Reporting Requirements Healthcare

News & Analysis as of

CMS Gives Providers Some Leverage in RAC Record Collection Requirements: Five Things to Know about ADRs

The Centers for Medicare & Medicaid Services (“CMS”) announced that it has reduced the maximum percentage of records that providers must submit to Recovery Audit Contractors (“RAC”) through the payment auditing process...more

CMS Makes Significant Changes to Stage 2 Meaningful Use and Finalizes Stage 3

On October 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) that streamlines Stage 2 and finalizes Stage 3 of the Medicare and Medicaid electronichealth record (EHR) Incentive...more

Recent Amendments to Security Breach Notification Laws Further Complicate Breach Notification for Employers

It is not a matter of "if" but "when" an employer will be required to notify employees of a security breach.  Forty-seven states require employers to notify employees when defined categories of personal information, including...more

CMS Proposes Sweeping Changes to Medicare Reimbursement for Clinical Diagnostic Laboratory Tests

First Data Collection Period for Clinical Laboratories Is July 1, 2015 to December 31, 2015 - In the October 1, 2015 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule...more

Meaningful Use Stage 3 Final Rule Reduces Provider Burdens

CMS and the Office of the National Coordinator for Health Information (ONC) recently released the 752-page final rule for Meaningful Use Stages 2 (MU2) and 3 (MU3). The final rule provides a flexible timeline for providers...more

Proposed Budget Deal Would Add Medicaid Inflation Rebates for Generic Drugs

As noted in our recent Health Industry Washington Watch blog post, outgoing House Speaker John Boehner and the Obama Administration have reached agreement on a two-year, $80 billion budget/debt-ceiling deal that includes...more

CMS Adopts Changes to Medicare & Medicaid EHR Policies

The Centers for Medicare & Medicaid Services (CMS) has published a sweeping final rule with comment period that specifies the requirements that eligible professionals (EPs), eligible hospitals, and critical access hospitals...more

Preparing for the Approaching ACA Reporting Deadlines

With ACA reporting deadlines quickly approaching, many employers should be preparing to address the various reporting requirements in order to avoid the significant fines and penalties associated with non-compliance. As of...more

CMS Sends Long-Awaited Medicare 60-Day Overpayment Rule to OMB for Final Clearance

CMS is moving ahead on its much-anticipated final rule implementing Affordable Care Act (ACA) requirements on reporting and returning of Medicare overpayments. Under the ACA, enrolled providers and suppliers (and certain...more

Meaningful Use Audits: Proactive Tips for Success

For health care professionals who began accepting Meaningful Use incentive money at the outset of availability under the Medicare option in 2011, the year 2015 is an important year. If the provider has met all core...more

Navigating Legal Issues in Connection with Employer Sponsored On-Site Health Clinics

Employers are increasingly concerned with the high cost of health care and executives in the C-Suite are beginning to take notice. The Affordable Care Act (‘‘ACA’’) required employers who sponsor group health plans to adopt a...more

Bristol-Myers Squibb Pays $14 Million to SEC to Resolve China FCPA Offenses

On October 5, the SEC announced a settlement with Bristol-Myers Squibb to resolve allegations that the pharmaceutical company’s Chinese joint venture, BMS China, gave cash, jewelry, and other benefits to health care providers...more

Reporting for ACA Mandates: Final Forms and Additional Guidance

The IRS has finalized the 2015 forms and instructions for reporting under the individual and employer mandates and issued additional guidance on these new reporting requirements. The following forms are now available...more

Employee Benefits Developments - September 2015

IRS Issues New Draft Form 1095-C and Instructions. On August 6, 2015, the IRS published its most recent updates to Form 1095-C and the instructions for Forms 1094-C and 1095-C. Beginning in early 2016, applicable large...more

CMS Proposes Overhaul of Clinical Lab Payment Methodology: What You Need To Know

On Friday, the Centers for Medicare & Medicaid Services (“CMS”) issued a long-awaited proposed rule that would drastically change the payment rates for clinical laboratory services beginning January 1, 2017 (the “Proposed...more

The Affordable Care Act: What’s Ahead?

More than five years after its enactment, the Affordable Care Act (ACA) continues to be one of the top concerns for employers, and rightly so: the ACA is one of the most comprehensive laws impacting employee benefits since...more

Crafting a more realistic business associate agreement

According to a recent survey by KPMG, eighty percent (80%) of health care executives report that their information technology systems have been compromised by cyber attacks. Most healthcare institutions, the survey found,...more

GAO Calls for Expanded State Reporting on Medicaid Prescription Drug Fraud Controls

In light of continuing indicators of potential prescription-medication fraud and abuse in state Medicaid programs, the Government Accountability Office (GAO) has reviewed federal and state pharmacy-related policies and...more

Employee Benefits Alert - August 2015

Retirement Plans - IRS Issues Guidance on Benefit Suspension Voting under MPRA - As we have written in prior alerts, the Multiemployer Pension Reform Act of 2014 (MPRA) permits trustees of financially troubled...more

Court Imposes Potentially Unworkable Burden on Providers Under ACA's Report and Return Rule

In Kane ex rel. U.S. v. Healthfirst, Inc., the federal district court for the Southern District of New York (District Court or Court) provided on August 3 the first and long-awaited interpretation as to when a health care...more

Federal Court Sides with Government in First Interpretation of ACA’s 60-day False Claims Act Rule: Takeaway for Health Systems

In a significant development for healthcare providers, a federal court in New York has adopted the government’s interpretation of the 2010 Patient Protection and Affordable Care Act’s (ACA’s) so-called 60-day rule, which...more

IRS Issues New Forms for ACA Reporting; Congress Increases Penalties for Failure to Meet Requirements

The IRS has completed drafts of the 2015 forms and instructions for employers, insurers, and other health plan sponsors to use to meet their reporting obligations for the employer and individual mandates under the Affordable...more

Connecticut Enacts Health Care Legislation in June Special Session

On June 29 and 30, 2015, the Connecticut General Assembly conducted a special legislative session following the close of the 2015 regular session. Among other things, the General Assembly passed a bill to implement the state...more

CMS Publishes Final FY 2016 Update to SNF PPS Rates, Policies

On August 4, 2015, CMS published its final rule updating Medicare skilled nursing facility (SNF) PPS rates and policies for FY 2016. CMS projects that the final rule will increase overall payments to SNFs by $430 million, or...more

In Closely Watched Case, Federal Court Upholds the Government’s Position on Provider Mandate to Report and Return Medicare and...

The Patient Protection and Affordable Care Act (“PPACA”), signed into law on March 23, 2010, included a provision (the “Report and Refund Mandate”), broadly requiring health care providers, suppliers, Part D plans and managed...more

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