Articles and Blogs

The Department of Health and Human Services Office of Inspector General (“OIG”) is currently soliciting proposals and recommendations for additional Anti-Kickback Statute safe harbors and OIG Special Fraud Alerts.1 The Health Insurance Portability and Accountability Act requires an annual notice period to solicit these comments in order to identify and protect non-abusive arrangements from the... READ MORE

Executive Summary Riding the wave of an unprecedented winning streak and continuing its trend of aggressive antitrust enforcement in the hospital merger arena, the FTC recently challenged three proposed hospital mergers – one in West Virginia, one in Pennsylvania and one in Chicago, Illinois – in a two-month period.  In each challenge, the FTC... READ MORE

In an opinion filed January 5, 2016, the Illinois Fourth District Appellate Court ruled that the Illinois statute authorizing hospital property tax exemptions is unconstitutional. Until formal guidance is released from the Illinois Department of Revenue, this decision will likely create a period of uncertainty for hospitals that have secured or that are seeking... READ MORE

Executive Summary On December 18, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released a draft Quality Measure Development Plan (“Draft Plan”) to serve as a strategic framework for the future of clinician quality measure development for the transition to new Merit-Based Incentive Payment System (“MIPS”) and alternative payment models (“APMs”).1 The Draft... READ MORE

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