Articles and Blogs

Late last year, Rep. Edward Canfield (R-Sebewaing) and Sen. Peter MacGregor (R-Rockford) proposed legislation that would amend: (1) the Public Health Code to prohibit the Department of Licensing and Regulatory Affairs or a professional board from requiring a physician to maintain a national or regional certification and prohibits hospitals from denying admitting privileges on... READ MORE

As has been widely reported, on July 21, 2016, the Antitrust Division of the DOJ filed two separate complaints to block both Anthem’s acquisition of Cigna and Aetna’s acquisition of Humana, alleging both acquisitions violate the federal antitrust laws. In both cases, the parties have decided to fight the DOJ’s challenge. Originally, both cases were... READ MORE

On August 4, the Office for Civil Rights (“OCR”) announced a $5.55 million settlement with the largest fully integrated health care system in Illinois. The settlement is the largest HIPAA settlement ever by a single entity and follows two recent settlements with university health systems in Oregon and Mississippi that were $2.7 million and... READ MORE

On August 5, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued an Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) adopting the updated labor market area delineations based on the 2010 census. The updated labor market area delineations became effective October 1, 2014. The Final Rule effectively caused, among other changes,... READ MORE

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued a favorable Advisory Opinion, No. 16-07, of an arrangement that offers Medicare Part D beneficiaries discounts on prescriptions for an erectile dysfunction drug that is statutorily excluded from coverage under Part D (the “Arrangement”). While OIG concluded that the Arrangement... READ MORE

On August 2, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a Proposed Rule establishing three new mandatory retrospective bundled payment models and creating an incentive payment program for cardiac rehabilitation services. In this Proposed Rule, CMS also outlined several proposed changes to the recently implemented Comprehensive Care for Joint Replacement (“CJR”)... READ MORE

Background On August 2, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule (the “Proposed Rule“) to create three new episode payment models (“EPMs”) covering services provided to Medicare beneficiaries admitted to certain Inpatient Prospective Payment System (“IPPS”) hospitals for heart attacks, coronary bypass surgery or surgical treatment of hip... READ MORE

On August 5, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released a Survey and Certification Memo (“S&C Memo”) on protecting resident privacy and prohibiting abuse-related photographs and recordings by nursing home staff.¹  Recent news stories have reported nursing home staff taking unauthorized photographs or video recordings of nursing home residents, sometimes in... READ MORE

The Michigan Supreme Court recently declined to review, and thus affirmed, a Michigan Court of Appeals’ (“COA”) decision in which the COA held that Michigan law allows a cause of action for wrongful termination in violation of public policy under MCL 333.20176a(1)(a) of the Public Health Code, which prohibits discharge of employees reporting malpractice by health... READ MORE

On August 2, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released its Hospital Inpatient Prospective Payment System and Long-Term Acute Care Hospital Final Rule Issues for Fiscal Year 2017, which are set to be published on August 22, 2016 and effective October 1, 2016. CMS included the final rule for Hospital Notification... READ MORE