Articles and Blogs

On August 22, 2016, the Department of Health and Human Services Office of the Inspector General (“OIG”) released additional guidance (“IRO Guidance”) on relevant principles that should be used to assess the independence of Independent Review Organizations (“IROs”) performing reviews required as a condition of Corporate Integrity Agreements (“CIAs”). This most recent update reflects the…Read More

On May 12, 2016, the Occupational Safety and Health Administration (“OSHA”) issued a final rule (“Final Rule”) amending 29 C.F.R. § 1904.35 to improve tracking of workplace injuries and illnesses. The Final Rule seeks to increase the accuracy of reports by prohibiting retaliation and adverse action against employees that inappropriately deters or discourages employees from reporting work-related…Read More

Update: The IRS has modified the effective date of Rev. Proc. 2016-44 to extend the transition period by 6 months. The revision allows an issuer to apply the safe harbors in Rev. Proc. 97-13, as modified and amplified, to a management contract entered into before August 18, 2017 and that is not materially modified or…Read More

Enrollment will soon be closing for the Centers for Medicare and Medicaid Services’ (“CMS”) new Comprehensive Primary Care Plus (“CPC+”) payment model. Building on the success of the Comprehensive Primary Care model, CPC+ aims to strengthen primary care by creating new incentives for providers to invest in resources to improve the quality and efficiency of…Read More

On August 23, 2016, eight plaintiffs jointly sued the federal Department of Health and Human Services (“HHS”) disputing the definition of the term “sex” in recent HHS regulations implementing the Affordable Care Act’s (“ACA”) non-discrimination provisions. A link to the Complaint is here.  The HHS regulations, which, among other things, protect patients who receive federally…Read More

Late last year, Rep. Edward Canfield (R-Sebewaing) and Sen. Peter MacGregor (R-Rockford) proposed legislation that would amend: (1) the Public Health Code to prohibit the Department of Licensing and Regulatory Affairs or a professional board from requiring a physician to maintain a national or regional certification and prohibits hospitals from denying admitting privileges on that…Read More

On August 18, 2016, Judge Sean F. Cox in the U.S. District Court for the Eastern District of Michigan ruled that a funeral home business did not violate the law when it terminated a transgender employee who wished to dress as a woman. This decision is significant because it is one of the first cases…Read More

As has been widely reported, on July 21, 2016, the Antitrust Division of the DOJ filed two separate complaints to block both Anthem’s acquisition of Cigna and Aetna’s acquisition of Humana, alleging both acquisitions violate the federal antitrust laws. In both cases, the parties have decided to fight the DOJ’s challenge. Originally, both cases were scheduled…Read More

On August 4, the Office for Civil Rights (“OCR”) announced a $5.55 million settlement with the largest fully integrated health care system in Illinois. The settlement is the largest HIPAA settlement ever by a single entity and follows two recent settlements with university health systems in Oregon and Mississippi that were $2.7 million and $2.75…Read More

On August 5, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued an Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) adopting the updated labor market area delineations based on the 2010 census. The updated labor market area delineations became effective October 1, 2014. The Final Rule effectively caused, among other changes, several…Read More