Articles and Blogs

Draft House Republican ACA Replacement Bill Leaked With Congress set to return to Washington on February 27, a draft of the House legislation to repeal parts of the Affordable Care Act (“ACA”) using the procedure known as budget reconciliation was posted by the Politico news site on Friday. The 106-page measure would eliminate key aspects of…Read More

A Seventh Circuit panel including Judge Posner affirmed summary judgment for AMS Mechanical System, Inc., the employer in an ADA case, despite some facts adverse to AMS. The panel accepted the employee’s version of the facts insofar as they were supported by his testimony: the employee, a welder named Gogos, left work early for a…Read More

OFCCP mailed letters last week to over 350 separate companies notifying them that they are on the agency’s “to be audited” list. Known as Corporate Scheduling Announcement Letters (“CSALs”), the letters are provided as a courtesy in the hope that the company will be better prepared for the compliance review. Importantly, the notices are addressed to the…Read More

Legislation introduced by Representative Rob Nosse on January 9, 2017 – House Bill 2664 – provides for the establishment of extended stay centers in Oregon. Specifically, the legislation authorizes the operation of extended stay centers,  specifies criteria for their licensure and requires the Oregon Health Authority to adopt rules to implement the licensing program. If…Read More

The Cures Act addresses certain electronic health record (“EHR”) difficulties faced by physicians who practice primarily in ambulatory surgery centers (“ASCs”). Section 16003 explicitly excludes physicians who furnish substantially all of their Medicare services at ASCs from the penalties imposed under various programs for failure to adopt a certified EHR. Under the current Medicare Meaningful…Read More

Under the Breach Notification Rule, HIPAA covered entities are required to submit reports of certain breaches of unsecured protected health information (“PHI”) affecting fewer than 500 individuals to the Office for Civil Rights (“OCR”) on an annual basis. Covered entities must submit their breaches electronically through OCR’s breach notification web page, which can be found…Read More

Recently, the U.S. Court of Appeals for the District of Columbia Circuit ruled against two Michigan hospitals, holding that their written agreements regarding their medical residents’ off-site training programs failed to comply with the Centers for Medicare & Medicaid Services’ (“CMS”) requirements for graduate medical education (“GME”) reimbursement. While the laws applicable in this case…Read More

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