Hospitals

News & Analysis as of

Third Circuit Affirms Dismissal of FLSA Overtime Claims in Hospital Meal Break Cases

On August 26, the United States Court of Appeals for the Third Circuit affirmed the District Court’s dismissal of the Fair Labor Standards Act (FLSA) overtime claims brought against a myriad of health care systems and their...more

New York Proposes Revised Regulations for Health Care Collaborations

Today, New York health regulators proposed revised rules that would allow health care providers to merge or cooperate with one another without being subject to federal or state antitrust scrutiny....more

AHA Responds to Proposed Home Health Face-to-Face Changes

As previously reported, on July 7, 2014, CMS issued the Calendar Year 2015 Home Health Prospective Payment System Proposed Rule (Proposed Rule). On August 18, 2014, the American Hospital Association (AHA) submitted comments...more

OIG Okays Medigap Insurer’s Arrangement for Discount on Inpatient Deductibles

Last Monday the Office of Inspector General (OIG) of Health & Human Services posted an advisory opinion (No. 14-07) allowing a Medigap insurance company to strike a deal with hospitals for discounts—even waivers—of the...more

Another Court Weighs in on Rule 9(b)’s Requirements Under the False Claims Act

A federal district court recently dismissed a qui tam relator’s complaint in a declined case against the Hospital for Special Surgery (“Hospital”), its former CEO, and an outside billing company alleging that they violated...more

Hospital’s Failure to Abate Patient and Visitor Violence Against Employees Results in OSHA Penalty

Hospitals, remarkably, are one of the most hazardous places to work. According to the U.S. Bureau of Labor Statistics, hospital workers have an estimated rate of 8.3 assaults per 10,000 workers compared to an estimated 2...more

AHRQ Releases Guidance for Reductions in Medicaid Hospital Readmissions

The Agency for Healthcare Research and Quality (AHRQ) has issued a comprehensive guide with an interactive toolkit for providers to target reductions in Medicaid hospital readmissions. While numerous CMS initiatives have...more

AHA Renews Complaints about OIG Hospital Compliance Reviews

The American Hospital Association (AHA) has renewed its complaints about OIG “hospital compliance reviews.” Last Thursday AHA Executive Vice President Rick Pollack sent a letter to Health & Human Services Secretary Burwell...more

Blog Exclusive: 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

New Federal Guidance on Reducing Medicaid Hospital Readmissions

The Agency for Healthcare Research and Quality (AHRQ) recently issued a guide to assist hospitals in reducing Medicaid patient readmissions. The AHRQ Hospital Guide to Reducing Medicaid Readmissions is the product of a...more

One Of The Country’s Largest Hospital Organizations to Pay $98.15 Million Settlement on False Claims Act Allegations

On Monday, August 4, 2014, The Department of Justice announced that Community Health Systems (“CHS”) agreed to pay $98.15 million to settle nine whistleblower lawsuits alleging that the company violated the False Claims Act. ...more

How the US Government is cracking down on Medicare fraud

Medicare fraud is a major problem in the United States, with estimates of fraud and systematic overcharging totaling $60 billion each year. That’s nearly five times the cost of healthcare fraud in Canada, and makes up a...more

Sunshine Act Implementation Proceeds; CMS Re-opens the Open Payments System

On August 15, 2014, the Centers for Medicare and Medicaid Services (CMS) re-opened the Open Payments system for physicians and teaching hospitals to register, review, and, if needed, dispute information gathered to date. CMS...more

One Of The Country’s Largest Hospital Organizations to Pay $98.15 Million Settlement on False Claims Act Allegations

On Monday, August 4, 2014, The Department of Justice announced that Community Health Systems (“CHS”), the nation’s largest operator of acute care hospitals, agreed to pay $98.15 million to settle nine whistleblower lawsuits...more

August Scam-of-the-Month Award

It turns out that back in 2011 the hospital sold the right to use its hospital billing codes to free-standing clinics. So under the arrangement, when the clinics sent bills, they were hospital bills rather than clinic bills...more

Week in Review

Significant electronic data breaches made headlines again this week. Supervalu announced that millions of customer credit card numbers were stolen at various stores. ...more

Alabama CON Report - August 2014

In This Report: - I. SHPDA Administrative Report - A. For Informational Purposes Only - II. Certificate of Need Program - A. Reconsideration on Home Health Batched Applications - B....more

Antitrust Considerations Surrounding Health Care Consolidation Among Hospitals and Physicians

The Affordable Care Act (“ACA”) has resuscitated the demand for hospital and health care provider mergers. The law explicitly encourages collaborative care—through, for example, financial incentives surrounding the creation...more

Massive Data Breach Affects 4.5 Million Patients in 29 States

Community Health Systems, Inc. (the “Company”), one of the largest hospital organizations in the country, announced via a public filing (Form 8K) made yesterday with the Securities and Exchange Commission (“Report”) that the...more

Class Action Plaintiffs Look to Fair Credit Reporting Act for Private Relief from Data Breaches Involving Health Information

A recent class action brought against the University of Miami (“University”) previews what could become an emerging trend among plaintiffs’ class action attorneys to seek damages for the unauthorized disclosure of personal...more

Hospital Operator Reports 4.5 Million Patients’ Data Stolen in Cyberattack

The Tennessee-based acute-care hospital chain Community Health Systems, Inc. (CHS), reported on August 18 that information on approximately 4.5 million patients was stolen from the company. CHS is one of the largest hospital...more

4.5 Million Patients’ Information Stolen by Hackers

Community Health Systems Inc. (“CHS”), a Tennessee-based hospital provider, has reported it was the target of data hackers who were able to obtain identification information belonging to approximately 4.5 million CHS...more

Who Audits the Auditors?

Since the advent of Medicare in 1965, hospitals have bemoaned the cost and burden of Medicare audits. The complaints increased when CMS hired private contractors for the audits. They became deafening in 2009 with the advent...more

New Jersey DCA Extends Deadline for Prescription Blanks

On February 18, 2014, the New Jersey Division of Consumer Affairs (the “DCA”) adopted new regulations which incorporate print-based security features into all New Jersey Prescription Blanks (NJPBs). The DCA has recently...more

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

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