Articles and Blogs

On March 5, 2019, the Center for Clinical Standards and Quality/Survey & Certification Group released a memorandum titled “Revisions to Appendix Q, Guidance on Immediate Jeopardy” (“Memorandum”). The Memorandum’s revisions create a “Core Appendix Q” that will be used by surveyors of all provider and supplier types in determining when to cite immediate jeopardy.... READ MORE

If the Trump administration moves forward with a plan to revoke work authorization for certain H-4 visa holders, over 100,000 foreign nationals could lose their ability to work in the United States. Overview The H-4 nonimmigrant visa allows spouses and unmarried children (under 21 years of age) of H-1B visa holders to join them... READ MORE

Location, location, location – this will be the focus of a Medicare hospital claims processing requirement. Starting in April 2019, CMS will activate billing edits that will Return to Provider (“RTP”) any hospital UB-04 claims that identify a service location that is not an exact match to a Medicare enrolled location identified in Provider... READ MORE

During a speech on March 4, 2019, Secretary of Health and Human Services Alex Azar announced that the Trump administration plans to overhaul the Medicare payment system for certain dialysis services provided to patients with end-stage renal disease. The overhaul, as envisioned, would incentivize moving the place of treatment from outpatient clinics to home... READ MORE

As explained in our previous post, on September 5, 2018, the Michigan Legislature voted to approve the Earned Sick Time Act (“ESTA”), a citizen petition-initiated measure that was due to go into effect in March of 2019. However, before the ESTA could go into effect, in December of 2018, it was renamed as the... READ MORE

House Democrats Unveil Single-Payor Legislation House Democrats introduced sweeping “Medicare for All” legislation, providing the most detailed plan to overhaul the current health care system by enrolling all U.S. residents in a single-payor, government-run health plan. It would cover a more expansive set of benefits than the current Medicare program and restructure payment for... READ MORE

Over the years, there have been a number of federal cases involving allegations that health care providers used improper real estate arrangements to induce referrals. Recently, two real estate-related cases have made headlines. Hospitals should pay careful consideration to the following two cases. Serial Whistleblower Seeks to Overturn Ruling Involving Alleged Cash-Flow Subsidies under... READ MORE

Health care providers are increasingly relying on technology to market, communicate with and otherwise provide services to their community, such as information about services provided on the website, patient portals, check-in kiosks and mobile applications. In using technology to communicate with patients and the larger community, it is important to remember the importance of... READ MORE

NATIONAL CMS paid $84M for nursing home services that didn’t meet Medicare rule, audit finds S. judge will not block Amazon-Berkshire-JPMorgan health venture’s new hire Senate Inquiry On Drug Prices Echoes Landmark Hearings Held 60 Years Ago Physician burnout rate drops 10.5 points after spike The metrics healthcare leaders check daily Amazon exec says... READ MORE

 NATIONAL HHS launches payment model for ambulance providers Medicare ambulance rides may no longer end up at ER Healthcare billing fraud: 8 latest settlements 3 revenue cycle leaders on their hospital’s biggest concern now that standard charges are public 4 strategies for keeping your millennial healthcare workers Rural hospitals face widespread closures CMS can... READ MORE