Hospitals

News & Analysis as of

Hospital Operator Pays $98 Million to Settle False Claims Act Lawsuits

A large operator of acute-care hospitals reached a settlement with the U.S. Department of Justice (DOJ) to resolve multiple whistleblower lawsuits, which alleged the company knowingly defrauded government healthcare systems...more

Immigration Alert: September 2014

Sixth Circuit Expands the Liability of Health Care Employers for Sponsorship Costs - On August 20, 2014, the U.S. Court of Appeals for the Sixth Circuit issued its decision in Kutty v. U.S. Department of Labor, No....more

Federal Court Blasts Hospital’s Kitchen Sink Privilege Claim

Lawyers for Chicago’s Mercy Hospital found that out Monday when a federal court ruled on their claim of peer review privilege for hundreds of documents sought by the plaintiff in a malpractice case. The court blasted the...more

D.C. Circuit Declines Hospitals’ Plea for Relief from CMS Catch-22

Here’s how the catch works. A hospital admits and treats a Medicare patient who needs care. The hospital bills Medicare and gets paid. Later—usually much later—a RAC auditor rules that the patient needed only outpatient care...more

Torts – Effect of The Howell Decision on Liens Brought Under The Hospital Lien Act

Dameron Hospital Association v. AAA Northern California, Nevada, and Utah Insurance Exchange et al. - California Court Of Appeal, Third Appellate District (September 4, 2014) - In Howell v. Hamilton Meats (...more

Roseland Community Hospital Sued By EEOC for Pregnancy Discrimination

Agency Charges South Side Hospital Refused to Accommodate And Fired Pregnant Employee - CHICAGO - Roseland Community Hospital, on Chicago's South Side, violated federal law when it refused to accommodate an employee...more

Third Circuit Affirms Dismissal of Class Allegations for Vague Pleading

Whenever I see the names of the Iqbal and Twombly pleading cases, I can’t help but feel that the names were clipped from lost lines of Lewis Carroll’s Jabberwocky poem, perhaps as something similar to “Iqbal were the Civil...more

CMS Clarifies Terms of Global Settlement Offer

As previously reported, on August 29, 2014, CMS issued a global settlement offer (GSO) to acute care hospitals with pending appeals of denials for inpatient claims. Specifically, CMS is offering to settle all qualifying...more

Big Data in Health Care

The use of big data is now widespread in the U.S. health care system. At major industry conferences and in leading publications, big data has become a watchword for clinical care providers, private insurers, pharmaceutical...more

Medigap Policy Contract with Preferred Hospital Networks Approved by OIG

On August 18, 2014, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued another advisory opinion approving a licensed insurance broker’s proposal to establish a preferred hospital network...more

New Jersey Superior Court Appellate Division rules that physicians’ damages for breach of contract with hospital are limited to...

The New Jersey Superior Court Appellate Division recently ruled that the damages a physician-independent contractor can recover are limited to those sustained during a notice period in the physician’s contract. The decision...more

HHS Asserts the Everybody-Does-It Defense

If that sounds familiar, your child may have a future as a lawyer for Health & Human Services. Because that’s one of the primary arguments asserted by HHS last Friday in its motion to dismiss the lawsuit by the American...more

Trends in New Jersey Employment Law - September 2014

Third Circuit Renders Important Decisions on FMLA and FLSA - In recent weeks, the U.S. Court of Appeals for the Third Circuit rendered a trio of significant employment law decisions....more

EEOC Sues McLeod Health for Disability Discrimination

Non-Profit Medical Institution Subjected Employee to Illegal Medical Examinations And Fired Her in Violation of Federal Law, Federal Agency Charges - FLORENCE, S.C. - McLeod Health, Inc., a South Carolina regional...more

Attention Hospitals! Act Now To Get 68 Cents For Your Medicare Dollar!

It’s no secret that CMS is drowning in appeals from denials of Medicare claims for inpatient care. The number of pending appeals was estimated at half a million back in February, and it’s only grown since then. One reason...more

Bankruptcy sales for distressed hospitals: 4 questions to ask before you begin

Over the last several years, a wide range of healthcare companies, among them hospitals, home health agencies and continuing care facilities, have faced financial distress as a result of declining revenues, high operating...more

CMS Offers Global Settlement of Inpatient Status Claims with Pending Appeals

On August 29, 2014, the Centers for Medicare & Medicaid Services (“CMS”) announced a global settlement offer to acute care and critical access hospitals with currently pending appeals of inpatient status claims denials....more

North Carolina’s Medicaid RAC Program - Don't Let Your Guard Down

With Section 6411(a) of the Patient Protection and Affordable Care Act (ACA) and the Final Rules found at 42 CFR Part 455, the Recovery Audit Contractor (RAC) program has been expanded to the North Carolina Medicaid program,...more

Hospitals File Lawsuit Over Medicare ALJ Hearings Delays

Over 460,000 appeals requesting hearings before an administrative law judge (ALJ) were pending in the Office of Medicare Hearings and Appeals (OMHA) at the end of 2013, with 15,000 new appeals being submitted each week. At...more

A Primer on Medicare Requirements for Physician Supervision of "Incident to" Services

Services provided by a physician’s auxiliary staff that are “incident to” the physician’s services are paid under the physician fee schedule at a higher rate, as though the physician had personally furnished the services....more

Fire Safety Requirements for Hospitals and Other Health Care Facilities: How CMS Is Interpreting Occupancy Classifications and...

On April 16, 2014, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule amending the fire safety standards for hospitals and other types of health care facilities. Compliance with the fire safety...more

U.S. Department of Justice Files False Claims Action Against 3 PODs and Physician Investors for Physician and Hospital Claims

On September 8, 2014, the U.S. Department of Justice (DOJ) filed a False Claims Act (FCA) case in the Central District of California against Reliance Medical Systems, two related distributors (Apex Medical Technologies and...more

Court Rejects Hospital’s ADA Argument That Proves Too Much

Dr. Robinson is an obstetrician at St. Francis Hospital. A diabetic, he underwent surgery for a broken foot and can’t always remain standing throughout deliveries. So he uses a rolling stool and practices from a seated...more

Hospital Options for Unused Long Term Care Beds - Corridors Newsletter Fall 2014

A number of hospitals in North Carolina have skilled nursing beds in their bed inventory. According to the Proposed 2015 State Medical Facilities Plan (SMFP), 1,652 of the 45,724 (or approximately 4 percent) of the licensed...more

Corridors Fall 2014 - News for NC Hospitals

In this issue: - North Carolina’s Medicaid RAC Program – Don’t Let Your Guard Down - A Primer on Medicare Requirements for Physician Supervision of “Incident to” Services - Hospital Options for Unused...more

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