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News & Analysis as of

OMB Extends Review of Rule That Would Require Labs to Release Results to Patients

The Office of Management and Budget has extended its review of a proposed rule that would require HIPAA-covered laboratories to make test results available to patients. In our previous post on this issue way back in...more

What You Need to Know About the Patient Injury Act

Big changes could be coming to Georgia’s medical malpractice laws. The state legislature is currently considering the Patient Injury Act, which would require all claims to be decided by an administrative panel rather than a...more

Clinically Integrated Networks Give Providers and Payers an Opportunity for Transformative Collaboration

I. Executive Summary - The health care sector is experiencing a series of market reforms that have the potential to reshape how care will be delivered and reimbursed for decades to come. Although a number of concepts...more

CMS Instructs Contractors Not to Conduct Patient Status Reviews for Claims with Dates of Admission Through December 31, 2013

On November 15, 2013, CMS issued Transmittal 1315, a One-Time Notification (CMS Transmittal), instructing Medicare Administrative Contractors (MACs), Recovery Auditors and the Supplemental Medical Review Contractor not to...more

Arbitration Agreement with a Care Facility is not Enforceable when not Authorized by the Patient Herself

A California court of appeal recently ruled that an agreement to arbitrate disputes between an elderly patient and a nursing facility was not enforceable. The arbitration agreement was signed by the daughter of the patient...more

HFMA Releases Provider-Patient Financial Communications Best Practices

Healthcare financial interactions are often complex and confusing for patients and can involve complicated payment structures and various “key players.” As patients become responsible for greater proportions of their...more

Terminating The Physician-Patient Relationship

Oftentimes, I am asked by physicians how to end the physician-patient relationship. For various reasons, the physician desires to end the relationship and have the parties go their separate ways. Such may stem from a...more

OIG Issues Favorable Opinion Regarding Post-Discharge Services Arrangement

The Department of Health & Human Services Office of Inspector General (OIG) recently issued a favorable advisory opinion regarding an electronic health record vendor’s plan to provide services to hospitals to help manage...more

OIG rejects management arrangement that carves out federal healthcare program patients

The Office of Inspector General of the Department of Health and Human Services recently posted an Advisory Opinion describing a proposed arrangement by a clinical laboratory. ...more

CMS Releases FY 2014 Hospital IPPS Final Rule

On August 2, 2013, CMS released the annual Hospital Inpatient Prospective Payment System Final Rule for FY 2014 (the “Final Rule”), effective for discharges occurring on or after October 1, 2013....more

Getting the Best Medical Care: a Newsletter from Patrick Malone - August 2013

In This Issue: - Everyone Has an Agenda - How Executive Pay Skews Some Rankings - Learn More From These Resources - Excerpt: The Dicey Connection between Hospital Ratings and Superior Patient...more

Healthcare Update, No. 3, August 2013: Protect Your Key Information – And Your Key Relationships

Decades ago, it was reasonable to imagine that one could work for the same company from the start of one’s career to the end. Think about the world portrayed in Mad Men. Don Draper has mostly worked with the same fictional...more

Expanding Access to, and Development of, Personalized Medicine

In a July 8th, 2013 letter to the Centers for Medicare & Medicaid Services (CMS), the Personalized Medicine Coalition (PMC) advised that proposed reimbursement schedules for diagnostic medicine will threaten the development...more

Hospitals Fight Back to Defend 340B Program Operations

Adhering to the axiom that the best defense is a good offense, SNHPA (Safety Net Hospitals for Pharmaceutical Access), an organization of close to 1000 hospitals participating in the 340B Drug Pricing Program, is attempting...more

CMS Issues Proposed Rule Updating ESRD PPS for CY 2014

CMS recently issued a proposed rule detailing updates and revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2014 and requirements for the ESRD quality incentive program...more

New York’s Highest Court Finds ER Physician and Hospital Have No Duty to Prevent Intoxicated Patient from Leaving Hospital

In a landmark decision, the New York Court of Appeals held that a physician’s duty does not allow, let alone mandate, the involuntary detention of intoxicated patients wishing to leave a hospital. ...more

Are Hospitals Safer Today? Why Patient Safety Levels Remain Static

We have entered a new era in medical technologies. From electronic patient charts to robotic surgeries, hospitals have become more advanced in the types of care they provide. Despite a multitude of technological and...more

CMS Updates Manual to Reflect Ambulance Fee Schedule Reduction for Non-Emergency BLS Transports of Patients With ESRD

On May 10, 2013, CMS issued a transmittal clarifying the requirement in Section 637 of the American Taxpayer Relief Act of 2012 (ATRA) that ambulance payments for non-emergency basic life support (BLS) transports for end...more

Managing Peer Review Hearings and Litigation

In this presentation: - Overview and recommendations regarding hearing procedures. - Ways to maximize confidentiality and immunity protections under state law, HCQIA and the Patient Safety Act. -...more

Nonprofit Posts New Patient Safety Grades

The national nonprofit organization Leapfrog Group (“Leapfrog”) recently released its updated Hospital Safety ScoreSM, a searchable database of patient safety scores for over 2,500 acute care hospitals. The safety scores,...more

Getting the Best Medical Care: a Newsletter from Patrick Malone - May 2013

In This Issue: - When Hospital Errors Follow You Home, and Into Your Soul - What Survivors of Patient Harm Can Expect - Hurting the Healing Process - Learn More About Your Rights and How to Reduce the Harms of...more

Working Toward Fewer Medical Mistakes

A new study suggests limiting the work hours of resident physicians does not lead to patient death. In fact, mortality declined during the study period even though patients may have received fewer hours of care....more

The Court Rules on the Consequences of Failure to Process Hospital Patient Complaints in the Allotted Time

This publication is available in French only. Depuis quelque temps, plusieurs comités de discipline constitués pour étudier les plaintes portées à l’endroit de médecins ont été saisis de requêtes demandant qu’ils...more

CMS Issues Proposed Changes to LTCH Payment Rates and Other Payment Policies for Fiscal Year 2014

On April 26, 2013, the Centers for Medicare & Medicaid Services (“CMS”) released the proposed update to the Medicare long-term acute care hospital prospective payment system (“LTCH PPS”) policies and payment rates for fiscal...more

Whistleblower Guidance from NJ Appellate Court May Help Employers Keep More CEPA Claims from Reaching a Jury

A plaintiff cannot succeed in whistleblower litigation against his former employer without demonstrating a specific, objectively reasonable belief that the employer violated a law or public policy, according to a recently...more

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