Articles and Blogs

On December 7, 2016, the Department of Health and Human Services Office of Inspector General (“OIG”) published a final rule (“Final Rule”) clarifying several exceptions to the Civil Monetary Penalties law (“CMP”) dealing with beneficiary inducements. OIG has finalized all of the beneficiary inducement CMP exceptions proposed in the October 2014 proposed rule (“Proposed Rule”).1…Read More

Effective today, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a Policy Statement regarding gifts of nominal value to Medicare and Medicaid Beneficiaries (“Beneficiary(ies)”). In its statement, OIG increased the dollar amount of the “nominal value” exception to the Civil Monetary Penalties law (“CMP”) from $10 per item or service…Read More

On November 22, 2016, the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) reported its thirteenth settlement for 2016 related to a malware infection at a workstation that infiltrated the entire system of a covered entity that had elected to be a hybrid entity. The incident resulted in the impermissible disclosure…Read More

Trump Nominates HHS Secretary and CMS Administrator On November 29, President-elect Donald Trump announced his choice to lead the top federal health care agencies.  Trump nominated Rep. Tom Price, MD, (R-GA) to head HHS and health care consultant Seema Verma as the next CMS Administrator.  Dr. Price currently serves as the House Budget Committee Chairman…Read More

In recent years, increasing numbers of municipalities have asked health care entities that might otherwise be exempt from property taxes to enter into payment in lieu of taxes agreements (“PILOTs”). While most prevalent in the Northeast Region of the country, PILOTs are expanding in popularity nationwide as municipalities seek to expand their budgets by taxing…Read More

Under the federal Stark Law, hospitals may provide non-monetary compensation to physicians up to an aggregate amount of $398 for calendar year 2017. The dollar limit for “medical staff incidental benefits” (e.g., meals, parking and other items or incidental services that are used on the hospital’s campus) is less than $33 per occurrence. Other requirements of the…Read More

Driven in part by retroactive fees imposed upon pharmacies by pharmacy benefit managers (“PBMs”) and compounded by recent high profile cases of significant price increases for relatively common drugs,1 both retail and institutional pharmacies have continued to push for enhanced prescription drug pricing transparency. Recent state and federal legislation, as well as lawsuits filed by coalitions of…Read More

Yesterday, the First Circuit Court of Appeals issued a new opinion in Universal Health Services, Inc. v. United States ex rel. Escobar.  Applying the materiality test enunciated by the Supreme Court in June, the First Circuit reaffirmed its previous decision that the whistleblowers’ complaint sufficiently stated a claim under the False Claims Act (“FCA”) to…Read More

DOL’s Final Rule Blocked On November 22, 2016, a federal district judge in Texas issued a nationwide preliminary injunction preventing the U.S. Department of Labor (“DOL”) from implementing and enforcing its final rule establishing new salary thresholds for millions of traditionally exempt white collar employees.  As we reported in July, that new rule, which was…Read More

On November 21, the EEOC announced the release of its updated Enforcement Guidance on National Origin Discrimination (“Guidance”), representing the first official guidance on this topic in 14 years. The new Guidance replaces the EEOC Compliance Manual, Volume II, Section 13: National Origin Discrimination, previously published in 2002. The Guidance may be accessed here. The EEOC…Read More