Articles and Blogs

CMS Issues Final Regulations for Stark Law Modifications Late on October 30, CMS issued the CY 2016 Physician Payment final rule. The comprehensive rule provides clarification and establishes two new exceptions to the Stark Law in regards to the Self-Referral Disclosure Protocol, which should ease the compliance burden for hospitals. The compliance revisions in the…Read More

Last week, CMS promulgated a final rule that creates a new “timeshare license” exception to the Stark Law. A few days ago, we reported on this and other changes here but believe that the timeshare topic merits additional discussion. The new exception was created due to the difficulty hospitals and physicians experience when trying to…Read More

Executive Summary On November 2, 2015, the Office of Inspector General (“OIG”) published its Work Plan for Fiscal Year (“FY”) 2016 (“Plan”).  The Plan, which is published annually and describes OIG’s new and ongoing audit and enforcement priorities for the upcoming year, is helpful in identifying corporate compliance risk areas and providing focus for providers’…Read More

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 15-13,1 which provided a favorable opinion of a health system’s (“Requestor’s”) proposed arrangement to offer free transportation services to patients in a rural community (“Arrangement”). OIG stated that it would not impose sanctions against Requestor for violations of the Civil…Read More

A trend in real estate-related False Claims Act litigation should put hospitals and other health care providers on notice that relators are looking for big paydays for non-compliant real estate arrangements. The relators described in this article are real estate professionals who are bringing technically complex claims with little to no institutional knowledge of the…Read More

Last week, Congress passed the Bipartisan Budget Act of 2015 (“Budget”), and President Obama signed the Budget into law on November 2, 2015.  Among many other changes, the Budget includes an impending exclusion on hospital coverage for off-campus hospital outpatient departments that first bill for services on or after November 2, 2015.  Even though site-neutral payment proposals…Read More

On Thursday, October 29, 2015, CMS issued the pre-publication copy of the final home health PPS rule for CY 2016 (“the Rule”).  The Rule adopts most of the proposals from July but makes a few key changes. Rates, Payments and Home Health Spending Although CMS makes several key changes to the final rule, CMS projects…Read More

On October 30, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released the CY 2016 final rule for revisions to Payment Policies under the Physician Fee Schedule (“Final Rule”) following the proposed rule published in July 2015 (“Proposed Rule”).1  Among other Stark Law revisions, the Final Rule updates the Stark Law regulations for physician-owned…Read More

Overview On October 30, 2015, the Centers for Medicare & Medicaid Services (“CMS”) issued the final rule (“Final Rule”) in follow up to the proposed rule published in July 2015 (“Proposed Rule”).1  It is anticipated that the final regulations will be published in the Federal Register on November 16, 2015.  The Final Rule establishes two new exceptions…Read More

Over the years, we have “followed” the NLRB’s analysis of employer social medial policies. You can catch up on this evolution by accessing our past HR Insights blogs. Employee’s “Like” of Another’s Facebook Rant Is Protected The evolution continues. On October 21, in an unpublished opinion, the Second Circuit (with district courts in Connecticut, New…Read More