Articles and Blogs

This Health Care Tax News article is Part I in a series discussing the proposed regulations under Code Section 501(r). Since the Affordable Care Act (“ACA”) imposed four significant new requirements on tax-exempt Hospital Organizations, the IRS has offered various forms of guidance for complying with the new law, including two detailed sets of proposed... READ MORE

On several occasions over the past year, the IRS has publicly expressed its intention to clear a significant backlog of exemption applications.  With its July 1 release of Form 1023-EZ, a shorter exemption application form for small nonprofits, the IRS took a significant step towards reducing this backlog. READ MORE

Executive Summary Health care providers can significantly manage the risk posed by retained overpayments under the False Claims Act (“FCA”) by requesting counsel to conduct appropriate compliance investigations rather than performing the investigations internally. READ MORE

Governor Scott Walker recently signed into law the HIPAA Harmonization – Mental Health Care Coordination Act (2013 WI Act 238, the “Act”).  The Act is intended to alleviate barriers to coordination of care for patients receiving mental health treatment by aligning aspects of Wisconsin’s mental health privacy laws with the Federal Health Insurance Portability... READ MORE

Yesterday, the D.C. Circuit issued a much-anticipated decision regarding whether or not internal compliance investigations were privileged. Two recent lower court decisions had ruled that such compliance investigations were not privileged because they were for business rather than legal purposes. The D.C. Circuit disagreed and found that such compliance investigations are for legal purposes... READ MORE

Executive Summary On June 25, 2014, the U.S. Department of Health and Human Services Office of the Inspector General (“OIG”) released a Special Fraud Alert (the “Alert”) addressing Laboratory Payments to Referring Physicians.  The Alert supplements previous guidance and is the latest in a series of advisories, dating back to 1994, discussing the fraud... READ MORE

Yesterday, the American Hospital Association (“AHA”) submitted comments to CMS regarding the proposed FY 2015 inpatient prospective payment system (“PPS”) rule.  Topics addressed by AHA include: READ MORE

Executive Summary The Department of Health & Human Services Office of Inspector General (“OIG”) recently released a Supplemental Special Advisory Bulletin (“Supplemental Bulletin”) on the potential fraud and abuse implications of prescription drug patient assistance programs (“PAPs”).  The Bulletin updates OIG’s 2005 Special Advisory Bulletin (“2005 Bulletin”) on PAPs for Medicare Part D enrollees... READ MORE

Executive Summary On May 23, 2014, the Centers for Medicare and Medicaid Services (“CMS”) published a final rule addressing various changes to the Medicare Advantage (Part C) and Medicare Prescription Drug Benefit (Part D) Programs (“Final Rule”). Among other changes, the Final Rule enumerated new Medicare enrollment or opt-out requirements for prescribers of Part D covered... READ MORE

Executive Summary CMS issued a proposed rule that, if finalized, may make it harder for hospitals to file cost report-based appeals or possibly reimbursement-related appeals from the Federal Register.  Hall Render has already submitted comments to CMS on behalf of its client hospitals, but hospitals are welcomed and encouraged to submit their own comments to... READ MORE