Hospitals

News & Analysis as of

Government Sues Hospital for Birthing Mama’s Babies

The Clinica de la Mama case could well serve as an instruction manual of what not to do to stay out of the government’s crosshairs. In this case, several hospitals entered into contracts for Clinica de la Mama to provide...more

Hospital Network Reports Large HIPAA Breach

Community Health Systems announced yesterday, August 18th, that hackers broke into its computers and stole data on 4.5 million patients. ...more

Acute Care Hospitals Settle FCA Lawsuits for $98 Million

Community Health Systems, Inc. (CHS) and Community Health Systems Professional Services Corporation, together a national owner and operator of acute care hospitals, and 119 of their hospitals, agreed to pay $98 million to...more

CMS Releases FY 2015 Hospital Inpatient Prospective Payment System (IPPS) Final Rule

On August 4, 2014, CMS released the annual Hospital Inpatient Prospective Payment System Final Rule for FY 2015 (the “Final Rule”) affecting discharges occurring on or after October 1, 2014. For inpatient acute care...more

New Federal Health Care Facility Regulations Could Mean More Construction Work

On April 16, 2014, the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services, published proposed rules that would amend the fire safety standards for hospitals,...more

Unnecessary Surgeries Put Hospital in Three-Front War

When the government accuses a hospital of committing Medicare fraud by billing for unnecessary surgeries, the hospital has a real problem on its hands. It’s at war with the government, and that’s expensive, as well as...more

Pennsylvania Issues Regulations Under Excessive Overtime in Health Care Act

On July 19, 2014, the Pennsylvania Department of Labor and Industry published new regulations to implement certain provisions of the Prohibition of Excessive Overtime in Health Care Act, 43 P.S. §§ 932.1 to 932.6 (the "Act")....more

What’s Scarier than a Compliance Officer Turned Whistleblower? A Whole Association of Them

In U.S. ex rel. Corporate Compliance Assocs. v. N.Y. Society for the Relief of the Ruptured & Crippled the court ruled that the whistleblower failed to meet the False Claims Act’s requirement that allegations be described...more

Proskauer Obtains Dismissal of High-Stakes False Claims Act Suit

On August 7, 2014, Judge Castel of the Southern District of New York dismissed a False Claims Act (“FCA”) complaint that was based primarily on allegations that the defendant Hospital improperly focused on referral revenue in...more

Massachusetts Enforces Data Security Regulations Against Out-of-State Entity

On July 23, 2014, the Massachusetts Attorney General announced a consent judgment with an out-of-state Rhode Island hospital, Women & Infants Hospital of Rhode Island (“WIH” or the “Hospital”), resolving a lawsuit against WIH...more

CMS Publishes FY 2015 Final IPPS Rule

On August 4, 2014, CMS posted its final changes and updates to the Medicare Inpatient Prospective Payment System (IPPS) that apply for fiscal year (FY) 2015, effective October 1, 2014. Below are some of the highlights of the...more

Federal Prosecutors Bring Criminal Charges against Individual for Alleged HIPAA Violation

Federal prosecutors in the Eastern District of Texas recently brought criminal charges under the Health Insurance Portability and Accountability Act (“HIPAA”) against a former East Texas hospital employee. The former...more

Early Report on Value-Based Purchasing: Less to It Than Meets the Eye?

Medicare’s Value-Based Purchasing (VBP) program produced no improvement in either quality of care or patient satisfaction during its first nine months of operation. That’s the finding of a study led by Andrew Ryan, of the...more

Health Headlines: Also in the News - August 2014

Hospital IPPS Final Rule Not Yet Released – As of the time this edition of Health Headlines was sent to press, CMS has not yet released the hospital inpatient prospective payment system (IPPS) final rule for FY 2015....more

The Reformed Health Care Industry: Creative Structures and Alliances Can Yield Great Benefits, but Also Great Risks

Since the Affordable Care Act (the “ACA”) was enacted in 2010, the health care industry has been on the edge of its proverbial seat waiting to see which care delivery models are best suited to sustain all the changes: to...more

Highlights from the Senate Special Committee on Aging’s Hearing on Medicare Observation Status

A recent Senate Special Committee on Aging hearing focused on the impact of Medicare observation status, a hospital outpatient designation for which Medicare covers fewer services and generally reimburses for services at a...more

Profits over People - Big Insurance finds another way to cash in on injured people

The latest investigative piece published in the News Tribune this week, entitled “MultiCare sues estate of boy killed in Tacoma Dome accident”, outlines a struggle that lawyers representing injured people in Washington State...more

Brace Yourself: The RACs Are Back

Under the controversial program private contractors audit hospitals and other Medicare providers for fraudulent and erroneous Medicare billing. Why is it controversial? Because the auditors are paid a percentage of...more

Impact on Medicare Payments of Shift in Site of Care for Chemotherapy Administration

Two independent trends, acting in combination, are currently resulting in increased Medicare fee-for-service (FFS) chemotherapy payments. The first trend is a shift in the site of care for cancer patients from physicians’...more

Privacy Update: In For A Penny, In For A Pound

A Warning for Health Service Providers - The Australian Privacy Commissioner has found that a suburban Melbourne medical practice has breached the Privacy Act 1988 (Cth) by failing to take reasonable steps to secure...more

Rhode Island Hospital’s Breach of Health Information Leads to Settlement with Massachusetts Attorney General

On July 23, 2014, the Massachusetts attorney general announced a settlement with Women & Infants Hospital of Rhode Island (WIH) over the loss of unencrypted backup tapes. WIH agreed to pay $150,000 and undertake numerous...more

Ten Ways to Energize Research Organization Collaborations

Energizing Research Organization Collaborations Research collaborations that extend across organization — universities, hospitals, independent research institutes, national labs, companies, etc.— require a certain amount of...more

FDA Issues Updated Draft Guidance on Reporting Drug Samples

The guidance calls for 2014 reporting by April 1, 2015. When signed into law in March 2010, the Affordable Care Act (ACA) put a renewed focus on transparency. While section 6002, the Physician Payment Sunshine Act,...more

CMS Proposes Regulations: Changes to Physician Fee Schedule, Hospital Outpatient, and Ambulatory Surgical Center Policy and...

On July 3, 2014, The former revises payment policies under the Medicare Physician Fee ScheCenters for Medicare and Medicaid Services (CMS) proposed two regulations, CMS-1612-P and CMS-1613-P. dule, while the latter makes...more

New Baltimore City Law Limits Employee Criminal Record Checks: How Health Care Employers Are Affected

Effective August 13, 2014, certain Baltimore City employers will be restricted from asking applicants and employees about their criminal history. However, many health care employers will be exempt from this new law either...more

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