Articles and Blogs

Executive Summary On November 2, 2015, the Office of Inspector General (“OIG”) published its Work Plan for Fiscal Year (“FY”) 2016 (“Plan”).  The Plan, which is published annually and describes OIG’s new and ongoing audit and enforcement priorities for the upcoming year, is helpful in identifying corporate compliance risk areas and providing focus for... READ MORE

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 15-13,1 which provided a favorable opinion of a health system’s (“Requestor’s”) proposed arrangement to offer free transportation services to patients in a rural community (“Arrangement”). OIG stated that it would not impose sanctions against Requestor for violations of the... READ MORE

A trend in real estate-related False Claims Act litigation should put hospitals and other health care providers on notice that relators are looking for big paydays for non-compliant real estate arrangements. The relators described in this article are real estate professionals who are bringing technically complex claims with little to no institutional knowledge of... READ MORE

Last week, Congress passed the Bipartisan Budget Act of 2015 (“Budget”), and President Obama signed the Budget into law on November 2, 2015.  Among many other changes, the Budget includes an impending exclusion on hospital coverage for off-campus hospital outpatient departments that first bill for services on or after November 2, 2015.  Even though site-neutral payment... READ MORE

On October 30, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released the CY 2016 final rule for revisions to Payment Policies under the Physician Fee Schedule (“Final Rule”) following the proposed rule published in July 2015 (“Proposed Rule”).1  Among other Stark Law revisions, the Final Rule updates the Stark Law regulations for... READ MORE

Overview On October 30, 2015, the Centers for Medicare & Medicaid Services (“CMS”) issued the final rule (“Final Rule”) in follow up to the proposed rule published in July 2015 (“Proposed Rule”).1  It is anticipated that the final regulations will be published in the Federal Register on November 16, 2015.  The Final Rule establishes two new... READ MORE

Over the years, we have “followed” the NLRB’s analysis of employer social medial policies. You can catch up on this evolution by accessing our past HR Insights blogs. Employee’s “Like” of Another’s Facebook Rant Is Protected The evolution continues. On October 21, in an unpublished opinion, the Second Circuit (with district courts in Connecticut,... READ MORE

Executive Summary On October 28, 2015, the Food and Drug Administration (“FDA”) revised its June 30, 2015 guidance delaying the enforcement of key track and trace requirements of the Drug Supply Chain Security Act (“DSCSA”) for Dispensers1 (including pharmacies, health systems and physician offices) until March 1, 2016 (“Guidance”). Previously, on June 30, 2015,... READ MORE

On October 12, 2015, three Texas hospitals filed suit against the Department of Health and Human Services (“HHS”), the Secretary of HHS (“Secretary”) and the Centers for Medicare & Medicaid Services (“CMS”) seeking to reverse CMS’s decision to grant the request of a Texas physician-owned hospital (“POH”) to expand the hospital’s current facility by... READ MORE

Yesterday, the House passed a sweeping budget bill that impacts Medicare coverage of services provided in off-campus hospital departments.  Currently, Medicare pays for items and services provided in both on- and off-campus hospital outpatient departments as hospital services when those departments are in compliance with 42 CFR §413.65 (the Medicare “provider-based rule”).  With some... READ MORE