News & Analysis as of

Mintz Levin Health Care Qui Tam Update - Recent Developments & Unsealed Cases: November 2014

Trends & Analysis - In the period covered by this issue, we have identified 68 whistleblower cases related to health care that were unsealed. In this Qui Tam Update, we analyze the trends and take an in-depth look at...more

Health Update - November 2014

“Healthcare-Related” Calls: Ambiguity at the Intersection of HIPAA and TCPA - Editor’s Note: The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer...more

The Game Plan for Health Care Enforcement: Office of Inspector General Releases 2015 Work Plan

The Office of Inspector General (“OIG”) within the federal Department of Health and Human Services (“HHS”) is charged with protecting the integrity of HHS programs by combating fraud, abuse and waste. On Halloween of 2014,...more

Arrangements between Laboratories and Referring Physicians Involving “Registries”

The United States Office of Inspector General (“OIG”) recently issued a “Special Fraud Alert” focusing on two potentially illegal trends that it has detected in arrangements between laboratories and their referring...more

CMS Releases CY 2015 Physician Fee Schedule Final Rule

On October 31, 2014, CMS released the CY 2015 Physician Fee Schedule (PFS) final rule. CMS calculated the conversion factor using the Sustainable Growth Rate (SGR). Due to the Protecting Access to Medicare Act of 2014, there...more

Government demonstrates willingness to enforce Affordable Care Act provision that could cost providers millions of dollars

Under a little-known provision of the Patient Protection and Affordable Care Act (“ACA”), healthcare providers could face millions of dollars in liability for failing to reimburse the government for overpayments in a timely...more

CMS Releases the 2015 Medicare Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) issued the 2015 Medicare Physician Fee Schedule (Medicare PFS) on October 31, 2014. The final rule updates payment policies and payment rates for services furnished to...more

Exploring the Relationship Between Price and Competition Among Physician Practices

The latest from the Journal of the American Medical Association (JAMA) is a thematic issue organized around a prominent topic in healthcare: price, cost, and competition. Contributing to the debate is an article titled,...more

Health Alert (Australia) - October 27, 2014

In This Issue: Judgments; Legislation; and Reports. Excerpt from Judgments: Queensland - 23 October 2014 - Vision Eye Institute Ltd v Kitchen & Anor [2014] QSC 260 In 2006, Kitchen sold...more

Polsinelli Podcasts - What Matters in Hospital/Physician Arrangements [Video]

Recent enforcement actions and changes in health care payment systems highlight the importance of properly structured hospital/physician compensation arrangements. In this week's Polsinelli Podcast, Health Care Shareholder...more

New CDC Ebola Monitoring Protocol is Good News for Employers

The CDC has just announced new active post-arrival monitoring for all travelers entering the U.S. from Liberia, Sierra Leone or Guinea. ...more

Do You Offer or Accept Copayment Coupons? OIG says YOU are Responsible for Compliance with Federal Law

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...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

Getting the Most Out of Physician Practice Acquisitions: Considerations for Converting Acquired Physician Practices into...

Hospitals acquiring physician practices need to balance competing considerations when determining how to fit them in the larger organization. Financial considerations weigh heavily, but so do considerations about finding some...more

What Employers Can Learn from Physicians When It Comes to Administering the FMLA

Earlier this month, I took one for the team. And I survived. I had the privilege of presenting to a number of employers and health care providers at the annual “Impairment Without Disability” conference, an event...more

FSMB Releases Completed Draft Framework for Interstate Physician Licensure

On September 5, 2014, the Federation of State Medical Boards (“FSMB”), a nonprofit organization representing the 70 state medical and osteopathic boards nationwide, announced the completion of its drafting process for its...more

Medical Staff Bylaws: Compliance Gaps and Best Practices - Part 2

In this presentation: - Reappointment - Exclusive Contracts - Expedited Credentialing - Temporary Privileges - Remedial/Corrective Action - Fair Hearing - Officers -...more

Medical Staff Bylaws: Compliance Gaps and Best Practices - Part 1

In this presentation: - Background - Definitions - Purposes/Preamble - Nature of Medical Staff Membership - Qualifications for Membership - Insurance...more

CMS Publishes Open Payments Data Detailing Payments and Transfers of Value Provided by Life Sciences Manufacturers to Physicians...

On September 30, 2014, CMS published data regarding payments and transfers of value that pharmaceutical, biologic, and medical device manufacturers provided to U.S. physicians and teaching hospitals during the period August 1...more

Ex Parte Communications between Treating Physician and Attorneys

Under HIPAA, physicians are permitted to disclose “protected health information” to their attorneys for purposes of their own healthcare operations. This allows physicians sued by patients for malpractice to provide their...more

Health Care E-Note - September 2014

In This Issue: - Doctors, Insurers Critical of Medicare Physician Fee Schedule - Health Spending Expected to Increase Modestly Over Next Decade - U.S. Hospitals Have Highest Administrative Costs...more

Healthcare industry compliance in a shifting world: putting it all together

Health industry clients face regulatory and enforcement challenges on multiple fronts. It can be difficult to prioritize and allocate resources properly when government agencies’ initiatives are constantly shifting. The...more

The Evolution of Efficiencies and Treatment of Quality of Care Defenses in Light of Changing Health Care Industry Dynamics

The consolidation of health care markets and the impact of this consolidation on prices, costs, and quality, has been a hotly debated topic in the health care industry. Hospitals across the country are merging and acquiring...more

CMS Announces Launch of Open Payments Database: $3.5 Billion Paid to Physicians and Teaching Hospitals

The Open Payments database (the “Database”) is now live, and the first round of data is available to the public on the Centers for Medicare and Medicaid Services (“CMS”) website. This first round of data reflects “nearly 4.4...more

Health Law Alert: American Telemedicine Association Releases Report Showing Minnesota, Upper Midwest Fare Well Among State...

The American Telemedicine Association (ATA) recently released two reports that compare and contrast telemedicine polices of every state in the U.S. The reports offer a state-by-state comparison, allowing providers to easily...more

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