed Rules Providing for New AKS Safe Harbors, CMP Changes

In the October 3 Federal Register (79 FR 59717), the Office of Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”) published a proposed rule that would amend the safe harbor regulations to the...more

OIG Solicits Comments Regarding New Healthcare Rules

OIG Proposed Rule to Expand Safe Harbors under the Anti-Kickback Statute and Exemptions under Civil Monetary Penalties Law - The Department of Health and Human Services, Office of Inspector General (OIG) released a...more

Post-Hobby Lobby Questions Remain About the Scope of Corporate Religious Freedom

The U.S. Supreme Court upheld a challenge to regulations mandating that employers provide contraceptive coverage for their employees. In Burwell v. Hobby Lobby Stores, Inc., the Court found the regulations promulgated by the...more

Health Care Update - September 2014 #4

In This Issue: - Policymakers Continue Bi-partisan Push to Accelerate ACO Evolution - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and...more

Health Reform + Related Health Policy News - September 2014, Issue 1

In This Issue: - Top News ..The Congressional Agenda is Light as the Focus Shifts to the Midyear Elections ..Physician Supervision Requirement for Small and Rural Hospitals ..CMS Offers Hospitals...more

OIG Reports Medicare Part B Supplying and Dispensing Fees Significantly Higher Than Those Under Part D and Medicaid

According to a recently released report from the HHS OIG, pharmacies are reimbursed significantly more for dispensing drugs under Medicare Part B than they would be for dispensing the same drugs under Medicare Part D and...more

Lawmakers Call to Clarify HHS’ Mobile Medical App Regulation

The mobile medical application marketplace has developed into a $68 billion industry; however, the U.S. Department of Health and Human Services (HHS) has not yet updated guidance regarding the Health Insurance Portability and...more

Business Associate Agreement September 22 Deadline; Same Sex Marriage Guidance Released

There are two important updates with respect to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). First, on September 17, 2014, the U.S. Department of Health and Human Services (HHS) issued guidance to...more

OIG Releases Special Advisory Bulletin and Report on Copayment Coupons

Last week, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released a Special Advisory Bulletin titled, Pharmaceutical Manufacturer Copayment Coupons (Bulletin), and a report titled,...more

Mishandling Medical Records Turns Into an $800,000 HIPAA-Compliance Mistake

A non-profit healthcare company agreed to pay $800,000 as part of a settlement with the U.S. Department of Health and Human Services (HHS) for allegedly mishandling 71 boxes of medical records in violation of the privacy rule...more

Health Law Alert: CMS Modifications to Meaningful Use Rule Gives Providers a Welcome Reprieve

On September 4, the Centers for Medicare & Medicaid Services (CMS) published a Final Rule that made several helpful changes to the meaningful use requirements for the Electronic Health Record (EHR) Incentive Program. Among...more

Implications on Pharmacies of Recent OIG Advisory Opinion on Per-Fill Fees

The U.S. Department of Health & Human Services, Office of Inspector General (OIG) recently issued an advisory opinion regarding a proposed arrangement by a specialty pharmacy (Requestor) to pay local pharmacies a per-fill fee...more

Health Care Update - September 2014

In This Issue: - HealthCare.gov Hacking Breach - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State Initiatives - Other Health...more

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