Articles and Blogs

On June 29, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a favorable advisory opinion, Advisory Opinion 17-02, concerning a hospital (the “Hospital”) outpatient facility’s proposal to waive or reduce cost-sharing amounts owed by financially needy Medicare beneficiaries for items and services furnished in connection with a clinical... READ MORE

On June 30, 2017, CMS published in the Federal Register a proposed rule (“Proposed Rule”) to update the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”) Quality Payment Program (“QPP”) for CY 2018 and future years. CMS has stated that it endeavors to increase flexibility, decrease administrative burden and overall simplify the QPP,... READ MORE

On June 2, 2017, the Survey and Certification Group at the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum, “Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires’ Disease (LD)” (“S&C Memo”), requiring that facilities develop and follow policies and procedures that inhibit microbial growth... READ MORE

Many hospitals and health systems are using telehealth technologies to improve patient access (particularly in remote or rural locations), monitor and manage chronic conditions and generally deliver health care in a more timely and cost-efficient fashion. There are currently three general modalities of telehealth services. First, the asynchronous transmission of images, test results or... READ MORE

In January of 2014, a relator filed suit against a Florida hospital system (“Health System”) under the False Claims Act. We originally reported on the suit against the Health System in this blog post. The suit garnered national attention based on the unique facts of the case. The suit involved a medical office building that was... READ MORE

With employee health plan costs continuing to rise at an alarming rate, medium-sized employers are increasingly rejecting traditional insurance models built around a network of preferred providers and turning to a non-network model wherein the plan appoints a pricing consultant as a “Designated Decision Maker” (“DDM”) with discretionary and ultimate decision-making authority for determining... READ MORE

On June 26, the Supreme Court granted certiorari to review the current administration’s executive orders barring people from certain countries from entering the United States. The Court granted a stay of the executive orders in part but will allow some people to be stopped at the border under the executive orders while the case... READ MORE

In case you missed it, on June 16, the American Health Law Association released a comprehensive member briefing entitled “The OIG’s Resource Guide: An Important New Tool for Measuring Compliance Program Effectiveness”[1] (Compliance Program Briefing). The Compliance Program Briefing was authored by four Hall Render attorneys. A copy of the Compliance Program Briefing can... READ MORE

Health system supply chain departments (and increasingly more C-suite leaders) appreciate the potential savings that standardization and centralization can generate for their organization given that 30 to 50 percent of their budget is associated with supply chain costs. However, implementing strategies and procedures, or even knowing where to start in order to generate these savings,... READ MORE

CDC’s opioid prescribing guidelines prompt states to adopt quantity limits Indiana Governor Eric Holcomb recently signed into law Senate Enrolled Act 226 (SEA 226), which places limits on the opioid quantities that may be prescribed by state-licensed practitioners beginning July 1, 2017. Prescribing caps on opioids have gained increasing popularity following the March 2016... READ MORE