Hospitals

News & Analysis as of

Aggressive New Cms Pre-Payment Review Initiative Threatens Physician Practices And Hospitals

According to a recent report in the American Medical News, The Center for Medicare and Medicaid Services (“CMS”) published plans to increase the number of pre-payment reviews of hospital and physician claims from 1.2 million...more

Anti-Kickback and Stark Law: Pitfalls and Problems

When you think your life is tough in the FCPA compliance arena, just remember you could be head of compliance for a pharmaceutical company or hospital responsible for domestic anti-kickback and Stark law compliance....more

OIG Reports Lack of Oversight on Hospital Use of Compounded Drugs

On January 22, 2015, the HHS OIG released a report regarding CMS’s oversight of compounded sterile preparations (CSPs) used in hospitals. After reviewing oversight efforts at CMS and the entities that accredit hospitals to...more

Trademark Review | January 2015

Diageo Enforces Trade Dress Rights in its CROWN ROYAL Drawstring Bag - Diageo owns a registration for the mark CROWN ROYAL for whiskey. Diageo has sold its CROWN ROYAL whiskey in a purple drawstring bag for many...more

Washington Healthcare Update

This Week: Energy and Commerce Holds Two-Day Hearing on SGR Replacement…CDC Report Finds Providers Making Progress on Lowering Rates of Hospital Infections…Montana Governor Introduces Plan for Medicaid Expansion....more

Mississippi CON Report - December 2014

In This Report: - I. December 2014 – Mississippi Certificate of Need Meeting - II. Certificate of Need Program Report – Filings/Reports Since November 2014 - A. Letters of Intent to Change Ownership...more

Chinese Government Further Encourages, Regulates Multi-Site Practice by Physicians

The Opinions on Encouragement and Regulation of Multi-Sited Practices of Physicians demonstrate the Chinese government’s continued efforts to develop Chinese physicians’ ability to practise at multiple sites, and will provide...more

Second Circuit Revives Medicare Beneficiaries’ Observation Status Suit

On January 22, 2015, the U.S. Court of Appeals for the Second Circuit reversed a decision by the U.S. District Court for the District of Connecticut dismissing a lawsuit by Medicare beneficiaries alleging deprivation of due...more

OIG Defends Its Hospital Compliance Reviews in Response to AHA Criticism

The Office of the Inspector General for the Department of Health and Human Services(“OIG”) responded to concerns expressed by the American Hospital Association (“AHA”) regarding the OIG’s hospital compliance reviews,...more

Catching Up on the False Claims Act

From a corporate risk perspective, if your company is in the financial industry, healthcare, or defense industry, your greatest legal and compliance risk has to be the False Claims Act....more

Alabama CON Report

In this Report: - I. For Informational Purposes Only - II. Certificate of Need Program - III. Reviewability Determinations and Pending Reviewability Determinations - Excerpt from For...more

Beginnings and Endings: New Administration Moves In, Massachusetts Legislative Session Concludes

The last several months witnessed a flurry of activity on Beacon Hill: Governor Deval Patrick inked a number of bills as the two-year legislative session drew to an official end, and his successor, Governor Charlie Baker, has...more

Healthcare Fraud: Aggressive Enforcement Strategies

This week I am focusing on the persistent problem of healthcare fraud. For healthcare providers, the challenge of compliance and avoiding enforcement risks is particularly difficult. ...more

IRS Finalizes Regulations Under Section 501(r)

On December 29, 2014, the Internal Revenue Service issued final regulations under Section 501(r) of the Internal Revenue Code clarifying certain requirements applicable to charitable tax-exempt hospitals. ...more

Certificate of Need Opportunities in 2015

While many of us were shopping for last-minute gifts for our families, Governor McCrory was busy approving the 2015 State Medical Facilities Plan (“SMFP”). The SMFP is a document created annually by the State Health...more

Illinois District Court Holds That a Plan Maintained by a Religiously Affiliated Organization Is Not a Church Plan

The United States District Court for the Northern District of Illinois recently had the opportunity to weigh in on the issue of whether a religiously affiliated employer was exempt from federal regulation of its employee...more

IRS Publishes Final Regulations Regarding Section 501(r) Requirements for Charitable Hospitals

On December 31, 2014, the Internal Revenue Service (IRS) and the Department of the Treasury (Treasury Department) published final regulations (Final Regulations) that provide guidance to hospitals regarding compliance with...more

IRS Issues Additional ACA Requirements for Tax-Exempt Hospitals

On December 31, 2014, the IRS published final regulations providing guidance on the community health needs assessment and financial assistance policy requirements for charitable hospitals under the ACA. ...more

New Limitations on RAC Program

In March 2014, CMS temporarily suspended the Recovery Audit Contractor (RAC) program until it secured new contracts. The contracts for the program expired in June 2014, and in August, CMS said that it would restart the...more

IRS Issues Long-Awaited Final Regulations for Charitable Hospitals

In This Issue: - What You Should Do - Background - Final Regulations - Hospital Facilities and Organizations - Failures to Satisfy the Requirements of Section 501(r) - Community...more

IRS Issues Final Regulations on Requirements for Charitable Hospital Organizations

On December 29, 2014, Final Regulations providing guidance regarding the requirements for charitable hospital organizations were issued by the Internal Revenue Service (IRS). The ACA, enacted March 23, 2010, added new...more

New state law mandates education about end-of-life treatment

Beginning in 2015, the newly enacted Medical Treatment Laws Information Act imposes educational requirements on Oklahoma health care providers related to patient end-of-life treatment decision-making. Two groups of...more

BCBSNC Release of Data

After objecting to the release of hospital reimbursement rates mandated under North Carolina’s Health Care Cost Reduction and Transparency Act of 2013 (NCGS Section 131E-214.5), Blue Cross Blue Shield of North Carolina...more

Ensuring Data Protection In The Implementation Of The EFPIA Disclosure Code: Key Challenges And How Pharmaceutical Companies Are...

The EFPIA Disclosure Code will, from 2016, require pharmaceutical companies to disclose details of payments and transfers of value made to healthcare professionals and healthcare organisations. The Code aims to promote,...more

OIG Approves Nonprofit Foundation's Proposed Copayment Assistance Program

On January 5, 2015, the OIG posted a favorable advisory opinion, OIG Advisory Opinion 14-11, regarding a 501(c)(3) charitable foundation’s (Foundation) proposal to establish a patient assistance program that would provide...more

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