Articles and Blogs

On May 31, 2017, 184 legislators wrote a bipartisan letter to Secretary Tom Price of the Department of Health and Human Services (“HHS”) to request that HHS revisit and roll back a 2013 policy memo that discourages insurance companies selling Qualified Health Plans on the exchanges from accepting payments from hospitals and other third... READ MORE

On May 26, 2017, the U.S. Court of Appeals for the Sixth Circuit issued a decision (NLRB v AEI) holding that an employment agreement provision requiring arbitration of employment disputes, but prohibiting class action or other multiple-employee arbitrations, is unlawful. The court upheld a National Labor Relations Board order striking down the provision. Employees were... READ MORE

Providers and payers alike are increasingly exploring ways to treat the “whole person” by integrating behavioral health care with physical medicine. This integration is critical to helping achieve better outcomes and increasing quality of care. Achieving full integration has proven to be quite challenging, including navigating the legal and compliance requirements when designing and... READ MORE

On May 18, 2017, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule (the “Final Rule”) effectively postponing the start date of CMS’s new episode payment models (“EPMs”) and the Cardiac Rehabilitation Incentive Payment Model (“CR Incentive Model”) from July 1, 2017 until January 1, 2018. The Final Rule also delayed... READ MORE

In a May 15, 2017 7-1[1] decision authored by Hon. Justice Kagan, the U.S. Supreme Court held that the Kentucky Supreme Court’s “clear statement rule” – that an agent can deprive her principal of the rights of access to the courts and trial by jury through an arbitration agreement only if expressly provided in... READ MORE

On May 12, 2017, a massive cyber attack affecting health care organizations across the world prompted the United States Department of Health and Human Services (“HHS”) to issue a warning to U.S. health care organizations. The attack apparently first began in England, causing information systems at health care organizations throughout the country to become infected... READ MORE

On May 10th and May 12th, respectively, CGS Administrators, LLC (“CGS”) and Wisconsin Physician Services, Inc. (“WPS”) issued clarifications related to the MACs’ Local Coverage Determinations (“LCDs”) for polysomnography and other sleep studies. Click here for background on these LCDs. Due to efforts by state hospital associations, the MACs recognized that some hospitals relied... READ MORE

Title VII of the of the 21st Century Cures Act (the “Act”) underscores the importance of evidence-based programs and practices for diagnosing, preventing, treating and recovering from mental and substance use disorders. Title VII amends the Public Health Service Act to ensure that such programs reflect the increased knowledge obtained through the progress in... READ MORE

If HIPAA covered entities thought the increased rate of enforcement actions at the beginning of 2017 by the Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) was an anomaly, a flurry of settlement announcements by OCR in April indicate the trend may continue. The three recent enforcement actions discussed below... READ MORE

In a decision released May 4, 2017, the Wisconsin Supreme Court held that personal injury attorneys obtaining medical records on behalf of their clients are exempt from statutory certification and retrieval fees (Moya v. Healthport Technologies, LLC, 2017 WI 45, ¶ 2.). The plaintiff was involved in a motor vehicle accident and retained counsel... READ MORE