Hospitals

News & Analysis as of

In it Together -- Emerging Joint Venture Structures for Hospitals and Insurers

Locke Lord lawyers Jon Biasetti, Baird Allis and Benjamin Sykes provide a detailed look at recent efforts by hospitals, physician practice groups and health insurance and managed care companies to lower health care delivery...more

Ways and Means Committee to Markup Medicare Fraud, Competitive Bidding, and other Medicare Policy Bills

On February 26, 2015, the House Ways and Means Committee is scheduled to vote on the following bills: H.R. 1021, “Protecting the Integrity of Medicare Act of 2015” – a sweeping bill to promote Medicare program...more

Federal Court Decision Demonstrates Ongoing Challenges Faced by Plaintiffs in Data Breach Litigation

On February 11, 2015, the U.S. District Court for the Southern District of Texas dismissed a class action complaint against the St. Joseph Health System arising out of a data security breach that occurred after hackers...more

These Doctors Work Hard – Over 24 Hours a Day

Sir Arthur Conan Doyle might have called it “The Case of the Doctors Who Work More than 24 Hours a Day.” Unfortunately for the physician group in question, Sir Arthur wasn’t the author; the federal court for the Northern...more

Hospital Engagement Network Contract Solicitation

CMS is requesting proposals for Hospital Engagement Network (HEN) contracts from qualified entities to work on reducing preventable hospital acquired conditions and readmissions through the Partnership for Patients...more

Health Update - February 2015

Cyber Risk Insurance Policies: What You Need to Know - Editor’s Note: As data breach incidents and related cyber risks continue to increase and gain publicity—and government agencies become more actively involved in...more

Health Care Update - February 2015 #3

In This Issue: - IRS in the ACA Spotlight - DOJ and FTC Examine Competition - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Texas Supreme Court Argument Preview - 2/15 #2

The Texas Supreme Court will hear argument in two mandamus petitions on Wednesday, February 25, 2015, beginning at 9:00 am. ...more

New IRS guidance for certain entities benefitting from tax-exempt bond financings

The IRS has released guidance in three areas of interest to entities that benefit from tax-exempt bond financings, particularly hospitals and educational institutions....more

Divestiture of St. Luke's Acquisition Upheld Despite Transaction's "Laudable" Goals

On February 10, 2015, the Federal Trade Commission (FTC) achieved a historic victory when a U.S. Court of Appeals ruled that a hospital's acquisition of a physician's group – the transaction challenged by the FTC – ran afoul...more

CMS Corrects 2015 Medicare OPPS/ASC Final Rule, Impacts Rates

Today CMS published a notice correcting its November 10, 2014 final rule updating the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) Payment System rates and policies...more

Health Law Alert: Ninth Circuit Affirms Acquisition of Idaho Medical Group by St. Luke's Hospital Violates Antitrust Laws

On Feb. 12, the Ninth Circuit Court of Appeals affirmed a trial victory for the Federal Trade Commission (FTC) and Saint Alphonsus Medical Center (Saint Alphonsus) in their challenge to the acquisition by the St. Luke’s...more

Divestiture of St. Luke's Acquisition Upheld Despite Transaction's "Laudable" Goals

On February 10, 2015, the Federal Trade Commission (FTC) achieved a historic victory when a U.S. Court of Appeals ruled that a hospital's acquisition of a physician's group – the transaction challenged by the FTC – ran afoul...more

False Claims Act – 2014 Year in Review

The False Claims Act (FCA) imposes liability on individuals and companies who defraud or submit false claims to the federal government. The FCA allows the federal government to seek treble damages, civil penalties and...more

St. Luke's Health: Does Improving Patient Care Justify a Merger Under Antitrust Law? Ninth Circuit Says "No" and Orders...

Healthcare providers frequently consolidate to cut costs and improve patient care. These benefits can result from sharing administrative costs such as billing and electronic recordkeeping, eliminating excess capacity, better...more

Sixth Circuit Rejects Rule 23(F) Petition: Comcast Not Necessarily Triggered By Antitrust Class’s Use Of A Single Damages Model...

In an antitrust class action lawsuit, multiple theories of liability often create separable anticompetitive effects that, when combined, can result in aggregated damages, but a plaintiff’s model must measure damages...more

IRS Issues Regulations on Section 501(r) Applicable to Charitable Hospitals

On December 29, 2014, the IRS issued final regulations under Section 501(r) of the Internal Revenue Code. Section 501(r) requires charitable hospitals to meet the following requirements in order to be tax-exempt...more

In Highly-Anticipated Decision, Ninth Circuit Affirms That Hospital-Physician Group Merger in St. Luke’s Violated Section 7 And...

On February 10, 2015, the Ninth Circuit issued its highly-anticipated decision at the intersection of health care and antitrust, affirming the lower court’s finding that a hospital-physician group merger completed nearly...more

Healthcare Legal News: Volume 5, Number 1

CMS ANNOUNCES NEW RULES THAT MAKE OWNER DOCTORS LIABLE FOR ALL PRACTICE MEDICARE DEBTS - Even after they leave the Practice. CMS announced its final rules on "Medicare Provider Oversight" on December 3, 2014....more

California Health Care Employees Cannot Waive Entitlement to Second Meal Period When Working In Excess of 12 Hours

Narrowly construing the California Labor Code provisions on meal periods, the California Court of Appeal struck down a provision in the Industrial Welfare Commission Wage Orders that allows health care employees working...more

Classic Antitrust Principles Apply to Health Care Mergers Even Post-ACA

The Ninth Circuit last week held that St. Luke’s Health System’s purchase of a physician practice group violated federal antitrust laws. In doing so, it upheld a district court’s order that the merger be dissolved. ...more

Can an Arbitrator Rule Against a Hospital for Not Violating the Anti-Kickback Statute?

Here’s a nightmare. An arbitrator rules against your hospital for failing to honor an agreement to refer Medicare patients to a home health agency. Why? Because the home health agency paid your hospital good money for the...more

Preparing for Phase 2 HIPAA Audits: It’s All About the Documentation

The launch of Phase 2 HIPAA audits is imminent. Although any individual hospital has only a small chance of getting audited, preparation helps protect a hospital if it is ever investigated for potential HIPAA violations. In...more

California Court Decision on Meal Breaks May Cause Health Care Industry To Go To Code Blue

Executive Summary: A new California Court of Appeal decision has invalidated a 22-year-old healthcare industry exception that had given the industry some flexibility with respect to how it provided its employees working...more

Anatomy of a Provider Merger Antitrust Challenge (Part 1)

There seems to be unprecedented antitrust interest in mergers between health-care providers, particularly by the Federal Trade Commission (FTC or Commission). Why this interest? What triggers governmental interest? What are...more

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