Articles and Blogs

Executive Summary The Centers for Medicare & Medicaid Services (“CMS”) has engaged StrategicHealthSolutions, LLC (“Strategic”) as a Supplemental Medical Review Contractor (“SMRC”) to conduct post-payment claim reviews of selected Part A and Part B claims for blepharoplasty and other eyelid procedures.  READ MORE

Executive Summary On October 1, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule that would overhaul the clinical diagnostic lab test (“CDLT”) payment system by linking the clinical lab fee schedule (“CLFS”) to private payor payment rates (“Proposed Rule”).  Under the Proposed Rule, each applicable laboratory will be required... READ MORE

In SSM Health Care of Wisconsin, Inc. (“SSM“) v. City of Fitchburg (“City”), the Wisconsin Court of Appeals affirmed a circuit court’s grant of summary judgment that held that some of SSM’s personal property in a sleep center and a renal center is exempt from property taxes under Wis. Stat. § 70.11(4m)(a). Wisconsin Statute... READ MORE

Executive Summary On September 9, 2015, Deputy Attorney General Sally Quillian Yates of the Department of Justice (“DOJ”) issued to various divisions within the DOJ and released to the public a Memorandum addressing individual accountability for corporate wrongdoing.  This Memo is the latest in a long-running series of DOJ memorandums addressing corporate misconduct.  READ MORE

Background On September 8, 2015, the Department of Health and Human Services (“HHS”), through the Office for Human Research and Protection (“OHRP”), proposed several significant changes to the Federal Policy for the Protection of Human Subjects (the “Common Rule”).  In its notice of proposed rulemaking (“NPRM”), HHS and 15 other federal agencies and departments... READ MORE

According to a recent study by the British Medical Journal (“BMJ”) titled Access, Quality, and Costs of Care at Physician Owned Hospitals in the United States: Observational Study (“Study”), physician-owned hospitals (“POHs”) generally do not treat a higher volume of the most profitable patients (commonly referred to as “cherry-picking”) than other hospitals1.  The Study... READ MORE

Executive Summary As part of the Immigration Accountability Executive Action issued by President Obama on November 20, 2014 (detailed here), United States Citizenship and Immigration Services (“USCIS”) and the Department of State (“DOS”) announced revised procedures yesterday in determining visa availability for applicants waiting to file for adjustment of status.  The new procedures are intended to more accurately... READ MORE

Executive Summary On August 28, 2015, the Health Resources and Services Administration (“HRSA”) released its long-awaited proposed 340B Drug Pricing Program Omnibus Guidance.  The notice (a copy of which can be found here) proposes to establish guidance addressing a variety of longstanding open questions for covered entities enrolled in, and drug manufacturers participating in,... READ MORE

In a highly anticipated decision, the NLRB has restated and redefined the standard for determining when employers will be found to be joint employers for purposes of the National Labor Relations Act (“NLRA”). With more and more health systems and hospitals contracting out non-core services, this decision could have a far-reaching impact. The NLRA governs labor... READ MORE

Overview The use of telecommunication to complement health care delivery services is growing. Many health systems and providers are interested in developing a telehealth component as part of their offerings. With these expansions, professional licensure portability and practice standards for providers can be a significant challenge due to the conflicting and disparate requirements for... READ MORE