Hospitals

News & Analysis as of

Again, the OIG Approves a Medigap Policy Contract with Preferred Hospital Networks

On June 12, 2015, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued Advisory Opinion 15-08. This opinion continues the well-established pattern of favorable advisory opinions which...more

July Antitrust Bulletin

On June 29, 2015, Sysco Corp. announced that it was pulling the plug on its $3.5 billion proposed merger with US Foods Inc. The news comes less than a week after a Washington, D.C., federal judge concluded that the Federal...more

What Not To Do When Your Competitor’s CEO Calls

Apparently when the CEO of Hillsdale Community Health Center, Hillsdale, Michigan (Hillsdale), called his counterparts at neighboring general acute care hospitals, all of the antitrust advice they had received was left in the...more

DOJ and Michigan Sue Four Hospital Systems for Agreeing Not to Compete with Each Other

Together with the State of Michigan, the United States Department of Justice’s Antitrust Division has filed a civil suit against four Michigan hospital systems for allegedly agreeing to limit marketing in each other’s...more

DOJ Sues Four Michigan Hospitals for Secret Agreements Not to Compete

Late last week, the United States Department of Justice (DOJ) and the Michigan Attorney General (AG) filed suit against four southern Michigan hospitals, alleging that they secretly agreed not to compete with each other in...more

Health Alert (Australia) - June 29, 2015

In This Issue: - Judgments; Legislation; and Reports. - Excerpt from Judgments: Australian Capital Territory (ACT). Medical Board of Australia v Hocking [2015] ACAT 44 - The ACT Civil and...more

Court Upholds CMS' Prohibition on 'Under-Arrangements' Transactions, Strikes Down CMS' Prohibition on 'Per-Click' Equipment Rental...

A 2008 rule change from the Centers for Medicare and Medicaid (CMS)—which effectively prohibited referring physician-owned companies from furnishing hospital services “under arrangements”—has withstood a challenge by a...more

The Deeper Dive: C-Suite to Prison Pipeline

In recent years, the U.S. Department of Justice (DOJ) has been criticized for failing to prosecute executives for fraud, particularly in the financial sector. In response, the DOJ has begun to more heavily emphasize...more

CMS Pays $1.3 Billion to Hospitals for Settlements of Medicare Inpatient Appeals

On June 11, 2015, CMS announced that it had entered into settlements with over 1,900 hospitals for over 300,000 disputed inpatient billing claims. CMS updated its website dedicated to inpatient hospital reviews, noting that...more

Plaintiff Tripped Up By Summary Judgment

According to the Centers for Disease Control and Prevention (CDC), over 8 million people were treated in U.S. emergency rooms in 2013 for slips, trips, and other accidental falls, making such accidents the leading cause of...more

Patients poised to record doctor's visits?

The question of whether patients should be permitted to record interactions with their doctors, and when and how it is best to do so, has become a highly contentious issue to navigate in today’s increasingly complex medical...more

Structuring Healthcare Provider Agreements for Compliance

On June 23rd, the Healthcare Law Blog discussed the Fraud Alert recently issued by the Office of Inspector General of the United States Department of Health and Human Services regarding physician compensation arrangements...more

MedPAC Report to Congress on Medicare and the Health Care Delivery System

The Medicare Payment Advisory Commission (MedPAC) has released its June 2015 Report to the Congress on Medicare and the Health Care Delivery System. The report includes a series of recommendations on Medicare hospital...more

Alabama CON Report

In this Report: - I. Certificate of Need Program - A. AL2015-020 - B. AL2015-021 - II. Reviewability Determinations and Pending Reviewability Determinations - A. Reviewability...more

MedPAC Releases June 2015 Report to the Congress

The Medicare Payment Advisory Commission (MedPAC) released its “Report to the Congress: Medicare and the Health Care Delivery System” on June 15, 2015. As previously reported, the report makes recommendations for policy...more

Variables Affecting Medical PL Settlement Values [Video]

From the 2015 PLUS Medical PL Symposium session “Batch Claims: What are the ‘Three P’s?’,” Scott Crockett, Esq. of Wagstaff & Cartmell discusses the variables that impact claim settlement, including “fear of” claims....more

OIG Fraud Alert Cautions Against Sham Medical Director Arrangements

The HHS OIG recently issued a brief fraud alert (Fraud Alert) reminding physicians that inappropriate compensation arrangements may lead to enforcement actions under the federal anti-kickback statute and Civil Monetary...more

D.C. Circuit Remands HHS’ “Per-Click” Equipment Lease Rule to District Court

The Court of Appeals for the District of Columbia Circuit recently considered HHS’s authority to enact a 2008 rule that prohibited physicians who lease equipment to a hospital from doing so on a “per-click basis” while...more

The Recent Auditor General Report and Central Pennsylvania Hospitals

In April, 2015, the Pennsylvania Auditor General released a Report that chastised the Department of Labor and Industry for its failure to implement adequate procedures to ensure that all complaints under the Prohibition of...more

Senate Finance Committee to Vote on Bipartisan Health Bills

On June 24, 2015, the Senate Finance Committee is scheduled to vote on the following bipartisan health policy bills, described by Chairman Hatch as “common sense legislation that will improve the healthcare system for...more

A New Era of HIPAA Enforcement

Traditionally, HIPAA enforcement is assigned to the Department of Health and Human Services’ Office for Civil Rights (OCR). In November 2013, Health and Human Services’ Office of Inspector General sharply criticized OCR’s...more

China Issues New Guiding Opinions for Public Hospital Reform

Recently, the General Office of the State Council published the Guiding Opinions on Pilot Comprehensive Reform of Urban Public Hospitals, which took effect on 6 May 2015. The Guiding Opinions give directions for the ongoing...more

Health Update - June 2015

Examining Fee Splitting Statutes in the Context of Value-Based Healthcare - Editor’s note: One of the goals of the Affordable Care Act (ACA) is to align incentives among provider communities and their patients and...more

Health Alert (Australia) - June 22, 2015

In This Issue: - Judgments; Legislation; and Reports. - Excerpt from Judgements: Victoria. Inquest Into the Death of Baby Chloe Lee Kellett - The Victorian Coroner investigated an infant's death from...more

NLRB Affirms Its Previous Decision Requiring Employer to Continue Providing Annual Wage Increases Beyond Contract Expiration

We previously blogged about the NLRB’s relatively shocking September 2012 decision in Finley Hospital (359 NLRB No. 9), in which the Board held that an employer was required to continue providing wage increases after the...more

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