Articles and Blogs

On October 12, 2015, three Texas hospitals filed suit against the Department of Health and Human Services (“HHS”), the Secretary of HHS (“Secretary”) and the Centers for Medicare & Medicaid Services (“CMS”) seeking to reverse CMS’s decision to grant the request of a Texas physician-owned hospital (“POH”) to expand the hospital’s current facility by 100…Read More

Yesterday, the House passed a sweeping budget bill that impacts Medicare coverage of services provided in off-campus hospital departments.  Currently, Medicare pays for items and services provided in both on- and off-campus hospital outpatient departments as hospital services when those departments are in compliance with 42 CFR §413.65 (the Medicare “provider-based rule”).  With some limited…Read More

The National Labor Relations Board (“NLRB”) has reviewed a number of private employer rules restricting off-duty employees’ access to employer facilities. In some cases, the NLRB has held that the employer’s rule was unlawfully overbroad because it granted the employer too much discretion to determine the business reason for an employee’s access.  In other cases,…Read More

All Work and No Pay A recent provisionally approved settlement in a wage and hour class and collective action case serves as an important reminder for employers of the risks and potential costs of hiring interns to perform work without pay.  In Tart et al. v. Lions Gate Entertainment Corp. et al, two plaintiffs filed…Read More

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