Articles and Blogs

Providers and suppliers who continually submit noncompliant claims to Medicare may have their billing privileges revoked by the Centers for Medicare & Medicaid Services (“CMS”) according to a final rule recently published in the Federal Register (“Final Rule”).  The new regulation will appear at 42 CFR § 424.535(a)(8)(ii) and will be effective on February... READ MORE

On December 8, 2014, the Department of Health and Human Services (“HHS”) announced that it had reached a settlement with a nonprofit, community mental health care provider (“Provider”) arising out of alleged violations of the Security Rule under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). The settlement comes after an HHS... READ MORE

The IRS recently announced that the federal estate tax exemption amount will increase to $5,430,000 per person effective for individuals dying in or after 2015. The effects of this large exemption amount are addressed in this issue of Hall Render’s Estate Planning Insights audio series.  Please join Doug Long, Shareholder at Hall, Render, Killian,... READ MORE

The Indiana Court of Appeals recently issued an opinion in the case of Walgreen Co. vs Hinchy that could permanently alter the landscape for employer liability for HIPAA violations committed by employees.  Health care providers should be aware of this case and take actions to limit their exposure to this type of liability. Background... READ MORE

On Wednesday, November 19, the House Ways and Means Subcommittee on Health released draft legislation intended to improve hospital issues in the Medicare system.  The legislation addresses Medicare’s controversial “two-midnight” rule, short inpatient stays, outpatient observation status, the RAC audit program and the appeals process. While the legislative draft is subject to change following... READ MORE

Yesterday, November 20, the Department of Justice (“DOJ”) announced that the United States had recovered almost $6 billion from False Claims Act (“FCA”) litigation in 2014 – marking the first time the DOJ has recovered more than $5 billion in a single year.With these recoveries, the DOJ reached several milestones. Not only was this the largest... READ MORE

Yesterday, November 20, the Department of Justice (“DOJ”) announced that the United States had recovered almost $6 billion from False Claims Act (“FCA”) litigation in 2014, marking the first time the DOJ has recovered more than $5 billion in a single year. With these recoveries, the DOJ reached several milestones. Not only was this the... READ MORE

Under both the Stark Law and the Anti-Kickback Statute, space lease arrangements between referring physicians and hospitals are coming under growing scrutiny as the government’s concentration on eliminating Medicare and Medicaid fraud and overpayments increases. Safe harbors and exceptions with respect to lease arrangements exist under both statutes with one of the requirements being... READ MORE

On November 10, 2014, the Centers for Medicare & Medicaid Services (“CMS”) published the amended final rule regarding the expansion exception process for physician-owned hospitals (“2015 Final Rule”).  The 2015 Final Rule will take effect on January 1, 2015. Background Under the Affordable Care Act’s (“ACA’s”) amendments to the Stark Law, a physician-owned hospital... READ MORE

CMS recently released the display copy of the OPPS/ASC Final Rule for CY 2015 which finalizes proposals related to the reporting of services provided in hospital off-campus provider-based departments (“PBDs”).  The Final Rule can be found here. The changes require hospitals to identify services provided in off-campus PBDs through use of a new HCPCS... READ MORE