News & Analysis as of

Reporting Requirements Health Care Providers

REMINDER: Annual Reporting Deadline Approaches for Connecticut Hospitals and Hospital Systems

Hospitals and hospital systems in Connecticut must file annual reports by January 15, 2018 describing (1) the activities of their group practices (e.g., medical foundations or faculty practice plans), and (2) their respective...more

New York Legislature Expands Death and Felony Reporting Requirements

by Hodgson Russ LLP on

On December 18, 2017, Governor Andrew M. Cuomo approved an Act (2017 N.Y. Laws ch. 459) expanding the death and felony reporting requirements under Section 461-m of the Social Services Law. ...more

News from Second & State

Weekly Wrap - The Pennsylvania General Assembly wrapped up its business for the 2017 calendar year this week, marking the half-way point through the 2017-2018 legislative session. It was an expectedly busy week, as members...more

Peer Review Not Protected: U.S. Supreme Court Will Not Disturb Florida Decision Limiting the Patient Safety and Quality...

by Baker Ober Health Law on

A multi-year discovery dispute regarding the adverse medical incident reports of a Jacksonville, Florida hospital concluded on October 2, 2017 when the United States Supreme Court denied a petition for a writ of certiorari in...more

The Impact of the New Connecticut Budget on the Health Care Industry

The bipartisan state budget became law yesterday (the “Budget Act”). While Governor Malloy vetoed a provision requiring supplemental payments to hospitals, the Budget Act includes numerous other provisions affecting the...more

CMS Releases 2018 Open Payments/Sunshine Act Reporting Thresholds

by Reed Smith on

CMS has announced inflation-adjusted de minimis reporting thresholds for 2018 under the Open Payments/Physician Payments Sunshine Act program. Specifically, payments or transfers of value of less than $10.49 do not need to...more

OIG Issues Stark Warning to Skilled Nursing Facilities: Potential Abuse or Neglect of Residents Receiving Emergency Room Services...

On August 24, 2017, the Office of Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”) issued an “Early Alert” that disclosed the preliminary results of its ongoing review of abuse of Medicare...more

Final Rule for MACRA's Second Year (2018) Expected in November 2017

by Baker Donelson on

On June 20, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule entitled, "Medicare Program; CY 2018 Updates to the Quality Payment Program." CMS proposed changes for the second year (2018) of the...more

Nursing Home Nightmares — Beyond poor care

The lack of good care in nursing homes is a very real problem. Owners trying to enhance the bottom line often run with thin staffs, and it is the patient who suffers. For example, bed sores can cause terrible injuries and...more

Federal Government to Target False EHR Incentive Payments

by Barley Snyder on

While health care reform remains bogged down, the federal government’s efforts to curtail fraud, waste and abuse in its health care programs fervently continues. Most recently, the U.S. Department of Health and Human...more

Sixth Circuit: Technical Physician Signature Deficiencies not "Material" to Reimbursement Claims

by Jones Day on

The District Court for the Middle District of Tennessee held on June 22, 2017, that the timing requirements related to a physician's certification of need for home health services were not "material" to the Centers for...more

Healthcare Data: Are You Required to Report a Ransomware Attack?

by Bennett Jones LLP on

If you are a healthcare data custodian that is subject to a ransomware attack, you may be required to report the incident to regulators and to those individuals whose information was subject to the attack....more

AGG Food and Drug Newsletter - May 2017

by Arnall Golden Gregory LLP on

Arnall Golden Gregory LLP's Food and Drug Newsletter is a monthly update of legal and regulatory issues that affect the FDA-regulated community, including regular updates on legislative initiatives from AGG’s Washington, DC...more

Revocation of Enrollment in the Medicare Program- A Powerful Weapon in Medicare’s Arsenal

by Burr & Forman on

In 2014, CMS issued a final rule related to 42 CFR 424.535, which gave CMS expanded authority to impose penalties on providers. Although the rule is several years old, the first version published in 2006, the rule has been...more

French sunshine regulations: the puzzle now completed and in force

by Hogan Lovells on

The French sunshine regulations require industry to report certain agreements along with the fees and other benefits provided to various stakeholders in the healthcare sector. ...more

Florida Supreme Court Rejects PSQIA Preemption of Florida Constitution

On January 31, 2017, the Florida Supreme Court held that adverse medical incident reports produced in accordance with Florida law cannot constitute confidential and privileged patient safety work product (PSWP) under the...more

TortSource: Ransomware: A Reportable Breach?

by Burr & Forman on

In the past several years, a huge increase has occurred in the number of electronic attacks in the United States using ransomware, a form of malware that targets and encrypts critical data and systems for the purpose of...more

Burr Alert: New Requirements of Participation for Skilled Nursing Facilities

by Burr & Forman on

On October 4, 2016, The Centers for Medicare and Medicaid Services (“CMS”) released the final rules regarding the requirements of participation for skilled nursing facilities. One of the most significant changes to the...more

Final Rule Implements Quality Payment Program under MACRA

by Baker Ober Health Law on

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

Catching Up With the Times: CMS Reforms Long-Term Care Facility Requirements Part III

by Polsinelli on

On October 4, the Centers for Medicare and Medicaid Services (CMS) published the biggest overhaul to federal long-term care regulations since 1991, and impacted facilities can immediately take steps to ensure they’re prepared...more

Sixth Circuit Holds That Michigan Health Insurance Claims Assessment Act Falls Outside of ERISA’s Preemptive Reach

by K&L Gates LLP on

Whether state common law claims are preempted by the Employee Retirement Income Security Act of 1974 (ERISA) is a common issue in reimbursement disputes involving health care providers and insurance companies. In cases when...more

CMS Proposes OPPS Reimbursement Adjustments: What Hospital Outpatient Providers Need to Know

by Polsinelli on

In early July, the Centers for Medicare & Medicaid Services (CMS) proposed Hospital Outpatient Prospective Payment System (OPPS) reimbursement rule changes that will impact reimbursement payment amounts and requirements for...more

CMS Finalizes Plan to Expand Medicare/Private Claims Data Available for Care Improvement

by Reed Smith on

CMS has published a final rule to allow organizations approved as “qualified entities” to confidentially share or sell analyses of Medicare and private-sector claims data to providers, employers, and other groups who can use...more

New Proposed Legislation: Doctors Must Report Med Device-Related Deaths & Injuries

by Knobbe Martens on

Representatives Mike Fitzpatrick (R-PA) and Louise Slaughter (D-NY) announced plans to propose the Medical Device Guardians Act of 2016. According to a press release from Rep. Fitzpatrick, the Act is “a package of bills aimed...more

CMS Finalizes Changes to Medicare Clinical Lab Test Payment Policy, Pushes Back Effective Date to 2018

by Reed Smith on

On June 23, 2016, the Centers for Medicare & Medicaid Services (CMS) is publishing a major final rule to base Medicare clinical laboratory fee schedule (CLFS) reimbursement on private insurance payment amounts, as required by...more

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Cybersecurity

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