News & Analysis as of

Teaching Hospitals

Medical Residents and Title IX - What Teaching Hospitals Need to Know

by Baker Ober Health Law on

Last month, Baker Donelson reported the surprise ruling out of the Third Circuit in Jane Doe v. Mercy Medical Center in which the court held that the discrimination and harassment prohibitions of Title IX apply to a private...more

Welcome To The Neighborhood: Hospitals Need To Get To Know Title IX  

by Fisher Phillips on

Hospital administrators are well aware their institutions are subject to a whole host of workplace-related federal statutes: Title VII of the Civil Rights Act, the Health Insurance Portability and Accountability Act (HIPAA),...more

New teaching hospitals that started training residents before October 1, 2012, should verify their GME FTE cap calculations

by Dentons on

Due to potential inconsistencies in CMS's cap-setting calculation methodologies, new teaching hospitals that first started training residents after the 1996 cap-setting base year, but before October 1, 2012, are well-advised...more

Disputing Inaccurate Reports Under the Physician Payment Sunshine Act

by Ruder Ware on

The Affordable Care Act added the Physician Payment Sunshine Act (Sunshine Act) as section 1128G to the Social Security Act. The Sunshine Act requires applicable manufacturers of drugs, devices, biologicals, or medical...more

CMS now auditing Section 5503 slot awards

by Dentons on

Section 5503 of the Affordable Care Act (ACA) required CMS to redistribute 65 percent of each teaching hospital's unused direct graduate medical education (DGME) and indirect medical education (IME) slots to other teaching...more

Third Circuit Endorses Title IX and Title VII Claims of Medical Resident

by Proskauer Rose LLP on

Should a medical resident alleging sexual harassment and retaliation be treated as: (i) an employee who can seek relief under Title VII; (ii) a student who can seek relief under Title IX; or (iii) both? And if the answer is...more

CMS announces awardees for three rounds of redistributed slots from closed hospitals

by Dentons on

The Centers for Medicare & Medicaid Services (CMS) on January 31 released the awardees of resident cap increases from Rounds 8, 9, and 10 of the Affordable Care Act’s (ACA, P.L. 111-148 and P.L. 111-152) Section 5506 closed...more

CMS Hosts Call on Potential Future Changes to Open Payments/Sunshine Act Reporting Requirements (Aug. 2)

by Reed Smith on

On August 2, 2016, CMS is hosting a Special Open Door Forum Call on potential future changes to Open Payments/Physician Payments Sunshine Act requirements for reporting payments and transfers of value made by drug and device...more

Can moonlighting residents trigger Medicare GME caps?

by Dentons on

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

CMS Call on Opportunity to Review Open Payments/Sunshine Act Data (April 12)

by Reed Smith on

CMS is hosting a provider call on April 12, 2016 to discuss the Open Payments program, including the process for physicians and teaching hospitals to review applicable data on payments or transfers of value prior to...more

Concurrent Surgeries Under Review by the Senate Finance Committee

by King & Spalding on

Senator Orrin G. Hatch, chairman of the Senate Finance Committee, recently sent inquiries to 20 hospital systems throughout the country, asking for detailed information and records regarding concurrent surgeries. Concurrent...more

Partnering with nonprovider sites: Tips to keep in mind

by Dentons on

Provided applicable requirements are met, the Medicare program reimburses teaching hospitals for resident training that occurs both at the hospital itself and at clinical nonprovider locations, including, for example,...more

The Single GME Accreditation System and Medicare GME funding: A new set of challenges

by Dentons on

To date, two major accreditation bodies—the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA)—have accredited the majority of medical residency training programs in...more

The University Of Washington Medicine Agrees To Settlement For Potential HIPAA Violations

by King & Spalding on

The University of Washington Medicine (“UWM”) has agreed to settle the investigation conducted by the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) of potential HIPAA violations arising from a...more

The Medicare payment basics of becoming a new teaching hospital

by Dentons on

Approximately 1,000 of the 5,000 hospitals in the United States that are paid under the inpatient prospective payment system (IPPS) are teaching hospitals that receive federal funding for graduate medical education (GME)...more

Blog: University of Rochester Medical Center Reaches Agreement to Settle Alleged HIPAA Breach

by Cooley LLP on

Last week, the University of Rochester Medical Center (URMC) reached agreement with the New York Office of the Attorney General (NYOAG) to settle alleged violations of the Health Insurance Portability and Accountability Act...more

Hospital’s Turkey Dinner Is $850,000 Fine for Failure to Secure Mobile Medical Devices

Just before Thanksgiving, Lahey Hospital and Medical Center (“Lahey”), a non-profit teaching hospital located in Burlington, Massachusetts, agreed to pay $850,000 for a breach of unsecured electronic protected health...more

Beyond residency: How the Medicare program treats fellowship training

by Dentons on

Teaching hospitals are often responsible for the clinical training of three different categories of trainees: - Interns, or trainees in their first year of residency training - Residents, or trainees who have...more

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

by Dentons on

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

MedPAC Convenes to Discuss Open Payments, Payment for Post-Acute Care, and Other Issues

by King & Spalding on

On September 10-11, 2015, MedPAC held a meeting to discuss several issues related to the Medicare program, including (1) improving the Open Payments program, which makes public the payments from drug and device manufacturers...more

House Ways & Means Health Subcommittee Hosts Hearing on Hospital Payment Issues

by King & Spalding on

On July 22, 2015, the U.S. House Ways & Means Health Subcommittee heard testimony from Mark Miller, Ph.D., executive director of Medicare Payment Advisory Commission (MedPAC). Dr. Miller’s testimony highlighted recent trends...more

CMS Open Payment Program Data Indicates $6.49 Billion Paid by Manufacturers, GPOs to Physicians and Hospitals in 2014

by King & Spalding on

CMS recently released data collected through the Open Payments Program in accordance with the Affordable Care Act from applicable manufacturers and group purchasing organizations (GPOs) about payments and other transfers that...more

Blog: 2014 Open Payments Infographic

by Cooley LLP on

Policy and Medicine published today an interesting infographic prepared by Open Payments Analytics regarding the 2014 Open Payments data, which contains 11.41 million payments and other transfers of value totaling $6.49...more

2014 CMS Open Payments Data Released

by Saul Ewing LLP on

On June 29, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published detailed information regarding payments made by pharmaceutical and medical device manufacturers to physicians and teaching hospitals during 2014...more

Residents Can Be Hazardous to a Community Hospital's Medicare Health

by Morgan Lewis on

Although Medicare graduate medical education reimbursement can be a helpful source of financing to facilitate resident training, many community hospitals have suffered a “gotcha” moment when trying to establish new programs....more

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