Articles and Blogs

House Passes Reconciliation Bill On October 23, the House moved forward a reconciliation bill that repeals major provisions of the Affordable Care Act (“ACA”) and defunds Planned Parenthood for one year.  Reconciliation, which is a complicated budget procedure that allows the Senate to pass legislation with a simple majority, repeals the individual and employer mandates…Read More

Menorah Medical Center believed it was complying with the Kansas State peer review statute when it required peer review investigations be kept confidential, when it told employees that they were not allowed to bring a union representative to a peer review committee meeting and when it refused to provide peer review committee documents to the…Read More

Executive Summary The Centers for Medicare & Medicaid Services (“CMS”) has engaged StrategicHealthSolutions, LLC (“Strategic”) as a Supplemental Medical Review Contractor (“SMRC”) to conduct post-payment claim reviews of selected Part A and Part B claims for blepharoplasty and other eyelid procedures. 

Executive Summary On October 1, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule that would overhaul the clinical diagnostic lab test (“CDLT”) payment system by linking the clinical lab fee schedule (“CLFS”) to private payor payment rates (“Proposed Rule”).  Under the Proposed Rule, each applicable laboratory will be required to…Read More

OMB Begins Review of 2016 Medicare Payment Rules On October 13, the Office of Management and Budget (“OMB”) began its review of four separate 2016 Medicare payment rules. Each rule is required to be released by November 1. The first three rules under review would revise Medicare Part A payment rates for hospital outpatient departments and…Read More

McCarthy Quits Race for House Speaker On October 8, House Majority Leader Kevin McCarthy (R-CA) withdrew his name from consideration for the Speaker of the House of Representatives moments before House Republicans were expected to formally nominate him. Retiring House Speaker John Boehner (R-OH) will remain speaker until the House votes to elect a new…Read More

For years, companies in the United States have relied on a Safe Harbor to the EU Directives (the stringent privacy requirements imposed by the European Union) to qualify for the ability to transfer protected data between EU countries and the United States. Today, however, the European Court of Justice ruled that the agreement between the…Read More

Senate Finance Committee Holds Hearing on Improper Payments On October 1, the Senate Finance Committee held a hearing to examine how improper health care payments, including overpayments and underpayments, are problematic to the federal government.  More specifically, those stemming from Medicare, Medicaid and the Earned Income Tax Credit, which account for over 76 percent of all…Read More

In SSM Health Care of Wisconsin, Inc. (“SSM“) v. City of Fitchburg (“City”), the Wisconsin Court of Appeals affirmed a circuit court’s grant of summary judgment that held that some of SSM’s personal property in a sleep center and a renal center is exempt from property taxes under Wis. Stat. § 70.11(4m)(a). Wisconsin Statute §…Read More

The National Labor Relations Board (“NLRB”) continues its efforts to find employee status for individuals historically considered to be independent contractors. In Sisters’ Camelot, a decision issued on September 25, 2015, the Board reversed an administrative law judge’s finding that canvassers hired by a non-profit organization for fundraising purposes were independent contractors. What Were the…Read More