Articles and Blogs

On November 1, 2016, the Centers for Medicare & Medicaid Services (“CMS”) issued its long-awaited final rule for the CY 2017 Hospital Outpatient Prospective Payment System (“Final Rule”). Among many other changes, CMS finalized its implementation of Section 603 of the Bipartisan Budget Act of 2015 (“Section 603”), which excludes many off-campus services from being…Read More

On October 24, the Department of Justice (“DOJ”) announced a $145 million False Claims Act settlement with a national skilled nursing facility provider that operates more than 200 skilled nursing facilities (the “Company”) and its individual owner. The settlement has been touted as the largest in the DOJ’s history with a skilled nursing facility (“SNF”) chain. According to the…Read More

Have you ever asked or been asked, “What can I put away for retirement this year?” The answer could be different almost every year. Most of the limitations in the Internal Revenue Code are indexed with inflation.  They increase many years but not all. The IRS and Social Security Administration have released the 2017 adjusted…Read More

On October 20, 2016, the Federal Trade Commission (“FTC”) and the Antitrust Division of the Department of Justice (“DOJ”) released joint guidance for human resources (“HR”) professionals and others involved in hiring and compensation decisions. The joint guidance outlines how the federal antitrust laws apply to the employment arena and also warns employers that the…Read More

In light of the Supreme Court’s recent decision in Universal Health Services v. Escobar, the Seventh Circuit revisited its prior ruling in United States ex rel. Nelson v. Sanford-Brown, Ltd, a case alleging that a college receiving federal subsidies violated the False Claims Act (“FCA”) by maintaining discriminatory recruiting and retention practices. The Seventh Circuit…Read More

In United States of America and the State of Florida, ex rel. Bingham v. HCA, Inc., the employee of a medical office building management firm filed suit against a national health care system in the U.S. District Court for the Southern District of Florida. The lawsuit included allegations relating to one of the defendant’s hospitals…Read More

Health care providers subject to the Stark Law and the Anti-Kickback Statute can face significant penalties for non-compliant arrangements. In the event that a provider discovers a potentially non-compliant arrangement, it may elect to disclose the arrangement to government officials in an effort to limit its liability. Potential Stark Law violations are often disclosed to…Read More

The Eighth Circuit Court of Appeals yesterday applied the materiality standard enunciated by the Supreme Court in Universal Health Services, Inc. v. United States ex rel. Escobar to a False Claims Act (“FCA”) case alleging fraudulent inducement. In United States ex rel. Miller v. Weston Educational Inc., d/b/a Heritage College, two whistleblowers alleged Heritage College altered grade and attendance records…Read More

The Court of Appeals for the Seventh Circuit will rehear a once-dismissed Title VII sexual orientation case, possibly signaling that the Seventh Circuit will change course and read Title VII as prohibiting sexual orientation discrimination. Background Title VII prohibits employment discrimination based on race, color, religion, sex and national origin; the prohibitions apply to all…Read More

This is another article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for States and Long-Term Care Facilities (“Final Regulations”) by the Centers for Medicare & Medicaid Services (“CMS”). Background On September 28, 2016, CMS released a complete overhaul of Part 483…Read More