Articles and Blogs

On May 24, 2016, the Department of Health and Human Services, through the Agency for Healthcare Research and Quality, issued Guidance Regarding Patient Safety Work Product and Providers’ External Obligation (the “Guidance”). Since the enactment of the Patient Safety Act1 and its implementing regulation, the Patient Safety Rule2, there has been some confusion among... READ MORE

On June 7, 2016, a bill expanding the scope of practice for certified nurse anesthetists (“NAs”) was introduced to the Michigan Senate by Sen. Mike Kowall (R-White Lake). Senate Bill 1019 would amend sections 17210 & 17708 of the Public Health Code (the “Code”). Specifically, the bill would:  Include certain anesthesia and analgesia services in... READ MORE

Wisconsin’s long-standing hospital regulation, DHS 124, will be significantly reformed beginning on July 1, 2016. DHS 124, described in the governor’s 2013 Regulatory Review Report as “outdated, duplicative, and confusing for health care operators,” has been the focus of regulatory reform efforts for more than a decade. Signed into law on April 8, 2014,... READ MORE

On June 8, the Centers for Medicare & Medicaid Services (“CMS”) announced its plan to implement a three-year Medicare pre-claim review demonstration for home health services in the states of Illinois, Florida, Texas, Michigan and Massachusetts (the “Demonstration”). These states were selected based on high incidences of fraud and improper payments for home health... READ MORE

Recently, the Department of Health and Human Services Office of the Inspector General (“OIG”) and the Department of Justice (“DOJ”) released the FY 2015 Health Care Fraud and Abuse Control Program Annual Report (“Annual Report”). The Annual Report details the enforcement actions and the monetary gains from efforts by the OIG and DOJ to... READ MORE

On June 16, 2016, the United States Supreme Court issued its decision in Universal Health Services, Inc. v. United States ex rel. Escobar, a False Claims Act (“FCA”) case reviewing the theory of implied certification, which was subject to a circuit court split. In the opinion, the Court upheld the viability of the implied... READ MORE

On January 1, 2016, the new Stark Law “timeshare license” exception became law. We reported on the proposed rule here and the final rule here. Initially, the exception received somewhat mixed reviews, which resulted in some hesitancy to employ it. Now that the dust has settled, we believe that the exception presents significant advantages... READ MORE

On May 13, 2016, the Office of Civil Rights (“OCR”) of the Department of Health and Human Services (“HHS”) issued a final rule (“Final Rule”) implementing Section 1557 of the Patient Protection and Affordable Care Act (“ACA”). A copy of the Final Rule is available here. The rule is scheduled to become effective on... READ MORE

On June 10, 2016, CMS released a final rule regarding the Medicare Shared Savings Program (“MSSP”).  The rule modifies MSSP’s benchmarking methodology, including, for MSSP ACOs commencing their second or subsequent agreement period in 2017 or thereafter, the use of regional factors in resetting benchmarks.  The rule also provides a new option for MSSP... READ MORE

In a troubling split decision issued on March 22, 2016, a three-judge panel of the Sixth Circuit reversed the ruling by the district court for the Southern District of Ohio at Dayton in The Medical Center at Elizabeth Place, LLC v. Atrium Health System, et al. and remanded the case back to the district... READ MORE