Articles and Blogs

The health care industry is an exceedingly complex and ever-changing arena. Federal and state governments have enacted a multitude of statutes and regulations to protect against perceived fraudulent and abusive behaviors by hospitals and health systems, including the federal Stark Law, the Anti-Kickback Statute and the False Claims Act. To ensure compliance with these... READ MORE

When it comes to behavioral health, which is hugely important in the current era of the opioid crisis and the renewed—and much needed—focus on expanded access to care, Hall Render knows the territory. For example, a few of our more recent behavioral health articles covered updated guidance issued by SAMHSA (those articles can be... READ MORE

On July 11, 2019, the Antitrust Division of the DOJ (“Division”) announced a new initiative aimed at encouraging robust corporate antitrust compliance programs. The Division’s initiative incentivizes compliance programs by establishing that firms charged criminally for antitrust violations will be given credit in charging and sentencing recommendations if they have effective corporate antitrust compliance... READ MORE

NATIONAL Approaching an EHR customization: Key thoughts from 3 clinical informatics execs AHA report: 3 shifts providers must make to embrace digital health 6 hospital mergers called off in past year Healthcare consultancy with offices in 10 states files for bankruptcy EHR-integrated patient texting helps clinic boost patient capacity 68% to 89% Report: 3... READ MORE

CMS was dealt a blow from the D.C. District Court on September 17, 2019 when the court determined the agency’s “site neutral” payment policy in the CY 2019 Outpatient Prospective Payment System (“OPPS”) Final Rule exceeded its statutory authority to adjust payments under the OPPS. Refusing to accept the government’s argument that the plaintiffs... READ MORE

The Office of the Inspector General (“OIG”) and Department of Justice (“DOJ”) often release information about compliance settlements under the Anti-Kickback Statute (“AKS”), including both the settlement value and the subject arrangement. The most recent data from 2018 shows several of these settlements arose from real estate arrangements and some involved millions of dollars... READ MORE

For almost a decade, the Binford Medical-Professional Office Complex, a medical office building and immediate care center located on the northeast side of Indianapolis, Indiana, has sat vacant, creating an eyesore and reminding local residents of the potential health care option that could have been. Once known for its unrealized opportunity, the facility now... READ MORE

The Bankruptcy Court for the District of Delaware analyzed whether CMS could suspend payments to a health care organization once the organization seeks bankruptcy court protection. The question centered on whether such payments are considered estate property within the scope of the automatic stay rule, 11 U.S.C. § 362. This case highlights the limits... READ MORE

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