Articles and Blogs

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

Review of Changes to Sections on Infection Control, Compliance and Ethics Program, Physical Environment and Training Requirements This is the fourth article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for States and Long-Term Care Facilities by the Centers for Medicare... READ MORE

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 16-10, which approved an arrangement between two health care districts to coordinate the education and transportation of patients with financial need (“Proposed Arrangement”). OIG stated that it would not impose sanctions against the parties for violations of the... READ MORE

Review of Changes to Sections on Laboratory, Radiology and Other Diagnostic Services; Dental Services; Food and Nutrition Services; Specialized Rehabilitative Services; Administration; and Quality Assurance and Performance Improvement This is the third article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements... READ MORE

On October 3, 2016, the Department of Justice announced that it had reached a settlement agreement with a health care services company based in Dallas, Texas (the “Company”) and two of its Atlanta-area subsidiaries (“Hospitals”) (collectively, the “Parties”) to settle a case originally brought by a whistleblower under the False Claims Act. As part of the... READ MORE

Review of Changes to Sections on Quality of Life, Quality of Care, Physician Services, Nursing Services, Behavioral Health Services and Pharmacy Services This is the second article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for States and Long-Term Care Facilities... READ MORE