Hospitals

News & Analysis as of

Public Hospital Bankruptcy Under Chapter 9: A Success Story and a Powerful Tool

To the extent authorized by a State, Chapter 9 of the Bankruptcy Code allows municipalities (defined as a “political subdivision or public agency or instrumentality”) of that State – including public hospitals – to reorganize...more

Health Alert (Australia) - February 8, 2016

In This Issue: - Judgments; Legislation; and Reports. - Excerpt from Judgments: South Australia 28 January 2016 - Inquest into the death of Ebony Simone Napier The South Australian Coroner has...more

House Energy & Commerce Committee Seeks Comments on Medicare Site-Neutral Payment Policies

The House Energy and Commerce Committee is seeking input on Section 603 of the Bipartisan Budget Act of 2015, which established a site-neutral payment policy for newly-acquired, provider-based, off campus hospital outpatient...more

CMS Posts Revised Application for Meaningful Use Hardship Exceptions

On January 22, CMS posted a revised application and instructions for a hardship exception from the Meaningful Use program penalties in 2015. Under the new, streamlined application process, which CMS says is a temporary...more

Certain Illinois Employers Now Required to Post Human Trafficking Helpline

A new Illinois state law requires certain employers to post notices informing employees and other members of the public of a helpline to assist any person who is subject to human trafficking. This law, effective January 1,...more

Third Circuit Court of Appeals Rejects Hospital’s Religious Exemption from ERISA

On December 29, 2015, the U.S. Court of Appeals for the Third Circuit decided in Kaplan v. Saint Peter's Healthcare System, No. 15-1172 (3d. Cir. Dec. 29, 2015) that the pension plan for Saint Peter’s Healthcare System in New...more

CMS Issues Guide on Avoiding Readmissions in Diverse Medicare Populations

The CMS Office of Minority Health has released a “Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries.” The guide highlights data indicating that racial and ethnic minority...more

CMS Releases Guide to Preventing Readmissions Among Racially and Ethnically Diverse Medicare Beneficiaries

On January 26, 2016, the CMS Office of Minority Health released a new Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries (Guide). The purpose of the Guide is to assist hospital...more

Courts Continue To Expand ERISA Church Plan Exemption

Most employers know that there is a federal law – the Employee Retirement Income Security Act, or ERISA – that governs employer-sponsored employee benefit plans. There are a few notable exceptions that could apply to...more

Outliers: CMS Explains its Reasoning for FY2004 Fixed Loss Threshold Calculation

In accordance with the order issued by the D.C. Circuit in District Hospital Partners, LP v. Burwell and related cases, on January 22, CMS issued an explanation of the methodology it used to calculate the fixed-loss threshold...more

CMS Announces DSH Allotments

CMS has published the final fiscal year (FY) 2013 and preliminary FY 2015 disproportionate share hospital (DSH) allotments, along with final FY 2013 and preliminary FY 2015 limitations on aggregate DSH payments that states...more

Site Neutral Payments for Off-Campus Locations Established After Nov. 1, 2015

Provider-based off-campus hospital outpatient departments (OC-HOD’s) established after November 1, 2015 will be subject to a new site-neutral payment limitation starting Jan. 1, 2017 as a result of provisions in the Balanced...more

Credentials Materials Are Not Privileged Under the Health Care Professional Credentials Data Collection Act

The Illinois Supreme Court recently held in Klaine v. Southern Illinois Hospital Services, 2016 IL. 118217 that a physician’s application for hospital privileges, which included information obtained from the National...more

DOJ Reaches $3.28 Million Stark Settlement with San Diego Hospital

Tri-City Medical Center will pay $3.28 million to settle alleged Stark Law violations that stemmed from financial arrangements with its former chief of staff and paperwork problems in more than 90 of its physician agreements....more

Warning – a party who refused to accept an offer to mediate is penalised with indemnity costs for the entire proceedings!

In another clinical negligence action, the NHS Litigation Authority (NHSLA) has once more been ordered to pay indemnity costs on detailed assessment proceedings after rejecting a claimant’s offer to mediate....more

CMS Payment Initiatives Target Quality & Care Improvement - The Short Version

Like it or not, the Centers for Medicare & Medicaid Services (CMS) is expanding its strong commitment to focus on quality and care improvement as the basis for payment throughout the continuum of care. The final rule for the...more

CMS Publishes Clarification of FY 2004 Outlier Fixed-Loss Threshold As Required by Two Recent Federal Court Rulings

On January 22, 2016, CMS published an explanation of its FY 2004 outlier fixed-loss threshold rulemaking. The explanation was required by two 2015 federal court orders in cases brought by hospitals challenging the outlier...more

MedPAC Votes to Recommend Changes to 340B Drug Payment Under Medicare Part B

For most of the past year, the Medicare Payment Advisory Commission (MedPAC) has been examining Medicare Part B payments to hospitals that participate in the 340B drug purchasing discount program in an effort to better align...more

Manatt on Medicaid: CMS Approves California's Delivery System Reform Incentive Payment (DSRIP) Waiver Renewal

On December 30, 2015, the Centers for Medicare and Medicaid Services (CMS) approved California's request to renew its waiver under Section 1115 of the Social Security Act. A significant component of the waiver is the Delivery...more

Safety of Both Devices and Drugs Need to Be Better Tracked, FDA Hears from Oversight Bodies

FDA lacks the appropriate data to effectively conduct postmarket surveillance and safety tracking activities, according to two reports released earlier this month. First, Senator Patty Murray’s Health, Education, Labor, and...more

Summary of California Appellate Decisions - January 2016

Insurance Coverage; Vandalism and Malicious Mischief Exclusion - Hung Van Ong v. Fire Insurance Exchange (2015) 235 Cal.App.4th 901, 185 Cal.Rptr.3d 524 - Facts: The insured had a vacant apartment building....more

Deadline Looms for EHR Hardship Exceptions

The Centers for Medicare & Medicaid (CMS) expect 209,000 health care providers to face Medicare payment reductions for failing the electronic health records (EHR) “meaningful use” requirements in 2014. CMS puts the estimated...more

Alabama CON Report

I. Certificate of Need Program - A. Project Modification - AL2015-014, The Heath Care Authority of Cullman County d/b/a Cullman Regional Medical Center, Inc., Cullman, AL: Proposes to relicense thirty (30) acute care...more

Potential Part B Drug Payment Cuts for 340B Hospitals

The influential Medicare Payment Advisory Commission (MedPAC) has voted to recommend to Congress in its March report that Medicare Part B drug payment rates for 340B drugs be reduced by 10 percent for hospitals participating...more

Length of funded training: Initial Residency Period (IRP) issues

The payment rules for Medicare graduate medical education (GME) reimbursement inherently incentivize training during a resident's "initial residency period" (IRP), which is defined as the minimum accredited length for each...more

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