Articles and Blogs

Overview In recent years, the Centers for Medicare & Medicaid Services (“CMS”) has been committed to enforcing the requirement that hospitals must be “primarily engaged” in providing inpatient services to be qualified as a hospital under the Social Security Act and thus eligible to participate in Medicare.  This enforcement trend has resulted in the termination…Read More

We’ve blogged in the past about employees caught sleeping on the job. Most employers would say that an employee who is caught sleeping on the job will usually end up getting fired, and that is usually fine! However, where that employee suffers from a disability or a serious health condition, an employer will need to…Read More

Energy and Commerce Committee Republicans Question Medicaid’s Use of Provider Taxes On February 18, House Energy and Commerce Subcommittee on Health Chairman Joe Pitts (R-PA) and Vice Chairman Brett Guthrie (R-KY) sent a letter to CMS regarding the lack of oversight in how state Medicaid programs use provider taxes to pay for their expenditures. Pitts…Read More

Starting at the beginning of 2016, the Equal Employment Opportunity Commission (“EEOC”) has changed its procedures when it comes to employer position statements submitted in response to charges of discrimination. Now, the EEOC will release complete employer position statements and attachments to any charging party and their attorney who request release. In the past, the charging…Read More

The Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), signed by President Obama in April of 2015, enacted legislation that will significantly impact provider reimbursement. MACRA repealed the Sustainable Growth Rate (“SGR”) formula and implemented: (i) scheduled updates to the Medicare Physician Fee Schedule (“MPFS”) including a 0.5 percent positive annual update beginning July…Read More

On July 11, 2013, the Wisconsin Supreme Court (“Court”) released its decision in Outagamie County v. Melanie L., reversing the decision of the Wisconsin Court of Appeals which affirmed the circuit court’s extension of an involuntary medication order.  The full text of the opinion can be found at (http://www.wicourts.gov/sc/opinion/DisplayDocument.pdf?content=pdf&seqNo=99311). Procedural Posture The case involved review…Read More

Executive Summary On February 9, 2016, the Substance Abuse and Mental Health Services Administration (“SAMHSA”) issued proposed rules to substantially revise its Confidentiality of Alcohol and Drug Abuse Patient Records regulations (“Proposed Rules”)1.  The last substantive update to these regulations occurred in 1987, nearly 30 years ago, which was before the enactment of the Health…Read More

CMS Releases Core Measure Sets On February 16, CMS and America’s Health Insurance Plans (“AHIP”) released seven sets of clinical quality measures as part of the Core Quality Measures Collaborative (“Collaborative”) of health care system participants. The guiding principles used by the Collaborative in creating the measure sets are that they be meaningful to consumers,…Read More

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinions 15-16 and 15-17 approving two financial assistance programs offered by nonprofit, tax-exempt, charitable organizations. Based on the structure of each program, OIG concluded that the arrangements would not constitute grounds for the imposition of civil monetary penalties or result…Read More

In 2010, the False Claims Act (“FCA”) was extensively amended to limit the public disclosure bar and to expand the ability of whistleblowers to qualify as “original sources” in qui tam litigation. This month, the Fourth Circuit Court of Appeals took an in-depth look at both provisions, in the case US ex rel. Moore & Co. v…Read More