Articles and Blogs

On July 30, 1965, President Lyndon B. Johnson signed into law what we now know as the Medicare and Medicaid programs.  They came into being after a long political gestation period that can be traced back to President Theodore Roosevelt’s proposals for a national health insurance system in 1912 and President Harry Truman’s 1948 bid... READ MORE

Two separate alleged HIPAA violations resulted in an enforcement action by the Department of Health and Human Services (“HHS”) against a Massachusetts hospital (“Hospital”).  On July 10, 2015, the HHS Office for Civil Rights (“OCR”) announced a $218,400 settlement with the Hospital to resolve HIPAA investigations into two issues: READ MORE

On July 15, 2015, the U. S. Department of Labor (“DOL”) issued a Wage and Hour Division Administrator’s Interpretation that reasserts the broad definition of employee such that employers will rarely find that the individuals who work for them can be classified as independent contractors. This interpretation, although not having the effect of law,... READ MORE

Value-Based Purchasing Comes to Home Care On Monday, July 6, CMS issued the pre-publication copy of the proposed FY 2016 Home Health PPS Rule (the “Proposed Rule”).  The Proposed Rule will impose further cuts to home health reimbursement.  This is done in part through a continued application of the Affordable Care Act rebasing, which... READ MORE

Executive Summary On July 8, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule addressing many potential modifications to the Stark Law (“Proposed Rule”),1 as well as separate guidance for physician-owned hospitals relating to the required Annual Ownership/Investment Report (“Reporting Guidance”).2  The Proposed Rule, if implemented as currently proposed, would update... READ MORE

Overview On July 8, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule pertaining to payment policies under the Physician Fee Schedule for CY 2016 (“Proposed Rule”).1 In addition to changes to the Physician Fee Schedule and other Medicare Part B payment policies, the Proposed Rule addresses modifications to the Stark... READ MORE

Overview On July 8, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule pertaining to payment policies under the Physician Fee Schedule for CY 2016 (“Proposed Rule”).1  In addition to changes to the Physician Fee Schedule and other Medicare Part B payment policies, the Proposed Rule also addressed many potential... READ MORE

Executive Summary On June 30, 2015, the Food and Drug Administration (“FDA”) issued draft guidance delaying the enforcement of key track and trace requirements of the Drug Supply Chain Security Act (“DSCSA”) for Dispensers1 until November 1, 2015 (“Guidance”).  Specifically, the FDA indicated that it does not intend to take action against Dispensers that... READ MORE

Under the final Code Section 501(r) regulations, as published in December 2014, a hospital facility’s financial assistance policy (“FAP”) must include a list of all providers of emergency and medically necessary care in the facility and must identify which are and are not covered by the FAP. In the newly published Notice 2015-46 (“Notice”), the... READ MORE

In an eagerly awaited, mightily impactful health care decision, King v. Burwell (U.S. No. 14-114 June 25, 2015), the Supreme Court of the United States (the “Supreme Court”) held that individuals eligible for tax credits to subsidize their purchase of health insurance in health care marketplaces created by the Affordable Care Act (“ACA”) may... READ MORE