On September 10, 2018, the United States Government Accountability Office (GAO) published a report titled “Medicare Advantage: Benefits and Challenges of Payment Adjustments Based on Beneficiaries’ Ability to Perform Daily...more
On July 30, 2018, OIG released “Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio” (the Report). The Report reviews hospice care since 2005 and describes key...more
On May 21, 2018, the Supreme Court of the United States ruled that, pursuant to the Federal Arbitration Act (FAA), mandatory arbitration agreements with employees requiring individualized arbitration actions for disputes with...more
5/31/2018
/ Arbitration ,
Arbitration Agreements ,
Class Action Arbitration Waivers ,
Epic Systems Corp v Lewis ,
Ernst & Young v Morris ,
Federal Arbitration Act ,
Murphy Oil v NLRB ,
Remand ,
Reversal ,
Savings Clause ,
SCOTUS
Marshfield Medical, Inc., formerly Bromedicon, Inc. (“Bromedicon”), has agreed to pay $550,000 to settle allegations under the False Claims Act (FCA)....more
In a rare move, on February 8, 2018, the U.S. Department of Justice (DOJ) filed a Statement of Interest on behalf of the United States (Statement of Interest) in Marion Healthcare, LLC v. Southern Illinois Healthcare, Civil...more
On January 25, 2018, DOJ issued a Memorandum stating that “effective immediately for [affirmative civil enforcement (ACE)] cases, the Department may not use its enforcement authority to effectively convert agency guidance...more
On November 1, 2017, CMS issued the 2018 Hospital Outpatient Prospective Payment System (OPPS) final rule in which it finalized steep cuts to reimbursement for drugs purchased through the 340B Drug Pricing Program, among...more
In a status report filed in connection with the American Hospital Association v. Price case, HHS projects significant reductions to the Medicare appeals backlog if the “legislative and budgetary measures proposed” in the...more
Released on May 23, 2017, President Trump’s proposed fiscal year (FY) 2018 budget would cut spending for healthcare programs. Specifically, the proposed budget would reduce funding for biomedical research, programs to fight...more
On March 21, 2017, the National Academy of Medicine (NAM) released a discussion paper entitled Vital Directions for Health and Health Care Priorities from a National Academy of Medicine Initiative. The discussion paper...more
On February 8, 2017, and without the fanfare that often accompanies new policy guidance, the Fraud Section of the U.S. Department of Justice (DOJ) issued a new guidance document on corporate compliance programs (Compliance...more
CMS issued a final rule, which was published in the Federal Register on January 13, 2017, intended to modernize the home health agency Conditions of Participation (CoPs). The rule, which goes into effect on July 13, 2017,...more
On December 14, 2016, the Department of Justice (DOJ) announced that it recovered more than $4.7 billion in settlements and judgments involving fraud and false claims in fiscal year 2016. The fiscal year 2016 recovery...more
On October 27, 2016, the U.S. Senate Finance Committee released a discussion draft of a bill that seeks to improve treatment for Medicare beneficiaries with chronic illnesses, with an emphasis on increased payment for home...more
On July 28, 2016, CMS issued a notice updating the prospective rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities. Beginning in fiscal year 2017, inpatient psychiatric facilities will...more
The FTC dismissed its antitrust complaint against a proposed West Virginia hospital merger in a 3-0 vote in light of a recent West Virginia law immunizing hospitals from antitrust scrutiny. “Our decision to dismiss this...more