Articles and Blogs

After informal communications with the Centers for Medicare & Medicaid Services (“CMS”) Central Office, it appears that edits that impact Critical Access Hospital (“CAH”) Method II claims have been overreaching. Specifically, reason codes 17713, 17714, 17716 and 17717 should not be applying to the facility charges on CAH Method II claims. These reason codes should…Read More

On February 22, 2018, U.S. Citizenship and Immigration Services (“USCIS”) published a policy memorandum clarifying existing regulatory requirements relating to H-1B petitions filed for workers who will be employed at one or more third-party worksites. Effective immediately, the new guidance aligns with President Trump’s Buy American and Hire American Executive Order and the directive to…Read More

On Tuesday, February 27, 2018, Attorney General Jeff Sessions announced the creation of the U.S. Department of Justice (“DOJ”) Prescription Interdiction & Litigation (“PIL”) Task Force in an ongoing effort to curb the country’s current prescription opioid crisis. According to DOJ’s press release, the PIL Task Force will “aggressively deploy and coordinate all available criminal…Read More

On February 23, 2018, the Centers for Medicare & Medicaid Services (“CMS”) issued guidance that may result in fewer denials of claims made by Inpatient Rehabilitation Facilities (“IRFs”) for services (“Guidance”). Based on the Guidance, beginning March 23, 2018, Medicare contractors cannot make claim denials exclusively on the basis of a failure to meet the…Read More

More and more, we receive questions from clients about their obligations to accommodate pregnant employees in the workplace. Regardless of whether or not the pregnant employee is disabled as defined by the Americans with Disabilities Act (“ADA”), employers must consider whether pregnancy discrimination laws require an accommodation, including whether pregnant employees are entitled to a…Read More

Focus in Washington Shifts to the Opioid Crisis The federal response to the opioid epidemic is accelerating as both the Trump administration and members of Congress announced new steps this week to tackle the issue from both a law enforcement and public health standpoint. On March 1, the White House held a summit on the…Read More

NATIONAL CMS moves forward with new voluntary bundled payment AMA seeks MAT changes to combat opioid crisis 35 hospital groups urge court to halt $1.6B in Medicare payment cuts 20 states file lawsuit against federal government calling the Affordable Care Act unconstitutional Moody’s warns hospitals to beware of payer growth strategies on margins, bargaining power…Read More

Proposed Rule Released for Short-Term Health Insurance Plans On February 20, the Department of Health and Human Services issued a proposed rule to extend the availability of a lower cost, more narrowly tailored form of insurance called short-term limited duration health insurance plans. This would allow consumers to buy short-term health plans of up to…Read More

NATIONAL EHR interoperability, connectivity a big challenge around globe new study finds AHA Asks CMS to Delay New Bundled Payment Model Anthem amends ER policy but stands behind decision not to pay for avoidable emergency care Albertsons, Rite Aid deal creates U.S. supermarket and health care giant Health experts suggest signing bank loans at hospitals…Read More

In February of 2017, the U.S. District Court for the Eastern District of Texas ordered a Texas hospital (the “Hospital”) “to immediately submit to the National Practitioners Data Bank a Void Report” regarding a physician whose clinical privileges were restricted by the Hospital’s medical executive committee, resulting in a report to the National Practitioner Data Bank…Read More