Physicians Healthcare

News & Analysis as of

FTC Gives Mixed Review of South Carolina’s Nurse Supervision Proposal

The Federal Trade Commission (FTC or Commission) submitted written comments on November 2nd to South Carolina’s state legislature on the competitive impact of proposals to modify the supervision requirements for advanced...more

Advisory Opinion: Free van shuttle services to medical facilities

On October 21, 2015 the Department of Health and Human Services Office of Inspector General posted Advisory Opinion No. 15-13. This Opinion relates to a request for Advisory Opinion about a plan to offer free van shuttle...more

CMS Finalizes Significant Changes to the Two Midnight Rule in the 2016 OPPS Final Rule

On October 30, 2015, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2016 Outpatient Prospective Payment System Final Rule (2016 OPPS Final Rule). In the 2016 OPPS Final Rule, CMS finalizes...more

Reimbursement Change for Off-Campus Provider-Based Clinics, Physician Offices, and Ambulatory Surgical Centers

On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015, a two-year budget deal with a key provision affecting hospitals and other health care providers. Effective January 1, 2017, the Act decreases the...more

CMS finalizes significant Stark Law rulemaking

In July of this year, the US Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) proposed significant changes to the regulations implementing the federal physician self referral law...more

Justice Department Charges Pharma President with Kickback Conspiracy

In the public relations battle following the issuance of the Yates Memo, the Justice Department can now cite one example for the new policy – the recent arrest and charging of Carl Reichel, former President of Warner...more

Record-breaking FCA settlements underscore importance of Stark Law compliance

In September and October, the Department of Justice (DOJ) announced four record-breaking False Claims Act settlements – ranging from $25 million to $115 million – involving health care systems that allegedly made improper...more

CMS Publishes Proposed Rule on Hospital/HHA Discharge Planning Requirements

On November 3, 2015, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would modify the discharge planning conditions of participation (COPs) for hospitals, including long-term care hospitals...more

CMS/OIG Finalize Fraud Authority Waivers for Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program...

The Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) have finalized a rule designed to “remove legal and regulatory barriers that can impede care coordination in furtherance of the...more

Florida Constitutional Provision Mandating Disclosure of Adverse Medical Incidents Preempted by Federal Patient Safety and Quality...

The First District Court of Appeal in Florida recently held in Baptist Hospital of Florida, Inc. v. Jean Charles, Jr., No. 1D15-0109, October 28, 2015, that a Florida constitutional provision mandating disclosure of adverse...more

Congress Take Step Toward Site-Neutral Medicare Payments in Bipartisan Budget Act of 2015

On October 28, 2015, the U.S. House of Representatives approved legislation that, if enacted, would, among other things, substantially alter how and how much Medicare pays for outpatient services furnished by hospitals. The...more

Minimizing Exposure to Stark Law Liability in False Claims Act Cases by Isolating Those Who Determine Fair Market Value From Those...

I. Stark Law and False Claims Act - The FCA has become the primary enforcement vehicle for the Ethics in Patient Referrals Act, better known as the Stark Law. There are now more than 150 public cases citing to both the...more

Five Recent Developments in Labor and Employment Law That Health Care Employers Need to Know

Recent actions by federal agencies and courts will have a direct impact on employers in the health care industry. While still wrestling with the changes wrought by the Affordable Care Act, health care employers will now need...more

Effective November 1, 2015: New Jersey Expands Scope of Prescription Monitoring Program

In July, New Jersey Governor Chris Christie signed legislation that expands the access, registration, and utilization of the New Jersey Prescription Monitoring Program (NJPMP). The legislation, Senate Bill 1998 (S-1998), is...more

CMS Provides More Time to Comment on MACRA Physician Payment Reforms

CMS has extended the comment period on its October 1, 2015 request for information (RFI) regarding implementation of the Merit-based Incentive Payment System and promotion of alternative payment models in accordance with...more

Six Ways to Take Advantage of New Hampshire’s New Telemedicine Law

A physician in New Hampshire can now establish a valid doctor-patient relationship without needing a prior in-person exam. This is among several recent changes in New Hampshire’s telemedicine laws that offer new opportunities...more

Recent Developments in Massachusetts Health Policy

Building on the momentum of early October hearings on the state’s growing health care expenditures, the Health Policy Commission (HPC), the Joint Committee on Health Care Financing, Governor Charlie Baker, and others spent...more

Health Care Physicians in the Crosshairs: Criminal Prosecution

Recent changes to our health care system have been at the forefront of the American news cycle for several years. But certain aspects have not received adequate attention. One example is the scrutiny federal and state...more

Be careful with Resident Rotators: What You Don't Know Might Hurt Your Hospital's Ability to Receive Medicare GME Payments in the...

Residents participating in a graduate medical education (GME) training program are unlikely to spend 100 percent of their time at a single hospital and its affiliated physician practices, and for good reason. Hospitals and...more

Government Finally Investigating Power Morcellators

Patients undergoing medical treatments expect that their physicians will utilize tools that will assist in the treatment without causing undue harm or damage to their bodies. One of these tools, a power morcellator which is...more

In Avera Marshall Medical Staff Bylaws Dispute, District Court Rules in Hospital's Favor on Remand - Ruling affirms that boards of...

On remand from a decision by the Minnesota Supreme Court, the Lyon County District Court recently ruled that Avera Marshall Regional Medical Center’s Board had the authority to amend the hospital’s medical staff bylaws and...more

MedPAC Discusses Changes to Medicare Advantage Payment System

On October 8 and 9, 2015, the Medicare Payment Advisory Commission (MedPAC) held its second meeting of the 2015-2016 session. Commissioners met to examine ways to improve the Medicare Advantage (MA) payment system, including...more

CMS Sends Final 2016 Medicare Payment Rules to OMB for Review

This week CMS referred major final calendar year 2016 Medicare payment rules to the White House Office of Management and Budget (OMB) for regulatory clearance. Specifically, OMB is reviewing the final CMS rules to update the...more

Also In The News - Health Headlines - October 2015 #3

CMS Announces Part D Enhanced Medication Therapy Management Model Demonstration – On September 28, 2015, CMS announced a Part D Enhanced Medication Therapy Management Model (Enhanced MTM Model) that is designed to assess...more

A Recap of National Health IT Week

National Health IT Week wrapped up on Friday. This may have been the most eventful week in the ten year history of the event, which is organized by the Health Information Management Systems Society (HIMSS). Below are a few...more

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