Articles and Blogs

In a recent Sixth Circuit decision,[1] the Court concluded that an individual Medicare beneficiary, who had successfully sued a tortfeasor for personal injuries he suffered, did not have the right to bring a cause of action under the Medicare Secondary Payer Act (“MSPA”).[2] In effect, the Court concluded that the MSPA did not provide rights... READ MORE

Recently, there has been increased indication that patients, attorneys and the government are fed up with the fees that are being charged by providers when patients request access to or copies of their medical records. Providers who do not understand the type of request being made and the applicable fee rules that apply under... READ MORE

On June 24, 2019, the Trump administration changed the game for the health care industry through the release of an executive order on price transparency. Entitled “Improving Price and Quality Transparency in American Healthcare to Put Patients First,” the executive order is aimed primarily at giving patients access to price and quality information about... READ MORE

NATIONAL Rural hospital closings cause mortality rates to rise, study finds Medicare spends more on post-hospital care than private insurers Public comment period to close Sept. 27 for federal price transparency rule HIPAA: At what cost? It’s showtime: Providers, supporting cast members hustle to handle changes under PDPM 4 issues on nurse leaders’ radar... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) could revoke or deny a provider’s or supplier’s Medicare enrollment if it determines that any of its affiliations pose an “undue risk” under a Final Rule announced on September 5, 2019 (“Enrollment Rule”). Also under the Enrollment Rule, providers and suppliers (“Providers”) selected by CMS will... READ MORE

NATIONAL Physician pay increased in 2018 while productivity remained stagnant HHS Secretary Azar mulls Brett Giroir as next FDA commissioner 3 strategic differences between nonprofit and for-profit hospitals Physician viewpoint: 10 areas in which AI will transform primary care How providers can outperform their peers on MIPS regardless of what CMS changes Tougher inspections,... READ MORE

CMS recently posted reminders regarding the availability of MIPS final scores and the deadline to request review if an error has been made: “If you participated in the Merit-based Incentive Payment System (MIPS) in 2018, your performance feedback, which includes your MIPS final score and payment adjustment factor(s), are available for review on the Quality... READ MORE

In 2014, Congress enacted the Protecting Access to Medicare Act (“PAMA”), changing the landscape of Medicare reimbursement for lab services. PAMA required the Centers for Medicare & Medicaid Services (“CMS”) to establish a single, national Clinical Laboratory Fee Schedule (“CLFS”) based on current charges in the private health care market. Below, we provide background... READ MORE

 NATIONAL State-by-state breakdown of 113 rural hospital closures 6 Expectations Millennials Have For Their Healthcare Advice for new ASC administrators from Simplify ASC’s DeeDee Dalke The most dangerous trend in health IT from 5 execs Mystery group spent $13M on surprise-billing ads Johnson & Johnson Ordered to Pay $572 Million in Landmark Opioid Trial... READ MORE

In recent years, many health care providers have dedicated substantial resources to community health or initiatives targeted at improving social determinants of health. As outlined in a recent Hall Render article, the Tax Cuts and Jobs Act of 2017 gives health care providers a mechanism for furthering such goals while realizing significant tax savings... READ MORE