Articles and Blogs

As lawmakers return for the second session of the 114th Congress, physician-owned hospitals (“POHs”) across the country are closely watching the status of the Promoting Access, Competition, and Equity Act of 2015 (H.R. 2513) authored by Rep. Sam Johnson (R-TX). Also referred to as the PACE Act of 2015, H.R. 2513 would change existing law…Read More

This week, the Centers for Medicare & Medicaid Services (“CMS”) posted a much-anticipated FAQ related to off-campus provider-based departments and use of the “PO” modifier. Reporting of the modifier was voluntary in CY 2015 but mandatory beginning in CY 2016. CMS clarified that the “PO” modifier is only required for items and services provided in…Read More

Executive Summary On December 30, 2015, the Pennsylvania Commonwealth Court struck down a provision of the Older Adults Protective Services Act that barred individuals convicted of certain crimes, such as murder and rape, from working in nursing homes or other health care facilities serving the elderly. In Tyrone Peake et. al. v. Commonwealth of Pennsylvania,…Read More

Senate Takes New Approach to Medical Innovation Bills With the House of Representatives in recess, action in Washington this week was in the Senate. On January 19, the Senate Health, Education, Labor and Pensions (“HELP”) Committee announced it will hold the first of three executive sessions to review the Innovations for Healthier Americans Act, the…Read More

The Department of Health and Human Services Office of Inspector General (“OIG”) is currently soliciting proposals and recommendations for additional Anti-Kickback Statute safe harbors and OIG Special Fraud Alerts.1 The Health Insurance Portability and Accountability Act requires an annual notice period to solicit these comments in order to identify and protect non-abusive arrangements from the Anti-Kickback…Read More

On January 20, 2016, the Wage and Hour Division of the U.S. Department of Labor (“DOL”) released Administrator’s Interpretation an  concerning joint employment under the Fair Labor Standards Act (“FLSA”). The interpretation identifies common scenarios in which two or more employers jointly employ an employee and are thus jointly and severally liable for compliance. It provides a…Read More

Executive Summary Riding the wave of an unprecedented winning streak and continuing its trend of aggressive antitrust enforcement in the hospital merger arena, the FTC recently challenged three proposed hospital mergers – one in West Virginia, one in Pennsylvania and one in Chicago, Illinois – in a two-month period.  In each challenge, the FTC alleged…Read More

MedPAC Releases Payment Recommendations for Hospital Services On January 14, the Medicare Payment Advisory Commission (“MedPAC”) released its 2017 payment recommendations to Congress for hospital inpatient and outpatient services. The commission’s recommendations would increase total spending on hospital services by 1.65 percent. MedPAC voted to cut Medicare payments by 10 percent to safety net hospitals…Read More

In an opinion filed January 5, 2016, the Illinois Fourth District Appellate Court ruled that the Illinois statute authorizing hospital property tax exemptions is unconstitutional. Until formal guidance is released from the Illinois Department of Revenue, this decision will likely create a period of uncertainty for hospitals that have secured or that are seeking hospital-based…Read More

What Happened? Earlier this year, the U.S. Department of Labor (“DOL”) issued a Wage and Hour Division Administrator’s Interpretation that reasserts a broad definition of employee such that employers will rarely find that the individuals who work for them can be classified as independent contractors. This interpretation, although not having the effect of law, does indicate the…Read More