Articles and Blogs

This week, CMS released the proposed Medicare Physician Fee Schedule Rule for CY 2016 (“Proposed Rule”).  In an effort to ensure that billing physicians/practitioners have a “personal role in, and responsibility for, furnishing services for which they are billing and receiving payment as an incident to their own professional services,” CMS proposed to remove the…Read More

Proposed Physician Fee Schedule Contains Significant Stark Law Revisions Late on July 8, the Centers for Medicare & Medicaid Services (“CMS”) published the Physician Fee Schedule for 2016 in the form of a proposed rule.  While the measure would make changes to the Physician Fee Schedule and other Medicare Part B payment policies, it also…Read More

“Incident to” billing is a significant False Claims Act risk for Medicare and Medicaid providers. A new proposed rule will change how physicians and physician practices are supposed to bill for services provided in their offices. CMS Proposal to Limit Incident to Billing This week CMS released the proposed Medicare Physician Fee Schedule Rule for…Read More

Overview On July 8, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule pertaining to payment policies under the Physician Fee Schedule for CY 2016 (“Proposed Rule”).1  In addition to changes to the Physician Fee Schedule and other Medicare Part B payment policies, the Proposed Rule also addressed many potential modifications…Read More

A recent court decision had highlighted two issues on the cutting edge of health care and False Claims Act (“FCA”) law. Both address what happens in the transition from health care advice to health care litigation. The first is the application of the attorney client privilege and the advice of counsel defense. The second is the…Read More

Executive Summary On June 30, 2015, the Food and Drug Administration (“FDA”) issued draft guidance delaying the enforcement of key track and trace requirements of the Drug Supply Chain Security Act (“DSCSA”) for Dispensers1 until November 1, 2015 (“Guidance”).  Specifically, the FDA indicated that it does not intend to take action against Dispensers that accept…Read More

On June 26, 2015, the Supreme Court of the United States handed down a landmark opinion in Obergefell v. Hodges, holding that same-sex couples may exercise the fundamental right to marry in all 50 states and that there is no lawful basis for a state to refuse to recognize a lawful same-sex marriage performed in…Read More

The U.S. Department of Labor (“DOL”) has officially proposed a significant increase to the salary requirement governing which executive, administrative and professional employees are entitled to the Fair Labor Standards Act’s minimum wage and overtime pay. In order to be exempt from minimum wage and overtime, an employee must be a bona fide executive, administrative or…Read More

Under the final Code Section 501(r) regulations, as published in December 2014, a hospital facility’s financial assistance policy (“FAP”) must include a list of all providers of emergency and medically necessary care in the facility and must identify which are and are not covered by the FAP. In the newly published Notice 2015-46 (“Notice”), the IRS…Read More

Supreme Court Rules for White House in ACA Subsidies Case On June 25, the U.S. Supreme Court ruled that the Affordable Care Act’s (“ACA”) health insurance subsidies can continue to flow to residents of states that are using HealthCare.gov.  The 6-3 decision in King v. Burwell preserves the structure of the ACA and marks the…Read More