Articles and Blogs

NATIONAL 4 Health Systems Join Provider-Created Data Collective to Improve Care Amazon wants to add payer strategy muscle Full 4th Circuit to tackle Medicaid fraud standard under False Claims Act House passes reform to Medicare Advantage prior authorizations On Average, Two Nurses Are Assaulted Every Hour, New Press Ganey Analysis Finds Physician compensation trends... READ MORE

On September 2, 2022, the Office of the Inspector General (“OIG”) published a study assessing potential Medicare program integrity risks related to the proliferation of telehealth services during the first year of the COVID-19 pandemic. OIG identified 1,714 providers with billing practices deemed “high risk” to the Medicare program. These providers billed approximately 500,000... READ MORE

Recently, Simon et al, v. Healthsouth of Sarasota Limited Partnership, et al, the Eleventh Circuit held that for a plaintiff to qualify as engaging in “protected activity,” the plaintiff must demonstrate that they had both a subjectively reasonable belief of fraud and an objectively reasonable belief of fraud. Background The plaintiff in this action... READ MORE

Wellstar Atlanta Medical Center made a decision to close its doors effective November 1, 2022. The hospital, which incurred a $107 million loss last year, said it had been battling decreased revenue and increased staff and supply costs. The 460-bed hospital is currently one of two Level 1 Trauma Centers in Atlanta. A Federal Reserve... READ MORE

The leading driver of large employer health care costs are cancer, musculoskeletal conditions and cardiovascular disease according to a new survey of large employers across the country. Employers cover 82% of employee health care costs and health insurance costs increased 8.2% last year for large employers. The Economist released its list of the Best... READ MORE

On July 26, 2022, the Centers for Medicaid and Medicare (“CMS”) published the 2023 Hospital Outpatient Prospective Payment System (OOPS) and Ambulatory Surgery Center Payment System Proposed Rule. The proposed rule includes a new exception to the prohibition on physician self-referral (“Stark Law”) and would allow for physicians to have ownership or investment interests... READ MORE

Amazon Is Flexing Given the number of boxes we see on porches these days, it’s fair to say we are all familiar with the hallmarks of Amazon’s core business – low price, fast delivery, wide selection and convenience powered by technology. Could these same value propositions translate into a radically reformed primary care delivery... READ MORE

On August 26, 2022, the U.S. Departments of Health and Human Services, Labor and the Treasury (collectively, the “Departments”) published their first final rule (“Final Rule”) implementing certain requirements of the No Surprises Act. This third round of rulemaking is narrow in scope and generally: (1) Responds to stakeholder comments related to the federal... READ MORE

The Plaintiff, an information technology support specialist employed through a staffing agency, was employed on-site at an Assembly Plant. In April 2016, the Plaintiff complained to his staffing agency supervisor that he believed there was an issue with asbestos insulation in one of the work areas at the Assembly Plant. The Plaintiff e-mailed photographs... READ MORE

The United States Department of Health and Human Services Office for Civil Rights (“OCR”) announced a $300,640 settlement and corrective action plan with a dermatology provider over the improper disposal of protected health information (“PHI”). Background In May of 2021, the dermatology provider reported a breach to OCR when empty specimen containers with PHI on... READ MORE