Physicians Hospitals

News & Analysis as of

OIG Recommends Eliminating Provider-Based Designation for Facilities Owned by Hospitals

In a report released on June 17, 2016, OIG renewed its call for CMS to either eliminate the provider-based designation, which allows facilities owned by and integrated with a hospital to bill Medicare as a hospital outpatient...more

House Approves “Helping Hospitals Improve Patient Care Act of 2016”

The House of Representatives has approved H.R. 5273, the “Helping Hospitals Improve Patient Care Act of 2016,” as amended by the Ways and Means Committee in May. As previously reported, while the bill focuses on Medicare...more

Healthcare Lessons Learned From Reality TV

On March 31, 2016, a New York court determined that a lawsuit may proceed against a physician and hospital for breach of physician-patient confidentiality arising from a documentary series about medical trauma, NY Med. The...more

Can moonlighting residents trigger Medicare GME caps?

In our last edition of GME @ Dentons, we covered the ins and outs of reimbursement for fellow moonlighting. In several prior editions, we have discussed the potential harm, from a Medicare graduate medical education (GME)...more

Ask the Health Law Gurus™: What is a Non-Compete Clause in an Employment Contract? Is it Enforceable?

Question: I have heard about non-compete clauses being negotiated in employment agreements with physicians. What is a non-compete clause? What does it mean if my contract has a non-compete clause?...more

Physicians And Foundations And Facilities! Oh My!

On June 2, 2016, Governor Malloy signed into law Public Act 16-95, An Act Concerning Matters Affecting Physicians, Health Care Facilities and Medical Foundations (the "Act"). The Act will have significant impact on...more

California State Assembly Approves Bill on Rural Hospital Physician Employment

A bill that would permit rural hospitals to directly employ physicians has been approved by the California State Assembly. Assembly Bill 2024, authored by Jim Wood (D-Healdsburg), will be considered next by the Senate Health...more

Ways and Means Committee Approves Bill to Make Reforms to Medicare Hospital and Other Payment Policies

The House Ways and Means Committee has approved an amended version of H.R. 5273, the “Helping Hospitals Improve Patient Care Act of 2016.” While most of the provisions address Medicare payment policies pertaining to...more

Medical Litigation Newsletter - Spring 2016

Reducing Monetary Recovery in “Lost Chance Of [Medical] Recovery” Cases - In medical malpractice cases involving solely “iatrogenic” loss (e.g., harm of or relating to medical treatment), plaintiff bears the burden of...more

A Recent Illinois Decision Explains How to Deal with Medical Staff Claims

The Illinois Supreme Court released a decision on May 19, 2016 that provides useful guidance in defending and protecting a claim by a medical staff member against a hospital for improperly failing to appoint or reappoint or...more

Health Care Group News: Part Two: The Rest of SB 351 (Now Public Act 16-95)

While Senate Bill 351, now enacted as Public Act 16-95 (the "Act"), received attention for the limits it placed on physician non-compete provisions, numerous other provisions of the Act are worth highlighting. These...more

Connecticut Legislature Passes Non-Compete Act Concerning Contracts With Physicians

On May 18, 2016, the Connecticut legislature transmitted Public Act No. 16-95 (the “Act”) to the Governor for his signature. The Governor is expected to sign the bill into law in the coming weeks. Once he does, it will...more

Legal Issues Associated with Multi-Provider Alternative Payment Model

Since the passage of the Affordable Care Act (ACA), both federal and state policies have promoted the adoption of alternative payment models (APMs), providing financial incentives for groups of providers to improve care...more

Finance Committee Report Places Medical Device Arrangements under Increasing Scrutiny

Hospitals and providers participating in physician-owned distributorships, or “PODs” may be at increased risk for government investigation or enforcement. A Senate Finance Committee (SFC) Report issued this month highlights...more

Also In The News - Health Headlines - May 2016

Senators Proposing Meaningful Use Changes – A group of Republican Senators released proposed legislation that would provide flexibility to hospitals and physicians under the Meaningful Use program. The proposed legislation...more

Legislative Update: New Non-Compete Restrictions for Physicians

Continuing my review of new employment-related bills is a measure that limits the use of non-compete agreements for doctors. Anyone who tracks bills knows that the name on the bill sometimes doesn’t match the content....more

Tennessee Governor Signs Certificate of Need Changes into Law

Tennessee’s governor, Bill Haslam, has signed legislation that will significantly change the state’s certificate of need (CON) laws. The changes include revised requirements for multiple services regulated by CON, including...more

New Part B Drug Payment Model Proposed

On March 11, 2016, CMS proposed implementation of a new two-phase model for drugs reimbursed under Part B of the Medicare Program (“the Proposed Model”). Drugs reimbursed under Part B include drugs administered in hospital...more

Health Law Insights Newsletter - Issue 8 - April 2016

McCarter & English, LLP’s Health Care Group presents Issue 8 of the Health Law Insights, which discusses the latest legal issues in the health care industry. NATIONAL - New Payment Model for Part B Drugs Proposed -...more

All Right Stop, Collaborate and Listen! CMS Is Back with Its Brand New Invention, Preparing for CJR Gainsharing

Understandably, there is anticipation surrounding the April 1st start date for CMS’s newest bundled payment program, the Comprehensive Care for Joint Replacement (CJR) program. As participant hospitals consider gainsharing...more

Oregon's Statutory Peer Review Privilege for Health Care Providers: What It Is and How to Not Waive It

Where would you rather undergo coronary bypass surgery? At a hospital where mistakes and concerns that occurred during prior surgeries of other hospital patients are analyzed to develop and implement surgical policies that...more

The "predicate facts" rule: Providers, be vigilant!

Medicare GME payments do not compensate teaching hospitals for their actual costs of training residents in a given year. Rather, Medicare GME reimbursement is determined, in part, on the basis of historic cost data and...more

GAO Examines Hospital Challenges in Implementing Patient Safety Practices

The Government Accountability Office (GAO) has issued a report focusing on the roadblocks hospitals face in implementing evidence-based patient safety practices, such as the use of antiseptics to reduce Central...more

Six Trends Impacting Health Care M&A in 2016

From hospital expansions with large insurance deals to physician group consolidation, the continued outlook for health care mergers and acquisitions in 2016 is expected to be rampant. The following six factors will likely be...more

Also in The News - Health Headlines - February 2016 #2

ALSO IN THE NEWS: CMS Extends Deadline for Hardship Exception Applications – On February 26, 2016, CMS updated its online instructions for submitting a hardship exception application to reflect that hardship exception...more

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