Articles and Blogs

On October 1, 2012, the Centers for Medicare and Medicaid Services (“CMS”) began withholding 1% of hospital Medicare reimbursement payments as a part of the Value-Based Purchasing (“VBP”) program. The withheld amount will increase 0.25% each fiscal year until it is capped at 2% for FY 2017. Under the VBP program, hospitals compete with one... READ MORE

CMS Releases Part B Inpatient Billing Proposed Rule and Administrator’s Ruling On March 13, CMS released an administrative ruling and a proposed rule allowing Medicare to pay for additional hospital inpatient services under Medicare Part B. Specifically, the proposed rule would allow additional Part B payment when a Medicare Part A claim is denied because the beneficiary should have... READ MORE

The recent amendments to the False Claims Act, the Fraud Enforcement Recovery Act of 2009 (“FERA”), the Patient Protection and Affordable Care Act of 2010 (“PPACA”), and the Dodd-Frank Wall Street Reform and Consumer Protection Act (“Dodd-Frank”) continue to generate new rules and guidance. Effective 2007, Congress created incentives for States to pass and enforce mirror FCA statutes... READ MORE

If you or your business accepted payment via Visa or MasterCard between January 1, 2004 and November 28, 2012, you may be eligible for a cash award as a result of a pending class action lawsuit. Additionally, you may be approached by consultants who will offer to register you for participation in exchange for... READ MORE

Talk of Job Security Is “Inherently” Concerted and Protected We all know by now that private employees are protected if they engage in concerted activity for their mutual aid or protection.  We also know that the protections afforded employees under the NLRA can be interpreted quite broadly.  The current NLRB has done just that... READ MORE

This article is Part II in a five-part series of articles discussing the recently published federal Physician Payment Sunshine Act (“Sunshine Act”).  This article focuses on issues specific to group purchasing organizations and physician investment in health product manufacturers.  The first article in the series provided an overview of the major sections of the... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”), in the March 8, 2013 Memorandum, issued new guidance specifying those tasks that can and cannot be delegated in skilled nursing facilities (“SNFs”) and nursing facilities (“NFs”).  Physicians who improperly assign tasks to non-physician practitioners (“NPPs”) jeopardize the SNFs’ and NFs’ compliance with federal and state... READ MORE

NLRB to Petition for Supreme Court Review of Recess Appointments The National Labor Relations Board today announced that it has determined not to seek en banc rehearing in Noel Canning v. NLRB, in which the U.S. Court of Appeals for the D.C. Circuit held that the January 4, 2012 recess appointments of three members... READ MORE

The Centers for Medicare & Medicaid Services, in the March 8, 2013 S & C 13-16 NH, revised the Interpretative Guidelines for F-Tag 155 (“Advance Directives”) in Appendix PP of the State Operations Manual.  This memorandum updates S & C 12-47. READ MORE

According to the Centers for Medicare & Medicaid Services (“CMS”), since 1972, there have been in excess of 100 reports of Luer misconnections that have resulted in adverse events.  Recently, a patient’s blood pressure tubing was misconnected to an intravenous line in an ambulatory surgical center (“ASC”) that resulted in the patient’s death.  Generally,... READ MORE