Physicians Hospitals

News & Analysis as of

Pharmaceutical Manufacturers and Healthcare Leaders cite Fraud and Abuse Laws as Obstacle to Value-Based Arrangements

As the healthcare industry moves towards value-based purchasing, pay-for-performance, and other payment reform models, industry leaders have identified federal fraud and abuse laws as a barrier to full implementation of such...more

Rare Physician Win in Peer Review Lawsuit

Since enactment of the Health Care Quality Improvement Act in 1986, physicians haven’t usually fared well when they go to court to stop or delay hospital peer review actions, provided the hospitals follow the procedural steps...more

Healthcare Litigation - February 2017

HCQIA Preemption of State Physician Whistleblower Statutes - Medical professionals who are subject to adverse actions following peer review often seek to sue the peer review participants (including the individual...more

When 30 Days Is Not 30 Days

Concerned about a surgeon’s skill, a hospital ordered him to “have five bowel surgery cases proctored,” specifying no time limit. After a month, when the surgeon hadn’t met the five-case requirement, the hospital filed an...more

Alert: 2016 Round-Up: Key Decisions Affecting Connecticut Health Care Providers

Connecticut state and federal courts faced a number of significant health care issues last year. We have summarized those cases that we think are particularly relevant to Connecticut hospitals, group practices and individual...more

2016 Round-Up: Key Decisions Affecting Connecticut Health Care Providers

Connecticut state and federal courts faced a number of significant health care issues last year. We have summarized those cases that we think are particularly relevant to Connecticut hospitals, group practices and individual...more

Hold the Phone! The Joint Commission Reinstates Ban on Texting Orders

The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) took a firm stance against physicians texting patient orders in a recent joint statement, clarifying that it is not acceptable for physicians...more

Health Law Insights: January Newsletter

ALERT: Health Reform Outlook for 2017: A Year of Major Uncertainty - Fulfilling their promises, Congressional Republicans moved to repeal the Affordable Care Act (ACA) on the first day of the new Congress when Senate...more

Connecticut CON Task Force Issues Final Report

A major purpose of the Certificate of Need (“CON”) Task Force established by Governor Malloy last February was to deliver recommendations on how to improve the existing CON program in light of the evolving health care...more

Healthcare Transactions: Year in Review - January 2017

Healthcare transactional activity continued unabated throughout 2016, continuing a years long trend of sustained growth. This activity is due to a number of factors: innovative technology, pharmaceuticals, and services that...more

Final Rule Implements Quality Payment Program under MACRA

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

2016 Health Care Year in Review

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

OIG Releases 2017 Work Plan

On November 10, 2016, the Office of Inspector General (“the OIG”) of the U.S. Department of Health and Human Services (“DHHS”) is charged with ensuring the integrity of more than 100 programs administered by DHHS, including...more

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

South Dakota high court won’t force hospitals to disclose why they let a bad doctor operate on patients’ spines

South Dakotans will need their state lawmakers’ help now to pry open physicians’ iron grip on secret decisions about which doctors get to practice in hospitals and why. That’s because the state’s Supreme Court ruled this...more

GME Payments for Chief Residents

Whether a teaching hospital may receive DGME and IME payments for the "chief resident year" has long been a source of confusion, particularly given that some specialties require all residents to complete a chief resident...more

Hospitals, Physician Practices and Clinics are Reminded to Post New Non-Discrimination Notice

Hospitals, physician practices and other health care providers that receive federal financial assistance, which includes receiving reimbursement from Medicare Parts A, C and D and/or Medicaid, are reminded to post new...more

Are you ready for Section 1557’s notice requirements?

This is a reminder that beginning October 16, 2016, Covered Entities (as defined below) are required to comply with certain notice requirements under Section 1557 of the Affordable Care Act (“ACA”). Section 1557 of the ACA...more

Health Law Insights Newsletter - Issue 13

McCarter & English, LLP’s Health Care Group presents Issue 13 of the Health Law Insights, which discusses the latest legal issues in the health care industry. - Failure to Update Business Associate Agreement Results in...more

S. Dakota high court asked to pry open hospitals’ secret approval of brutal MD

South Dakota’s highest court has been asked to reject hospitals’ attempts to keep secret why a doctor, who also is a convicted burglar with a checkered medical past that could have easily been uncovered, passed a peer review...more

DOJ Announces Settlement with Tuomey CEO Following Yates Memo Directive to Hold Individuals Accountable

The Department of Justice’s recent settlement with a healthcare system executive indicates a continued focus on pursuing individuals in enforcement actions. On September 27, 2016, the DOJ announced it reached a $1 million...more

Managing the Transition to Transformation: Quality and Payment Reform: Who Is Asking for What and Why?

McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and care delivery...more

House Approves Medicare ESRD Coverage, Rural Hospital Supervision Bills

On September 21, 2016, the House of Representatives approved HR 5659, the Expanding Seniors Receiving Dialysis Choice Act of 2016, which would allow Medicare beneficiaries with end stage renal disease (ESRD) to enroll in...more

Healthcare Compliance: Juggling Risk Mitigation Strategies

Healthcare organizations – ranging from physician practice groups to large, multi-state hospital systems – face a variety of risks, including fraud and abuse, as well as HIPAA privacy issues. Starting from a baseline risk...more

Health Care Legislation Maryland 2016 First Interim Report

The bills cited and reviewed in this Report are not an exhaustive presentation of all healthcare legislation. Rather, they represent either proposed or adopted legislation that we believe are among the most beneficial,...more

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