Hospitals

News & Analysis as of

Don't Be Left On The Sidelines: CMS Is Seeking Applications For A New Hospice Demonstration Program

Currently, Medicare patients that wish to receive palliative hospice care have a tough choice to make—forgo any curative treatment or incur all hospice care costs. This could change, however, with the recent launch of CMS's...more

Medical Staff Bylaws Are Not Contracts in Delaware

One of the fundamental issues in credentialing disputes is whether the Medical Staff Bylaws constitute contracts between the Hospital and the individual physicians. If the Medical Staff Bylaws do constitute a contract, then...more

Over Hill, Over Dale, the NLRB Pens Another Cautionary Tale: Board Strikes Down Work Rules Prohibiting Negativity and Gossip

The NLRB is back at it, finding last week in Hills and Dales General Hospital, that seemingly innocuous policies prohibiting negativity and gossip in the workplace and requiring employees to represent their employer in a...more

Two Recent 340B Developments: New Hospital Registration Guidance and Proposed Rules Under Review at OMB

Earlier this week, the much-anticipated 340B Drug Pricing Program (340B Program) proposed rule arrived at the Office of Management and Budget for review. Publication of this proposed rule is expected in June and will likely...more

NLRB Strikes Hospital’s Work Rules Banning Negativity

Last week, the National Labor Relations Board (NLRB) ruled that a hospital’s work rules prohibiting negative comments and requiring that employees represent the hospital “in the community in a positive and professional...more

King & Spalding Files Court Challenge to 0.2 Percent IPPS Rate Reduction

On March 25, 2014, King & Spalding filed a complaint in the United States District Court for the District of Columbia challenging CMS’s 0.2 percent reduction to FY 2014 IPPS payment rates associated with the two-midnight...more

D.C. Circuit Requires Greater Disclosure of Changes in Medicare Regulations

The rulemaking process often accommodates a variety of interests, including the preference of regulatory agencies to maintain some flexibility and the rights of interested parties to participate in the regulatory process. On...more

OFCCP Withdraws Claim Regarding TRICARE Jurisdiction

Last week, the Office of Federal Contract Compliance Programs (OFCCP) dismissed OFCCP’s 2008 complaint against Florida Hospital of Orlando. In its Order of Dismissal, the Administrative Law Judge (ALJ) reported that OFCCP...more

Third Circuit Rules General Assistance Days May Be Excluded from DSH Payments

The Third Circuit recently issued an opinion in Nazareth Hospital et al. v. Sebelius, No. 13-2627, holding that Medicaid pilot projects, known as Section 1115 waiver projects, were different enough from the State of...more

Rising Scrutiny of Kwashiorkor Claims Places Hospitals at Risk

Whistleblower lawsuits against health care providers have nearly doubled in the past five years, and have resulted in massive awards. According to the Department of Justice, the government recovered $4.3 billion from health...more

Do You Know What Your Hospital Board Members Are Doing?

David Chandler was appointed to serve as chairman of Tri-Lakes Medical Center (TLMC), a community hospital in Panola County, Mississippi. As chairman, Chandler set board meeting agendas, regularly dealt with the administrator...more

TRICARE Complaint Dismissed Against Florida Hospital

On March 28, 2014, the OFCCP withdrew its jurisdictional Complaint against Florida Hospital of Orlando after several years of litigation. OFCCP alleged it had jurisdiction to conduct an audit because the Hospital...more

Also in the News

MACs to Hold Claims for MPFS Services for Ten Business Days Beginning April 1, 2014 – According to Medicare Learning Network Connects eNews, pending the outcome of the SGR Doc Fix legislation (discussed in more detail in...more

What You Don't Say Can Be Used Against You: Assessing The Fifth Amendment's Role In Qui Tam Litigation

In 1987, current Florida governor Rick Scott used his life savings to start Columbia Hospital with the idealistic goal of cutting healthcare costs and improving patient care. A few years later, Columbia merged with the...more

Mergers and Acquisitions for Academic Medical Centers

Academic Medical Centers and teaching hospitals (AMC/TH) are increasingly choosing to affiliate in some manner with other health care providers in order to surmount significant industry challenges. The first quarter of 2014...more

Health Care E-Note - March 26, 2014

In This Issue: - Hospital CEO Turnover Rate Reached Record 20 Percent in 2013 - States Take on Authority of Doctors vs. Advanced Practice Nurses - HHS Urges Hospitals to be More Prepared for Emergencies -...more

Practical considerations to protect against being ‘out of network’

Practical considerations to protect against being ‘out of network’ The disengagement of Highmark and UPMC is looming on the horizon; most of the hospital participation agreements between these two competing healthcare...more

MedPAC Releases Annual Report on Medicare Payments

The Medicare Payment Advisory Commission (MedPAC) recently submitted its annual report on Medicare payments to Congress. The report analyzes Medicare payment policy and makes payment update recommendations relating to...more

Federal Trade Commission And Competitors Successfully Challenge Hospital’s Acquisition Of Physician Practice

In This Issue: - What Providers Should Know - Background - Ruling - Excerpt from What Providers Should Know: A federal judge recently ordered a hospital system to unwind its year-old acquisition...more

Hospital and Health System M&A Series: The Role of the Nonprofit Hospital Board in Consolidation Transactions

As the hospital consolidation market continues to grow, most consolidation transactions involve nonprofit health systems. Nonprofit boards of directors should prepare well in advance to evaluate consolidation opportunities...more

Judge’s Order to Unwind Hospital’s Acquisition of Physician Group Tests Boundaries of Antitrust Laws and the Affordable Care Act

A federal judge’s recent order to unwind the acquisition of Saltzer Medical Group, an independent physicians group, by St. Luke’s Health System, Ltd., a hospital system with its own staff of physicians, presents challenges...more

CMS Extends Deadline for Low-Volume Hospitals and the Medicare-Dependent Hospital Program

On March 14, 2014, CMS released an interim final rule implementing a six-month extension of the low-volume payment adjustment and Medicare-Dependent Hospital (MDH) program under the inpatient prospective payment system (IPPS)...more

New York State budget negotiations contemplate private equity investment into hospitals…again

Should private equity play a bigger role in New York State healthcare facilities? This is the question facing New York State legislators for the second year in a row....more

Remaining Independent: A Viable Option for Community Hospitals

The environment for independent community hospitals is challenging. Government reimbursement reductions, technology enhancements and other capital demands, preparation for a changing health care system based on population...more

Federal Court Decision Highlights Importance of Documenting Employment Actions

A recent decision by the Seventh Circuit in Zayas v. Rockford Memorial Hospital highlights for employers the importance of documenting disciplinary actions taken with employees. Despite the plaintiff's evidence of...more

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