Articles and Blogs

Executive Summary On March 10, 2014, CMS announced in a letter to Congress that it plans to withdraw certain controversial provisions of its omnibus-type proposed rule on policy and technical changes to the Medicare Advantage Program (“Part C”) and Medicare Prescription Drug Benefit Program (“Part D”).  Following the proposed rule’s publication on January 10, 2014, CMS... READ MORE

An Important Update on the 2-Midnight Rule CMS continues to provide frequent updates on its “2-midnight rule,” which establishes a benchmark and a presumption that an inpatient admission is generally appropriate and payable under Medicare Part A if the admitting physician expects a Medicare beneficiary to require a stay that crosses at least 2 midnights,... READ MORE

On March 7, 2014, the U.S. Department of Health and Human Services (“HHS”) announced that it reached a settlement with a county in Washington state (the “County”) stemming from alleged violations of the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy, Security and Breach Notification Rules.  The settlement comes after the County reported a... READ MORE

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 14-01 (“Advisory Opinion”) approving an arrangement between a placement agency and several senior residential communities that allows the senior communities to compensate the placement agency for the referral of new residents to a participating community (the “Proposed Arrangement”).1 The OIG... READ MORE

Overview Since the U.S. Department of Health and Human Services (“HHS”) announced on October 30, 2013 that it does not consider Qualified Health Plans (“QHPs”) purchased on a federal or state marketplace established under the Affordable Care Act (“Marketplaces”) to be “Federal health care programs,”1 there has been significant debate in the health care... READ MORE

With the October 1, 2014 deadline for ICD-10 compliance looming, many providers might have been holding out in hope that the implementation would again be delayed.  However, Marilyn Tavenner, the administrator of CMS, stated today that there will be no further delays for ICD-10 and the system will go live October 1. READ MORE

The Office for Civil Rights (“OCR”) published a Spanish version of its model Notice of Privacy Practices (“NPP”) on February 19, 2014.  The English version of the OCR model NPP was published in September 2013 and comes in four formats (layered, booklet, full page and text) and two versions (one for health care providers and one... READ MORE

The Wisconsin Medical Examining Board (“MEB”) recently approved significant changes to the regulations governing, among other things, the physician supervision requirements of physician assistants (“PAs”).  The modifications increase the number of on-duty PAs a physician can supervise at the same time and change the requirements for documenting the supervision.  The revised regulations also simplify... READ MORE

Executive Summary On January 31, 2014, the Department of Health and Human Services Office of Inspector General (“OIG”) released its Work Plan for Fiscal Year 2014 (“Plan”).  The Plan provides insight into the OIG’s potential audit and enforcement activities for the next fiscal year.  While the Plan addresses several different provider types, this article... READ MORE

2-Midnight Rule Enforcement Delayed Until October 1, 2014 On January 31, 2014, the Centers for Medicare and Medicaid Services (“CMS”) announced another delay in enforcement of the 2-Midnight Rule, now pushed back to October 1, 2014.  The delay provides additional time for CMS to educate hospitals on how to implement the 2-Midnight Rule, which has... READ MORE