Healthcare

News & Analysis as of

Blog: Business Forward Hosts HHS’s Director of Private Sector Engagement for a Discussion on Health Care for Small Businesses

On Wednesday, October 15, 2014, Business Forward hosted a discussion with Rhett Buttle, the Director of Private Sector Engagement at the U.S. Department of Health and Human Services (HHS). Mr. Buttle began by providing...more

Seventh Circuit Reaffirms Worthlessness of Worthless Services Cases

In August the Seventh Circuit expressed its view that so-called “worthless services” cases don’t state a claim under the False Claims Act. Last Friday the court reaffirmed its view by refusing to rehear the case en banc....more

Health Care Update - October 2014 #3

In This Issue: - Policymakers Scrambling to Contain Ebola Crises - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional Initiatives -...more

Ninth Circuit Holds That Provider Cannot Sue Nonsignatory Insurer for Breach of Contract

On October 10, 2014, the Ninth Circuit affirmed a grant of summary judgment in favor of Manatt client The MEGA Life and Health Insurance Company. In an unpublished memorandum opinion, the Ninth Circuit held that a health care...more

Health Headlines: Also in the News - October 2014 #2

CMS Announces Changes to the Nursing Home Quality Rating System – On October 6, 2014, CMS announced upcoming changes to the nursing home five-star quality rating system. The changes include revising the scoring methodology...more

China Launches Pilot Program to Further Open Up Its Healthcare Industry

For a long period of time, China did not allow foreign investors to form wholly foreign-owned subsidiaries in China to operate medical institutions. This has now changed. ...more

CMS Releases New, Proposed Home Health Conditions of Participation

CMS published a proposed rule on Thursday, October 9th, 2014, updating the Home Health Agency (HHA) Conditions of Participation (CoPs). The proposed rule represents the first update to the HHA CoPs since 1989. Comments are...more

Health Care Researchers Publish on the Implications of New Provider Payment Models on Innovative Medical Technology

Analysis Group Senior Advisor Genia Long and Vice President Richard Mortimer published a peer-reviewed study examining the implications of new provider payment models and evidence requirements that are being used by a growing...more

From Second and State: Capitol Wrap – Week of October 2014

As expected, this week blew through the Columbus Day holiday and into a flurry of legislative activity. Dozens of bills went back and forth between the chambers this week, and many have already landed on the governor’s desk....more

Front End Changes and, Again, More DIR Columns

Since the beginning of the Medicare Part D program, CMS has introduced many reporting mechanisms for trying to understand drug pricing, price concessions, and the cost of providing services to Part D members. The tool CMS...more

DOL Announces Delay to Home Care Worker Wage Regulations

Last October, the federal Department of Labor’s Wage and Hour Division sent shockwaves through the home health care industry by issuing final rules declaring most of its employees to be subject to FLSA minimum wage and...more

Health Care Reform Implementation Update

In the past week, CMS has released several advisories including updates to the rating system for nursing homes, premium and deductible information for Medicare Part B and Part D for 2015, Pioneer ACO results, payment dispute...more

This Hobby Lobby Proposal Is Much Mistaken

Suzanne Weakley, editor-in-chief of the CEB Business Law Practitioner, recently called my attention to this letter from six professors at U.C. Berkeley (Robert P. Bartlett III, Richard Buxbaum, Stavros Gadinis, Justin...more

Providers Challenge CMS's Non-Hospital Rotation Rules for GME and IME

Prior to the enactment of the Affordable Care Act (ACA), CMS required hospitals to comply with a number of exacting payment and documentation rules in order to include as part of their graduate medical education (GME) and...more

Eighth Circuit Says Termination Made to Lower Health Care Costs Constitutes Age Discrimination

Under the U.S. Supreme Court’s 1993 Hazen Paper decision, employers that select employees for layoff using the date of vesting of their pensions based on years of service are not discriminating on the basis of age, even if...more

Health Alert (Australia) - October 20, 2014

In This Issue: Judgements, Legislation, and Reports. Excerpt from Judgments: Commonwealth - 15 October 2014 - Gray v Richards [2014] HCA 40 - In 2003, a 10-year-old girl...more

OIG Proposed Anti-Kickback Safe Harbors and CMP Regulations: The End of Frustration or Just the Beginning?

On October 3, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published an unexpected, yet long-awaited, set of proposed rules that would add new anti-kickback law safe harbors,...more

‘Health Care’-Related Calls: Ambiguity at the Intersection of HIPAA and TCPA

The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer Protection Act (TCPA) for health care messages regulated under the Health Insurance Portability and...more

IRS Proposes Key Changes to Schedule H's Community Health Needs Assessment and Financial Assistance Policy Questionss

On October 8, 2014, the IRS released drafts of the 2014 Form 990, Schedule H and Instructions, proposing significant changes related to a hospital facility's compliance with Section 501(r) of the Internal Revenue Code. These...more

Hospital’s Extortion & Fraud Too Quick to Violate RICO

Danielle Bennion and her co-plaintiffs filed a RICO (Racketeer Influenced & Corrupt Practices Act) action alleging that Mountain View Hospital and co-defendants engaged in a plan of extortion and wire fraud for the purpose of...more

CMS Announces Program to Fund ACO Growth, Extends Fraud and Abuse Waivers

The Centers for Medicare & Medicaid Services (“CMS”) announced a new initiative, the ACO Investment Model, on October 15, 2014. Under the model, ACOs which are made up of “providers [who] lack adequate access to … capital”...more

Eggs in the workplace

Eggs – human eggs, aka ova – have been in the news this week. First, it was announced that Facebook and Apple will begin offering insurance coverage for female employees to freeze their eggs for later fertilization and...more

Mintz Levin Health Care Qui Tam Update - Recent Developments & Unsealed False Claims Act Cases: October 2014

Trends & Analysis - Between our last Qui Tam Update and the end of June, 65 health care–related qui tam cases were unsealed (28 in April, 18 in May, and 19 in June). Within those 65 cases...more

Critical Access Hospital Soothsayers and the 96-Hour Physician Certification Requirement

This year critical access hospitals (CAH) have struggled to implement procedures to comply with both the "two-midnight" rule and the 96-hour physician certification requirement. The combination of both puts physicians in a...more

CMS Reopens Application Period for Meaningful Use Hardship Exception

CMS Reopens Application Period for Meaningful Use Hardship Exception - the period during which certain eligible providers may request a hardship exception from qualifying as a Meaningful User under the Medicare EHR Incentive...more

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