Articles and Blogs

Under the federal Stark Law, hospitals may provide non-monetary compensation to physicians up to an aggregate amount of $398 for calendar year 2017. 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 $33 per occurrence. Other requirements of... READ MORE

Driven in part by retroactive fees imposed upon pharmacies by pharmacy benefit managers (“PBMs”) and compounded by recent high profile cases of significant price increases for relatively common drugs,1 both retail and institutional pharmacies have continued to push for enhanced prescription drug pricing transparency. Recent state and federal legislation, as well as lawsuits filed by coalitions... READ MORE

On November 14, 2016, the United States Citizenship and Immigration Services (“USCIS”) published a revised Form I-9, Employment Eligibility Verification for use with all new hires. The new version (dated 11/14/2016) will be required for all employers on January 22, 2017. Until that date, employers may continue to use the older version (dated 03/08/2013),... READ MORE

Executive Summary On November 10, 2016, the Office of the Inspector General (“OIG”) published its Work Plan for Fiscal Year (“FY”) 2017 (“Work Plan”). The Work Plan, published annually, describes OIG’s new and continuing audit and enforcement priorities for the upcoming year. The Work Plan is also useful in identifying corporate compliance risk areas... READ MORE

On October 28, 2016, the Department of Health and Mental Hygiene (“DHMH”) published its final regulations regarding hospitals’ and certain other health care facilities’ obligations to report certain actions involving physicians, allied health providers and naturopathic doctors.  The final regulations are codified at COMAR 10.32.22 and became effective November 7, 2016. As you may... READ MORE

On November 1, 2016, the Centers for Medicare & Medicaid Services (“CMS”) issued its long-awaited final rule for the CY 2017 Hospital Outpatient Prospective Payment System (“Final Rule”). Among many other changes, CMS finalized its implementation of Section 603 of the Bipartisan Budget Act of 2015 (“Section 603”), which excludes many off-campus services from... READ MORE

On October 24, the Department of Justice (“DOJ”) announced a $145 million False Claims Act settlement with a national skilled nursing facility provider that operates more than 200 skilled nursing facilities (the “Company”) and its individual owner. The settlement has been touted as the largest in the DOJ’s history with a skilled nursing facility (“SNF”) chain. According to... READ MORE

On October 20, 2016, the Federal Trade Commission (“FTC”) and the Antitrust Division of the Department of Justice (“DOJ”) released joint guidance for human resources (“HR”) professionals and others involved in hiring and compensation decisions. The joint guidance outlines how the federal antitrust laws apply to the employment arena and also warns employers that... READ MORE

Health care providers subject to the Stark Law and the Anti-Kickback Statute can face significant penalties for non-compliant arrangements. In the event that a provider discovers a potentially non-compliant arrangement, it may elect to disclose the arrangement to government officials in an effort to limit its liability. Potential Stark Law violations are often disclosed... READ MORE

Today, the Centers for Medicare & Medicaid Services (“CMS”) published the much-anticipated Final Rule for the new Merit-Based Incentive Payment System (“MIPS”) and Advanced Alternative Payment Models (“AAPMs”) pathways to payment pursuant to the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). A copy of the Final Rule can be found here, and... READ MORE