News & Analysis as of

Hospitals Patient Protection and Affordable Care Act (PPACA) Proposed Regulation

Ogletree, Deakins, Nash, Smoak & Stewart,...

Employers May Need to Provide Cost Data Under Proposed ACA Rules

Employer-sponsored health plans and health insurers may be required to post online - and to provide participants upon request - a range of pricing and cost-sharing information beginning in 2021. Proposed Affordable Care...more

Mintz - Employment, Labor & Benefits...

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 11 of 24): Reporting 2015 Coverage of “MV-Lite”...

In Notice 2014-69, the Treasury Department and the IRS clarified that a group health plan that fails to provide substantial coverage for in-patient hospitalization and physician services will not be treated as providing...more

Balch & Bingham LLP

Updated Proposed Regulations Issued: Inpatient Hospital and Physician Services Must Be Covered

Balch & Bingham LLP on

Tuesday the IRS issued proposed regulations that require an employer-sponsored health plan to include substantial coverage of inpatient hospital and physician services in order for the plan be considered as providing minimum...more

King & Spalding

CMS Releases CY 2016 Proposed Rule on OPPS and ASC Payment Systems, Including Changes to the Two Midnight Rule

King & Spalding on

On July 1, 2015, CMS released a Proposed Rule that would revise the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System payment rates for calendar year (CY) 2016, and would...more

King & Spalding

CMS Issues CY 2016 Medicare Physician Fee Schedule Proposed Rule

King & Spalding on

On July 8, 2015, CMS issued its annual proposed rule outlining payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) for CY 2016. In the proposed rule,...more

McGuireWoods LLP

Washington Healthcare Update

McGuireWoods LLP on

This Week: Energy and Commerce Health Subcommittee Explores Post-Acute Bundling…CMS Releases First-ever Hospital Compare Star Ratings…Fiscal Year 2016 Proposed Inpatient and Long-term Care Hospital Policy and Payment Changes....more

Bradley Arant Boult Cummings LLP

Implications of Final Regulations Under Internal Revenue Code Section 501(r)

The Internal Revenue Service replaced proposed regulations under Section 501(r) of the Internal Revenue Code (the “Code”) with final regulations in late 2014 (the “Final Regulations”). As enacted in the Patient Protection and...more

Benesch

OIG Announces Proposed AKS and CMP Regulations

Benesch on

On October 3, 2014, the Office of the Inspector General (“OIG”) issued a proposed rule codifying into regulation several statutory changes to the Antikickback Statute (“AKS”) and the Civil Monetary Penalty (“CMP”) Law. Nearly...more

Mintz

OIG Special Advisory Bulletin Provides Guidance on Application of Federal Anti-Kickback Statute to Pharmaceutical Manufacturer...

Mintz on

In recent years, copayment coupon programs have become standard promotional practices for both large and small pharmaceutical manufacturers. Copayment coupons are typically offered to commercially insured patients in order to...more

Epstein Becker & Green

OIG Proposes New Safe Harbors to the Anti-Kickback Statute and New Exceptions to the Two Civil Monetary Penalty Provisions

Epstein Becker & Green on

On October 3, 2014, the Department of Health and Human Services’ Office of Inspector General (“OIG”) published a proposed rule (“Proposed Rule”) to add new safe harbors to the federal health care program anti-kickback statute...more

K&L Gates LLP

Proposed Updates to the Civil Monetary Penalties Law for Health Care Providers

K&L Gates LLP on

On October 3, 2014, the Office of Inspector General of the Department of Health and Human Services (“OIG”) published a proposed rule and request for comments (“Proposed Rule”) that would amend certain rules under the Civil...more

Davis Wright Tremaine LLP

Sometimes the Government is Here to Help: OIG Proposes More Flexibility in Rules Governing Local Transportation, Beneficiary...

The U.S. Department of Health & Human Services, Office of Inspector General ("OIG") just released a proposed rule (“Proposed Rule”) that provides long awaited guidance on patient transportation services, relaxes the...more

Morgan Lewis

OIG Proposes Rules on Free Transportation, Hospital Gainsharing, and Other Access to Care Arrangements

Morgan Lewis on

The proposed rule to give providers more protections to promote beneficiary access to care solicits significant industry input. On October 2, the Department of Health and Human Services (HHS) Office of Inspector...more

Foley & Lardner LLP

OIG's Proposed Rule to Expand Civil Monetary Penalties

Foley & Lardner LLP on

The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) on May 12, 2014 published a proposed rule (Proposed Rule) that would implement the OIG’s expanded authority under the Affordable Care...more

Baker Donelson

Changes Proposed to PRRB Dissatisfaction Requirement

Baker Donelson on

On May 15, 2014, CMS published in the Federal Register its FY 2015 IPPS Proposed Rule [PDF], which included changes and updates to its Medicare IPPS policies. 79 Fed. Reg. 27978-28384. One change that CMS proposes is to amend...more

Baker Donelson

Proposed 2015 IPPS Rule Contains Many Changes to GME and IME Rules

Baker Donelson on

Each year when CMS publishes its proposed changes to the IPPS Rule, it suggests a number of graduate medical education (GME) and indirect medical education (IME) reforms. This year has been no different. As part of the IPPS...more

Baker Donelson

IRS Proposes Regulations Regarding Community Health Needs Assessments for Charitable Hospitals

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The IRS has released its proposed regulations [PDF] detailing the requirements for conducting and reporting Community Health Needs Assessments (CHNAs) under section 501(r)(3) of the Internal Revenue Code, which were...more

King & Spalding

CMS Releases Proposed Inpatient Payment Regulation

King & Spalding on

On April 26, 2013, CMS released the proposed 2014 payment schedule for inpatient stays at general acute care and long-term care hospitals. In addition to the annual adjustment to payment rates, the proposed rule also reduces...more

Baker Donelson

IRS Issues Proposed Regulations Addressing Community Health Needs Assessment

Baker Donelson on

Earlier this month, the Internal Revenue Service (IRS) released proposed regulations addressing various requirements imposed upon charitable hospitals qualifying under Section 501(c)(3) of the Internal Revenue Code (Code). In...more

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