Articles and Blogs

As of late, commercial payors appear to be increasing the number of audits they are conducting focused on medical necessity. The commercial payor audit notices and overpayment demands appear to rely on some of the same techniques as those of government auditors, such as data analysis for outliers, predictive modeling and extrapolation, to scrutinize claims…Read More

Too often employers have reservations or concerns about employees’ misuse of FMLA leave and fail to act in response. A recent holding in a federal court case serves as a reminder to employers that if they have an “honest belief” that employee FMLA misuse has occurred, they may have a certain defense to retaliation claims…Read More

House Leadership Releases Outline for ACA Reform On February 16, Republican House leadership circulated a 16-page blueprint for ACA reform. The  proposal, which was not in legislative form, is intended to provide an outline of what the House will attempt to pass by their informal deadline of April 6. The measure’s highlights include: reforming Medicaid…Read More

As a result of legislation passed by the Indiana General Assembly in 2014, two important property tax dates changed for 2016 and going forward. January 1 is the assessment  date of real and personal property for taxes due and payable in the following year (see, IC 6-1.1-2-1.5). Historically, March 1 was the assessment date for…Read More

Title VIII: What Does It Mean for States This is the first article in a series on the 21st Century Cures Act (the “Act”), which was signed into law on December 13, 2016, and includes significant mental health reforms and funding to help combat mental health and substance abuse disorders, in addition to other changes….Read More

The Wisconsin Medical Examining Board (“MEB”), on January 27, 2017, filed with the Wisconsin Legislature a proposed administrative rule governing the practice of medicine using telemedicine (“Med 24”). Upon the completion of the legislative review and approval process and final publication by the MEB, Med 24 will delineate standards that apply to a physician providing…Read More

In continuation of its active beginning to the new year, the Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced on February 1, 2017, that it imposed a HIPAA civil money penalty of $3.2 million on a Texas medical center (“Medical Center”). OCR issued the penalty for wrongful disclosure of unsecured…Read More

Price Confirmation Expected to Expedite ACA Replacement Process After hours of contentious debate, the Senate confirmed Rep. Tom Price, M.D. (R-GA) as the next Secretary of Health and Human Services in the early morning hours of February 10. One of Price’s first tasks will be to release the ACA replacement proposal promised by President Trump….Read More

On February 3, 2017, President Donald Trump signed a presidential memorandum addressing the Department of Labor’s (“DOL”) so-called fiduciary rule that will go into effect on April 10, 2017.  Early media reports on February 2 and 3 indicated that the president would delay or suspend the rule. However, he did neither. The presidential memorandum directs the…Read More

On January 3, 2017, Michigan Lieutenant Governor Brian Calley signed Senate Bills 1015 and 1016 (collectively, the “Act”), which require applied behavior analysts to be licensed similarly to other professionals in the medical field. In an analysis of the Act, the Michigan Senate Fiscal Agency reasoned that early intervention using evidence-based treatment has shown to…Read More