Articles and Blogs

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

In an eagerly awaited, mightily impactful health care decision, King v. Burwell (U.S. No. 14-114 June 25, 2015), the Supreme Court of the United States (the “Supreme Court”) held that individuals eligible for tax credits to subsidize their purchase of health insurance in health care marketplaces created by the Affordable Care Act (“ACA”) may receive…Read More

On June 22, 2015, a jury awarded two employees of a grocery warehouse $2.2 million in what may be the first case to go to a jury under the Genetic Information Nondiscrimination Act (“GINA”). It serves as a heads-up for employers. A Cheek Swab to Match DNA of the Culprit In this case, the employer was…Read More

MedPAC Releases June Report to Congress On June 15, the Medicare Payment Advisory Commission (“MedPAC”) released its June 2015 Report to Congress. The MedPAC report makes recommendations regarding a new payment system for hospitals to the Congressional committees with jurisdiction over the Medicare program. The report compares the cost that Medicare pays for short inpatient…Read More

Overview and Executive Summary On Wednesday, June 17, 2015, the Department of Health Resources and Services Administration (“HRSA”) released an important 340B Drug Discount Program (“340B Program”) proposed rule (“Proposed Rule”) that, if finalized, would result in the first formal regulations governing the 340B Program. Prior 340B Program regulations related to orphan drugs were finalized on…Read More

The Seventh Circuit Court of Appeals just issued its decision in US ex rel. Nelson v. Sanford-Brown, Ltd.. This decision is sure to find its way into briefs and arguments for years to come in False Claims Act (“FCA”) cases. It touched upon many of the different ways a qui tam relator can fail to bring an adequate…Read More

On June 15, the Supreme Court of Colorado in Coats v. Dish Network ruled in a 5-1 opinion that Dish Network did not violate Colorado state law when it terminated Coats, a former employee and also a medical marijuana patient, for failing a drug test despite that the failure was caused by off-the-clock medical marijuana use….Read More

Health-Related Bills Tee-Up for Possible Senate Finance Markup The Senate Finance Committee is expected to mark up a number of health care bills that address issues regarding observation status notification and anti-fraud procedures. Legislation that could potentially be marked up by the committee include: the Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (S….Read More

Overview Recently, the Department of Health & Human Services Office of the Inspector General (“OIG”) issued Advisory Opinion 15-06 addressing a 501(c)(3) charitable organization’s proposed arrangement to provide financial assistance to individuals with certain chronic diseases.  Using donated funds, the organization would assist qualifying individuals with health insurance costs, drug/device therapy costs and other incidental…Read More