As a general rule, healthcare employers are required to pay employed physicians and other contracted providers fair market value (FMV) for their services, but many employers do not understand relevant regulatory standards. ...more
8/22/2024
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Compensation ,
EMTALA ,
Fair Market Value ,
Federal Health Care Programs (FHCP) ,
Health Care Providers ,
Healthcare Workers ,
Independent Contractors ,
Medicaid ,
Medicare ,
OIG ,
Penalties ,
Physicians ,
Private Equity ,
Regulatory Standards ,
Stark Law ,
Wages
Although often well-intentioned, offering free or discounted items or services to patients (e.g., gifts, rewards, writing off copays, free screening exams, free supplies, etc.) may violate federal and state laws governing...more
2/28/2024
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Cost-Sharing ,
Eliminating Kickbacks in Recovery Act of 2018 (EKRA) ,
Ethics ,
Fraud and Abuse ,
Inducements ,
Medicare ,
OIG ,
Patient Referrals ,
Patients ,
Reimbursements ,
Stark Law ,
Waivers
The Emergency Medical Treatment and Active Labor Act ("EMTALA") provides that if a patient comes to a hospital or hospital-owned urgent care center, the hospital and relevant on-call physicians must provide an appropriate...more
For nearly three years, federal and state agencies have waived or relaxed regulatory requirements and expanded reimbursement for services due to the COVID-19 public health emergency (PHE), but the signs indicate that the...more
11/29/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Consolidated Appropriations Act (CAA) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
FQHC ,
Medicare ,
Public Health Emergency ,
Regulatory Requirements ,
Reimbursements ,
Telehealth
On January 13, 2022, a divided Supreme Court vacated the injunctions that applied to CMS's vaccine mandate in 24 states, thereby allowing CMS to enforce its mandates in all states except Texas....more
1/19/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Coronavirus/COVID-19 ,
Employer Mandates ,
Enforcement ,
Exemptions ,
Healthcare Workers ,
Medicaid ,
Medicare ,
OSHA ,
SCOTUS ,
Vaccinations ,
Virus Testing
Many healthcare employers may want to incentivize or compensate their employees for referring patients to or generating business for the employer, but they (appropriately) fear application of the federal Stark law or...more
This week, rural providers began receiving the next round of Provider Relief Funds as authorized by the CARES Act. Recipients include rural acute care general hospitals, critical access hospitals (“CAHs”), rural health...more
5/7/2020
/ CAH ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Medicare Part D ,
Operating Costs ,
Provider Relief Fund ,
Virus Testing
The CARES Act adopts several measures to help stabilize the healthcare system, address health care issues directly and indirectly related to the current pandemic and ensure future preparedness. It also allocates $100 billion...more
Federal Action. To promote the use of telehealth in response to Coronavirus, the federal government took several significant steps this week:
- Medicare dramatically expanded the telehealth services for which it will pay.
...more
Hospitals—especially rural hospitals—may want to divert inbound ambulances to other facilities, especially when the patient requires services that the hospital may be unable to provide. However, improper diversions may...more
The Idaho Department of Health and Welfare has implemented new patient rights rules for hospitals effective July 1, 2019. (See IDAPA 16.03.14.220 to .350). The rules were advanced by patient advocacy groups and, to a large...more
7/16/2019
/ Advance Directives ,
Audio Recording ,
Grievance Process ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Facilities ,
Hospitals ,
Informed Consent ,
Medicare ,
New Rules ,
Patient Privacy Rights ,
Patient Rights ,
Policies and Procedures ,
Video Recordings
Most Idaho healthcare providers are—or should be—aware of federal fraud and abuse laws, including the False Claims Act, Anti-Kickback Statute, Ethics in Patient Referrals Act (“Stark”), and the Civil Monetary Penalties Law,...more