Articles and Blogs

Hospital organizations that are tax exempt pursuant to Code Section 501(c)(3) can face significant penalties for failures to comply with Code Section 501(r) and the related final regulations.  Fortunately, in drafting the final regulations, the IRS and Treasury Department acknowledged that even the most diligent hospital organizations may experience unintentional failures due to the... READ MORE

On March 20, 2015, Governor John Hickenlooper signed House Bill 15-1029 into law, expanding coverage for telehealth by requiring health insurers to provide reimbursement for telehealth services at the same level as in-person services in urban as well as rural areas beginning in 2017.  Previously, Colorado law only required reimbursement for telehealth services provided... READ MORE

Executive Summary April 16, 2015 is National Healthcare Decisions Day. The goal of the day is to encourage Americans to think and talk about their health care goals and communicate their health care decisions by executing advance health care directives.  READ MORE

Executive Summary On Tuesday, March 24, 2015, representatives from the Government Accountability Office (“GAO”), the Department of Health and Human Services Office of the Inspector General (“OIG”) and the Health Resources Services Administration (“HRSA”) testified regarding the drug discount program authorized by Section 340B of the Public Health Services Act (“340B Program”).  The testimony... READ MORE

Inpatient-Only Procedures. Earlier this month, CMS quietly revised its billing policy related to inpatient-only procedures.  In a Transmittal issued on March 13, CMS included inpatient-only procedures provided in the outpatient setting as preadmission services subject to the Three-Day (One-Day) Payment Window Rule.  Effective April 1, hospitals can bill Medicare for inpatient-only procedures provided to... READ MORE

Summary of the Bill The United States House of Representatives overwhelmingly approved a measure this week to repeal the Sustainable Grow Rate (“SGR”), which has been used to determine Medicare physician payment rates for more than a decade.  The SGR was established as part of the Balanced Budget Act of 1997 as a method... READ MORE

In January, HHS Secretary Sylvia Burwell announced that HHS is accelerating Medicare’s transition to “alternative payment models.”  HHS’s goal is to shift 30 percent of all Medicare provider payments to alternative payment models by 2016 and for 50 percent of all Medicare payments to be in alternative payment models by 2018.  These goals, according to HHS, will... READ MORE

With the last Sustainable Growth Rate (“SGR”) “patch” set to expire on March 31, 2015, lawmakers on Capitol Hill must soon decide whether to pass another “patch” or to finally tackle the issue of permanent SGR repeal and replacement. Just last week, House Majority Leader Kevin McCarthy (R-CA) and House Ways and Means Committee... READ MORE

On March 9, 2015, Wisconsin became the 25th state to enact Right to Work legislation with Governor Scott Walker signing Senate Bill No. 44 into law.Wisconsin’s Right to Work law “prohibits a person from requiring, as a condition of obtaining or continuing employment, an individual to refrain or resign from membership in a labor organization, to become... READ MORE

Employers that sponsor retirement and health plans subject to the Employee Retirement Income Security Act (“ERISA”) face significant potential fiduciary liability under the law. However, many employers have little or no training for their executives and staff on discharging those fiduciary responsibilities so as to limit that liability. Training can be costly and difficult... READ MORE