Articles and Blogs

Executive Summary April 16, 2015 is National Healthcare Decisions Day. The goal of the day is to encourage Americans to think and talk about their health care goals and communicate their health care decisions by executing advance health care directives. 

Conservatives Make Late Push for Fully Paid SGR Deal Conservative senators are pushing to strike a provision in legislation to repeal the Sustainable Growth Rate (“SGR”) and pressure Congress to pay for the remaining $141 billion of the doc fix deal’s cost later this year.  Sens. Ben Sasse (R-NE), Jeff Sessions (R-AL), Mike Lee (R-UT),…Read More

Despite Lack of Senate Action, Medicare Physicians Won’t Face Pay Cut Late last week, the Senate recessed for its Easter break without taking action on legislation to permanently repeal and replace the Sustainable Growth Rate (“SGR”).  The House had passed the Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2), known as the SGR replacement, on…Read More

In Bank of New York Mellon v. Carson, 2015 WI 2015 (Feb. 17, 2015), the Wisconsin Supreme Court held that Wis. Stat. § 846.102, the statute governing the foreclosure of abandoned properties, authorizes circuit courts to compel mortgagees to bring an abandoned property to sale after the expiration of the five-week redemption period. The court…Read More

On March 13, 2015, the Medicare Payment Advisory Commission (“MedPAC”) released its annual report to Congress (“Report”). The Report contains MedPAC’s recommendation for improvements to Medicare payments to providers as well as recommendations on controls to help combat fraud and waste. As usual, MedPAC has concerns about home health and hospice and makes a number…Read More

On February 25, 2015, we reported  the U.S. Department of Labor (“DOL”) had announced a Final Rule to update existing FMLA regulations, which would provide eligible employees in same-sex marriages the same rights and protections under the FMLA as employees in opposite-sex marriages currently enjoy. The Final Rule was scheduled to take effect March 27,…Read More

On Tuesday, March 31, the Supreme Court of the United States issued an opinion denying individual Medicaid providers the ability to sue state officials in court for failing to reimburse them appropriately under §1396a(30)(A) of the Medicaid Act. In a 5-4 decision, the Court rejected the providers’ argument that the Act or the Constitution provided…Read More

Executive Summary On Tuesday, March 24, 2015, representatives from the Government Accountability Office (“GAO”), the Department of Health and Human Services Office of the Inspector General (“OIG”) and the Health Resources Services Administration (“HRSA”) testified regarding the drug discount program authorized by Section 340B of the Public Health Services Act (“340B Program”).  The testimony took…Read More

Inpatient-Only Procedures. Earlier this month, CMS quietly revised its billing policy related to inpatient-only procedures.  In a Transmittal issued on March 13, CMS included inpatient-only procedures provided in the outpatient setting as preadmission services subject to the Three-Day (One-Day) Payment Window Rule.  Effective April 1, hospitals can bill Medicare for inpatient-only procedures provided to an…Read More

Subject to various exceptions, a covered skilled nursing facility (“SNF”) stay must initiate within 30 days of a qualifying hospital stay.  In some cases where it is medically predictable that an individual will require a covered level of SNF care within a determinable time frame, that same individual may also have a need for a covered level…Read More