Healthcare

News & Analysis as of

New Jersey Board of Dentistry Extends Deliberation on the Corporate Practice of Dentistry Rules Until November 3, 2014

On November 6, 2013, the New Jersey Board of Dentistry (the “Board”) published a notice that it received a petition for rulemaking on behalf of the New Jersey Dental Society requesting that the Board adopt rules to establish...more

CMS Reopens Open Payments System, Extends Review/Dispute Period and 15-Day Correction Period

On Friday, August 15, 2014, CMS officially announced the reopening of its Open Payments system and an extension of the covered recipient review/dispute period and subsequent data correction period. Our understanding is that...more

Georgia Composite Medical Board Issues New Telemedicine Rules

The Georgia Composite Medical Board enacted a new regulation governing the standards for telemedicine practice. The regulation, titled Practice Through Electronic or Other Such Means, is found under Georgia Comp. Rules and...more

Scientific Fraud: an acute malady - don't be blinded by it

It seems lately that the healthcare industry has had some horrible and ghastly press time in the media. It's unfortunate that there a number of people who seem to partake in questionable activities that flood the industry...more

FBI Warning to Health Care Sector Holds True

In April of this year, the FBI issued a Private Industry Notification (PIN) to the health care industry warning of the “likely increase [in] cyber intrusions against health care systems.” In the same month, and into June of...more

FDA Approves Cancer Screening Test as First Device Under Parallel Review Pilot

On August 11, 2014, the Food and Drug Administration (FDA) issued a premarket approval (PMA) for Exact Sciences’ Cologuard, a colorectal cancer screening test, and the Centers for Medicare & Medicaid Services (CMS) issued a...more

Court Enjoins CMS From Enforcing Dissatisfaction Requirement When a Provider’s Appeal Stems from the MAC’s Failure to Issue a...

On August 6, 2014, the United States District Court for the District of Columbia enjoined CMS, its Medicare Administrative Contractors (MACs), and the Provider Reimbursement Review Board (PRRB) from applying the...more

Splits Are Not the Best for Business: Uncertainty after Conflicting Decisions on the Scope of Obamacare Subsidies

The recent decisions by the Fourth Circuit and the D.C. Circuit address a controversy that could have far-reaching consequences for the Patient Protection and Affordable Care Act (the “ACA”). Under the ACA, states and the...more

Overview of the FY 2015 IRF Final Rule

On August 6th, the Centers for Medicare and Medicaid (CMS) published an Inpatient Rehabilitation Facility (IRF) final rule [PDF] in the Federal Register outlining (1) new Medicare payment policies and rates; and (2) guidance...more

Tennessee Attorney General States that Physical Therapists Cannot Perform Trigger-Point Dry Needling

In an opinion released on June 19, 2014, the Office of the Tennessee Attorney General stated that Physical Therapists cannot lawfully perform Intramuscular Manual Therapy or Trigger-Point Dry Needling. Dry Needling therapy...more

Alabama CON Report - August 2014

In This Report: - I. SHPDA Administrative Report - A. For Informational Purposes Only - II. Certificate of Need Program - A. Reconsideration on Home Health Batched Applications - B....more

Resistance WAS Futile—California Conforms to ACA Waiting Period Requirement

After wandering in the wilderness for a year, California has now come in from the cold and conformed its requirements for eligibility waiting periods to the federal standard adopted in the Affordable Care Act (ACA). Effective...more

FDA to Strengthen Oversight of Certain In Vitro Diagnostic Devices

In the wake of a new Medicare reimbursement framework, FDA plans stricter regulation of some in vitro diagnostic devices. On July 31, 2014, the U.S. Food and Drug Administration (FDA; Agency) announced its intent to...more

Research Doesn’t Pay—At Least Not in Graduate Medical Education

Indirect graduate medical costs, or IGME, are what Medicare allows teaching hospitals in increased Medicare rates. IGME represents the indirect costs to a teaching hospital of hosting residents and interns—costs above and...more

Nursing Home Abuse and Neglect Compliance Trails Federal Requirements

The Department of Health and Human Services Officer of Inspector General (“OIG”) released a report this month titled, “Nursing Facilities’ Compliance with Federal Regulations for Reporting Allegations of Abuse and Neglect.”...more

Antitrust Considerations Surrounding Health Care Consolidation Among Hospitals and Physicians

The Affordable Care Act (“ACA”) has resuscitated the demand for hospital and health care provider mergers. The law explicitly encourages collaborative care—through, for example, financial incentives surrounding the creation...more

Health Law Wire: OIG Report on Nursing Home Compliance with Federal Regulations for Reporting Allegations of Abuse or Neglect...

The Office of the Inspector General (OIG) for the U.S. Department of Health and Human Services released a report and recommendations for nursing facilities to develop and implement written policies related to reporting...more

Community Health Systems' HIPAA Breach: Significant Lessons for Health Care and Non-Health Care Companies

On August 18, 2014, Community Health Systems, Inc. (CHS) publicly confirmed, in a filing with the Securities and Exchange Commission (CHS filing), that its computer network was attacked between April and June 2014 by hackers...more

GAO Concludes CMS Should Increase Oversight of Post-Payment Claims Review Process

The Government Accountability Office (GAO) has released the findings of its study of the steps taken by CMS to prevent Medicare contractors from conducting certain duplicative post-payment claims reviews. Based on its audit,...more

IOM Study Recommends Major Changes in Graduate Medical Education Funding

An Institute of Medicine committee issued its long-awaited study on Graduate Medical Education (GME) funding on July 29, 2014. The committee, headed by two former Centers on Medicare & Medicaid Services administrators, Gail...more

CMS Care Coordination Payments – A Boon to Doctors and Patients but Patient Participation Will be Essential

As the Affordable Care Act continues to mature, we are seeing new efforts by the Obama administration to incentivize care coordination across a spectrum of services provided to Medicare Fee-for-Service (FFS) patients. A New...more

Chinese Hackers Infiltrate Health System Network – Information of 4.5 Million Individuals Stolen

Community Health Systems, Inc. (“CHS”) reported yesterday that the information of approximately 4.5 million individuals has been affected by a Chinese cyber-attack. CHS and its affiliates own and operate 206 hospitals in 29...more

Health Care Update - August 2014 #3

In This Issue: - Stakeholders Urge FDA to Provide Clarity on Biosimilars - Ebola Crisis Continues - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 19: Changes in Employment Status under the Look-Back...

An earlier post explained the two principle methods—the “monthly measurement method” and the “look-back measurement method”—available to applicable large employers to identify full-time employees for purposes of determining...more

CMS Temporarily Suspends Open Payments System

On August 7, 2014, CMS announced via email that it has temporarily suspended the Open Payments system “to investigate a reported issue.” Although CMS did not offer further explanation, our understanding is that the system has...more

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