Articles and Blogs

Executive Summary Under the federal Stark Law, hospitals may provide non-monetary compensation to physicians up to an aggregate amount of $392 for calendar year 2016, remaining the same from the previous calendar year.  The dollar limit for 2016 “medical staff incidental benefits” (e.g., meals, parking and other items or incidental services that are used on…Read More

Executive Summary Recently, the Department of Health and Human Services Office of Inspector General (“OIG”) released its Work Plan for Fiscal Year 2016 (“Plan”).  The Plan provides insight into OIG’s potential audit and enforcement activities for the next fiscal year.  While the Plan addresses several different provider types, this article addresses the Plan’s initiatives related…Read More

Senate Approves ACA Repeal On December 3, the Senate approved a bill (H.R. 3762) that repeals major provisions of the Affordable Care Act (“ACA”) by a vote of 52-47. The Senate used a budget rule known as reconciliation to pass the bill without the usual 60-vote threshold. The bill would repeal the ACA’s Medicaid expansion…Read More

Executive Summary On November 6, 2015, the FTC challenged the proposed acquisition of St. Mary’s Medical Center by Cabell Huntington Hospital in Huntington, West Virginia on the grounds that the proposed acquisition would create a “natural monopoly” and violate the federal antitrust laws. In its complaint, the FTC alleged that the proposed acquisition is likely…Read More

With the arrival of December, the deadline for full compliance with most aspects of Internal Revenue Code Section 501(r) is now just one month away for many tax-exempt hospital organizations. The specific deadlines will vary, however, based upon a hospital’s tax year and other factors. Hospital leadership should take this opportunity to confirm the applicable…Read More

New draft guidance (“Draft Guidance”) from the U.S. Food and Drug Administration (“FDA”) and the Office for Human Research Protections (“OHRP”) strongly highlights the need for Institutional Review Boards (“IRBs”) overseeing human subject research to keep detailed minutes of their meetings. Doing so, according to the Draft Guidance, will demonstrate to the IRBs’ research institutions…Read More

While hospitals have spent much of November 2015 grappling with the fallout of the Budget Act’s restriction on off-campus hospital outpatient departments (“HOPD”) (see Hall Render’s previous articles on the restriction, available here and here), another provider-based issue has quietly gone viral among interested parties, as well as being reported in local news outlets.  CMS…Read More

On November 16, 2015, the Centers for Medicare & Medicaid Services (“CMS”) issued a public inspection copy of the Final Rule related to the mandatory bundled payment program known as the Comprehensive Care for Joint Replacement (“CJR”) Model.  The CJR Model is a retrospective bundled payment program for lower extremity joint replacement (“LEJR”) procedures performed…Read More

Overview On October 30, 2015, the Centers for Medicare & Medicaid Services (“CMS”) announced the final rule (“Final Rule”)1 in follow up to the proposed rule published in July 2015 pertaining to payment policies under the Physician Fee Schedule for CY 2016 (“Proposed Rule”). In addition to changes to the Physician Fee Schedule and other updates…Read More

CMS Issues Final Joint Replacement Payment Rule On November 16, CMS released a final payment rule that creates bundled payments for hip and knee replacement surgery performed at most acute care hospitals in 67 geographic areas of the country. Under a model known as Comprehensive Care for Joint Replacement (“CJR”), a hospital where a joint…Read More