Articles and Blogs

On January 9, 2020, the Department of Justice (“DOJ”) announced that it collected over $3 billion in settlements and judgments under the False Claims Act (“FCA”) in the federal fiscal year 2019. The FCA has historically been the government’s primary tool for combatting perceived fraud, waste and abuse in the health care system, and... READ MORE

On December 18, 2019, in a 2-1 decision, the U.S. Court of Appeals for the Fifth Circuit held that the plaintiffs in Texas v. United States[1] had standing to bring a case challenging a provision of the Affordable Care Act (“ACA”) known as the individual mandate (26 U.S.C. §5000A) and that the individual mandate requiring... READ MORE

NATIONAL Hospitals Exploring Short-Term Housing For Homeless Patients To Free Up Beds VA drops its star ratings system for hospitals TEVA Agrees to Pay $54 Million to Settle McEldrew Young False Claims Act Qui Tam Whistleblower Lawsuit 43% of older patients seek out physician ratings CMS releases 2021 Medicare Advantage risk adjustment payment changes... READ MORE

NATIONAL Electronic Health Records Creating a ‘New Era’ of Health Care Fraud, Officials Say ‘Epidemic’: 75% Of Workplace Assaults Happen To Health Care Workers Despite privacy concerns, 88% of Americans would share data for cancer research Nonprofit hospitals get bump in Moody’s ratings for 2020 HHS proposed rule adds new performance measures for organ... READ MORE

Massive FY 2020 Funding Bills Loaded with Health Care-Related Provisions Just hours before another looming government shutdown, President Trump signed a two-part spending deal funding federal agencies that include CMS, FDA and NIH, among others. The funding bill contains several significant health policy provisions. Most notably, it will repeal three taxes enacted as part... READ MORE

Under the federal Stark Law, hospitals may provide non-monetary compensation to physicians up to an aggregate amount of $423 for calendar year 2020. The dollar limit for “medical staff incidental benefits” (e.g., meals, parking and other items or incidental services that are used on the hospital’s campus) is less than $36 per occurrence. Other... READ MORE

On December 11, 2019, the Center for Clinical Standards and Quality/Quality, Safety & Oversight Group at the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum to State Survey Agency Directors entitled “Fiscal Year (FY) 2020 Mission & Priority document (MPD) – Action” (“FY 2020 Memo”) that announced its work and intentions for the fiscal... READ MORE

This week, the Equal Employment Opportunity Commission (“EEOC”) rescinded a nearly 22-year-old policy opposing mandatory arbitration agreements in employment discrimination disputes imposed as a condition of employment. The 1997 Policy In 1997, the EEOC took the position that “agreements that mandate binding arbitration of discrimination claims as a condition of employment are contrary to... READ MORE

NATIONAL Where the AMA stands on 7 of the year’s biggest health care issues Why digital health has been such a disappointment, and how to change that 106 hospitals, health systems that launched telehealth services in 2019 64 hospitals that planned, opened or broke ground on ASCs in 2019 CMS to Repay Site-Neutral Payments... READ MORE

NATIONAL CMS Administrator Seema Verma scoffs at hospital execs’ arguments against transparency Hospital employed physicians see 7% drop in compensation for 2018: 14 statistics to know Physician Compensation Programs Move Toward Value-Based Pay Standalone hospitals in the M&A era: 3 CFOs to watch Optum’s ‘city by city’ healthcare strategy 3 ASC leaders forecast 2020... READ MORE