Hospitals

News & Analysis as of

Justice Department Continues to Target Health Care Providers with "Barrier-Free" Initiative

The Department of Justice's recent settlement with a Chicago-based hospital system is the latest reflecting the agency's continuing pursuit of claims against health care providers – small and large -- who fail to provide...more

Health Reform + Related Health Policy News - December 2014, Issue 1

In This Issue: - Top News ..Congress Passes Omnibus Spending Package ..HRSA Cancels Plan for 340B ‘Mega Reg’; Congress Weighs Options ..Supreme Court to Hear Challenge to ACA...more

Recent Changes to Stark Law's Whole Hospital Exception

The federal physician self-referral law, or Stark Law, provides a number of exceptions to the law's prohibition of physician referrals of designated health services to an entity in which the physician has an ownership or...more

How to Prepare Your Hospital or Medical Practice for a Meaningful Use Audit

For the past several years, the Centers for Medicare and Medicaid Services (“CMS”) has incentivized hospitals and eligible professionals to adopt and make “meaningful use” of certified electronic health records (“EHR”)...more

CMS Releases Final Rule That Increases Difficulty of Medicare Enrollment

In early December, CMS released a final rule that implements certain provider (i.e., Hospitals, SNFs, physicians, etc.) and supplier (i.e., DME companies, etc.) enrollment requirements (“Rule”). The goal of CMS’...more

CMS Final Rule Adds More Arrows but also Demonstrates Restraint

CMS reconsiders $10 million bounties for reporting of regulatory violations. On December 5, the Centers for Medicare & Medicaid Services (CMS) finalized a rule (the Final Rule) that expands its program integrity and...more

CMS Defines “Uninsured” for Medicaid DSH Payments But Leaves Impact on Hospital-Specific Payments Undefined

CMS’ Final Rule, “Medicaid; Disproportionate Share Hospital Payments – Uninsured Definition”, published on December 3, 2014, may offer relief to some hospitals receiving Medicaid disproportionate share hospital (DSH) payments...more

OIG Releases Proposed Gainsharing Regulation

In early October, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) released a proposed rule that included, among other provisions, a proposed gainsharing regulation (“Proposed Rule”),...more

Illinois Supreme Court to Consider Discovery Privileges Applicable in Medical Malpractice

In the closing days of its November term, the Illinois Supreme Court agreed to decide an issue of potential importance to the medical malpractice bar: what kinds of documents are privileged from disclosure in a negligent...more

Medical Marijuana Roundtable: Top Ten Takeaways

Minnesota recently became the latest state to permit the limited use of medical marijuana for treating certain health conditions. In early October, the Department of Health issued proposed regulations to implement the new...more

Tennessee CON Report - November 2014

In This Issue: - I. November 2014—Tennessee Certificate of Need Meeting - II. Certificate of Need Program Report—Filings Since October 2014 Meeting - III. Projects Deemed Complete for Review at December...more

Hospitals and Health Insurers Prodded on Same-Sex and Transgender Issues

In separate actions yesterday, CMS and the New York State insurance regulatory authority took steps to (a) assure equal treatment of same-sex spouses by hospitals and (b) insurance coverage of medically necessary transgender...more

Hospitals can be risky places to work

The notion that it could be more dangerous to work in a hospital than to work on a construction site might sound absurd. Hospitals exist in order to counteract the effects of injury and disease, so the fact that they are a...more

Connecticut Law Establishes New Reporting and Governance Requirements for Health Care Entities: Part 1: Requirements Applicable to...

A new Connecticut law, Public Act Number 14-168, entitled “An Act Concerning Notice of Acquisition, Joint Ventures, Affiliations of Group Medical Practices and Hospital Admissions, Medical Foundations and Certificates of...more

Government Applauds Gainsharing, But It's Still Illegal

It's frustrating enough when the government opposes a good idea and makes it illegal. But "gainsharing" presents an even more frustrating situation for hospitals. Why? Because the government continually signals its agreement...more

Retained Surgical Sponges: A serious medical error

Occasionally, doctors make mistakes while treating their patients. Some of the errors that occur are so egregious that the medical profession has come to know them as “never events” because they should never, under any...more

CMS Invites Comment on Availability of Waivers for ACOs That Particularly Affect Post-Acute Care

Solutions and opportunities may be on the horizon for post-acute providers (“PAPs”) and hospitals participating (or thinking of participating) in ACOs that have reservations about taking on additional downside cost risk...more

AHA Proposes Putting RACs on the Rack

The American Hospital Association formally proposed last week that Recovery Audit Contractors (RACs) be fined when their denials are overturned on appeal....more

Supreme Court Rejects Whistleblower’s Double-Dip Attempt

On Monday the United States Supreme Court declined to hear Danny Smart’s appeal of the Fifth Circuit’s rejection of his attempt to share in the proceeds of a $5 million settlement of a False Claims Act suit brought by another...more

Growth Of The 340b Program: Past Trends, Future Projections

The 340B program provides certain healthcare providers (referred to as “covered entities”) access to deeply discounted pharmaceuticals for outpatient use. Congress created the program in 1992 to help uninsured and vulnerable...more

Hospital Survey on Government Relations Function Reveals Variation in Practice and Measurements

A private consultant has just released a first-in-kind national survey on the use by hospitals of government relations professionals, indicating a broad range of practices within the hospital industry. The Report, entitled...more

HHS to Audit Hospital Reporting of GPO Payments: GAO Report Suggests Further Scrutiny of GPO Shareback with Hospitals

On November 24, 2014, the Government Accountability Office (“GAO”) published a report examining the contracting practices and funding structures of health care group purchasing organizations (“GPOs”) and their potential...more

Potential Changes in the South Carolina Certificate of Need Application and Review Process

After Governor Haley vetoed funding for the Certificate of Need (CON) program, the Department of Health and Environmental Control stopped administering the program, resulting in months of confusion in the regulated community....more

Illinois Supreme Court Agrees to Decide Whether Fees Must be Deducted From Health Care Settlements Before Applying Liens

In the final days of its November term, the Illinois Supreme Court allowed a petition for leave to appeal in McVey v. M.L.K. Enterprises, LLC. McVey, a case from the Fifth District, presents the following question: must...more

Blog: Beth Israel To Pay $100,000 for Massachusetts Health Information Breach

Beth Israel Deaconess Medical Center (Beth Israel) reached a settlement with the Massachusetts Attorney General’s Office for a data breach in which a physically unsecured laptop was stolen containing personal and protected...more

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