News & Analysis as of

Hospitals

Free Parking, Yes, But No Stark Law Claim

by Ruder Ware on

A federal court recently dealt a victory to a health care provider over whistleblower allegations that free parking and valet service at a medical office building violated the Stark Law and the Anti-Kickback Statute....more

Exclusive Agreement Between Hospital and Insurance Plan Does Not Violate Section 1

The Seventh Circuit refused to revive an exclusive dealing claim by one hospital against its competitor because of an exclusivity agreement with an insurance plan. Judge Richard Posner wrote the short opinion strongly...more

Mandatory Bundled Payments Delayed, CMS seeking comments

by Carlton Fields on

CMS Administrator, Seema Verma, and Secretary of Health and Human Services Secretary, Tom Price delayed implementation of the Comprehensive Care for Joint Replacement (“CJR”) program via an interim final rule. See CMS – 5519...more

Seventh Circuit Finds Exclusive Dealing in Hospital-Payer Case Pro Competitive

“But what is more common than exclusive dealing?” Affirming summary judgment for defendant Saint Francis Medical Center, the Seventh Circuit recently held that the hospital’s contracts with health care insurers—though...more

Some Will Always Have Paris: Withdrawal from the Climate Change Accord May Not Reduce the Heat on the Health Care Industry

President Trump’s decision earlier this month to withdraw the United States from the Paris Agreement—an international, nonbinding agreement to take steps to limit global temperature rise—followed a series of moves at the...more

MedPAC Takes Anti-POD Stance in Report to Congress, Echoing an Increasingly Uniform Consensus

by Ropes & Gray LLP on

On June 15, 2017, the Medicare Payment Advisory Commission (MedPAC), a non-partisan group that advises Congress on Medicare policy, released its annual Report to the Congress on Medicare and the Health Care Delivery System...more

Seventh Circuit Affirms Dismissal of Hospital Foreclosure Claims with Judge Posner Asking, “What is More Common Than Exclusive...

by Reed Smith on

The Seventh Circuit, on June 9, 2017, affirmed summary judgment against a hospital’s antitrust claims that it was substantially foreclosed from the market by its rival’s exclusive contracts with payors. The panel concluded...more

Health Alert (Australia) 19 June 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 9 June 2017 - Health Services Union v St John of God Health Care [2017] FWC 2981 - Alleged dispute arising under an enterprise...more

Telemedicine in the Emergency Department and EMTALA Compliance

by Jones Day on

Although enacted more than 30 years ago, the Emergency Medical Treatment and Labor Act ("EMTALA") remains aggressively enforced and important for Medicare-participating hospitals to consider as they implement telemedicine...more

Court Puts the Brakes on Whistleblower's FCA Parking Claims

by Baker Ober Health Law on

The Department of Justice (DOJ) reports that, in fiscal year 2016 ending September 30, it obtained more than $4.7 billion in settlements and judgments from civil cases involving fraud and false claims. More than half of this...more

Medicare Payment Advisory Commission Studying Payments To Stand-Alone Emergency Departments

by King & Spalding on

Mark Miller, MedPAC’s Executive Director, testified before the House Ways and Means Committee last week to discuss MedPAC’s Annual Report to Congress, Medicare Payment Policy, which was released March 15, 2017. ...more

Enforcement Considerations for the Health Care Industry in the Wake of the WannaCry Ransomware Attack

by Ropes & Gray LLP on

On May 12, 2017, the WannaCry ransomware cryptoworm attacked over 230,000 computers in over 150 countries, holding data on the computers for ransom. WannaCry spread rapidly through networked systems that had not been updated...more

The non-existent corporate practice of medicine prohibition in Oklahoma

by McAfee & Taft on

Physicians, hospitals and healthcare organizations frequently ask us about corporate practice of medicine restrictions in Oklahoma. The corporate practice of medicine doctrine basically restricts physicians from being...more

Supreme Court Clarifies “Church Plan” Definition for ERISA Exemption Purposes

by Saul Ewing LLP on

A recent U.S. Supreme Court decision in Advocate Health Care Network v. Stapleton implicates the benefit plans maintained by nonprofit entities affiliated with a church or religious organization, including many hospitals and...more

Supreme Court Decision Offers Some Relief to Church-Affiliated Nonprofits Using ERISA Church Plan Exemption

by FordHarrison on

Executive Summary: The U.S. Supreme Court’s decision in Advocate Health Care Network v. Stapleton serves as a reminder to church-affiliated hospitals and other organizations using the ERISA church plan exemption to review the...more

Last Rites for ER Doctor’s EMTALA Claims

by Faegre Baker Daniels on

ER physician Ryan Kime believed his hospital lacked the resources, procedures, and capacity to meet the requirements of EMTALA, and he repeatedly said so. At an ER meeting he reported two cases as possible EMTALA violations...more

CMS finalizes additional delay for episodic payment programs

by Thompson Coburn LLP on

After earlier delays following the change in administration and leadership, the Centers for Medicare and Medicaid Services (CMS) has set the start date for cardiac episode payment models (EPMs) and revisions to the...more

Health Alert (Australia) 12 June 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 7 June 2017 - Al Muderis v Duncan (No 3) [2017] NSWSC 726 - DEFAMATION – assessment of damage – highly respected orthopaedic...more

Hospital Seeks Second Opinion on Certifying Class with Uninjured Members

by BakerHostetler on

Ten years into litigation, a hospital has moved to decertify a class of plaintiffs who claim the hospital’s merger caused them to overpay for medical services. Arguing there is insufficient proof that class members were...more

Church Plans Rejoice: The Supreme Court has Spoken

by Locke Lord LLP on

Over 30 lawsuits have been filed over the past several years alleging that defined benefit plans maintained by religiously-affiliated hospital systems are not entitled to church plan status under the Employee Retirement...more

Sometimes It’s Not What You Say But How You Say It

by Faegre Baker Daniels on

A recent First Circuit opinion demonstrates that sometimes how you say something is more important that what you say. In fact, that principle led the court to reverse the NLRB’s order that a Massachusetts hospital must...more

ECRI Institute Releases Guidance on How to Protect Your Medical Device Systems

by Knobbe Martens on

The ECRI Institute released new guidance in its article: “Ransomware Attacks: How to Protect Your Medical Device Systems” on May 18, 2017. The report recommends various protective actions for hospitals to take and points to...more

Employee Benefit Plans For Principal-Purpose Organizations Need Not Be Established By A Church To Be Exempt From ERISA

by DeWitt Law, LLC on

In a ruling that could have cost nonprofit religious-affiliated employers millions of dollars in compliance and other costs had it gone the other way, on June 5, 2017, the U.S. Supreme Court held, in a unanimous opinion...more

Seventh Circuit OKs Exclusive Network Agreements Between “Must-Have” Hospital and Health Insurers

by Mintz Levin on

In an opinion written by Judge Posner, the Seventh Circuit on Friday gave its stamp of approval to a “must-have” hospital’s bargaining to exclude competitors from certain narrow-network payor contracts in and around Peoria,...more

U.S. Supreme Court Finds that Retirement Plans Sponsored by Religious Hospitals Are Exempt from ERISA

by Franczek Radelet P.C. on

The United States Supreme Court has ruled that retirement plans sponsored by church-affiliated organizations, such as hospitals, are exempt from ERISA. ERISA’s “church plan exemption” provides that a retirement plan that is...more

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