Articles and Blogs

Executive Summary The Centers for Medicare & Medicaid Services (“CMS”) issued Change Request 9271 on January 4, 2016, which informs providers to waive the deductible and coinsurance for Advanced Care Planning (“ACP”) when furnished as an optional element of an Annual Wellness Visit (“AWV”). When ACP services are performed separately from a covered AWV,... READ MORE

As the health care payment and delivery system continues to evolve, Hall Render attorneys are committed to providing practical counsel and insight to health care providers. Below is a compilation of key developments from 2015 that will continue to impact the health care industry in 2016. As the new year begins, our attorneys will continue... READ MORE

Hall Render has become aware that the Department of Justice Office of Special Counsel for Immigration-Related Unfair Employment Practices (“OSC”) is currently investigating numerous hospitals across the country on the grounds that the hospitals’ advertisements for podiatric residency positions may be in violation of the Immigration and Nationality Act (“INA”). OSC, which is responsible... READ MORE

Since the September 8, 2015 publication of the notice of proposed rulemaking (“NPRM”) proposing several significant changes to the Federal Policy for the Protection of Human Subjects (the “Common Rule”) in the Federal Register, the Department of Health and Human Services (“HHS”) Office of Human Research Protections (“OHRP”) has received sharp criticism from many... READ MORE

UPDATE – January 19, 2016: Although both houses of the New Jersey legislature passed the measure mentioned in this post, New Jersey Governor Chris Christie subsequently pocket vetoed the measure. Legislators at the state and local levels are reportedly continuing their efforts to craft a legislative solution to clarify hospital property tax exemptions in... READ MORE

Last year, as part of the CY 2015 Outpatient Prospective Payment System (“OPPS”) Final Rule (“Final Rule”), the Centers for Medicare & Medicaid Services (“CMS”) finalized a policy implementing new coding and billing requirements related to services furnished in off-campus provider-based departments of hospitals.  These new requirements, which are discussed in more detail below,... READ MORE

Executive Summary Recently, the U.S. Department of Justice (“DOJ”) announced a $256 million settlement with one of the nation’s largest urine drug testing (“UDT”) laboratories (“Lab”).  According to a False Claims Act (“FCA”) complaint in intervention filed by the U.S., from January 1, 2008 through May 20, 2015, the Lab “systematically” billed the federal... READ MORE

Executive Summary Under the federal Stark Law, hospitals may provide non-monetary compensation to physicians up to an aggregate amount of $392 for calendar year 2016, remaining the same from the previous calendar year.  The dollar limit for 2016 “medical staff incidental benefits” (e.g., meals, parking and other items or incidental services that are used... READ MORE

Executive Summary Recently, the Department of Health and Human Services Office of Inspector General (“OIG”) released its Work Plan for Fiscal Year 2016 (“Plan”).  The Plan provides insight into OIG’s potential audit and enforcement activities for the next fiscal year.  While the Plan addresses several different provider types, this article addresses the Plan’s initiatives... READ MORE

Executive Summary On November 6, 2015, the FTC challenged the proposed acquisition of St. Mary’s Medical Center by Cabell Huntington Hospital in Huntington, West Virginia on the grounds that the proposed acquisition would create a “natural monopoly” and violate the federal antitrust laws. In its complaint, the FTC alleged that the proposed acquisition is... READ MORE