Articles and Blogs

House Passes ACA Fix On Friday, the House passed a bill (H.R. 3350) that would allow health insurers to sell individual health policies in 2014 that were in effect as of January 1, 2013, even if they don’t meet minimum coverage requirements set by the Affordable Care Act (“ACA”). Passage of the bill, comes a day after…Read More

NLRB Administrative Law Judge Says Ban Is Lawful An Administrative Law Judge (“ALJ”) has put at least a temporary stop to what many have seen as a trend to expand employee rights under the National Labor Relations Act.  The NLRB General Counsel’s complaint filed against an employer, who maintained a policy prohibiting the recording of…Read More

The Health and Human Services Office of Inspector General (“OIG”) remains concerned with potential prescription drug abuse. The Centers for Disease Control and Prevention estimates that approximately seven million people in the U.S. misused prescription drugs in 20101 and has characterized prescription drug abuse as an epidemic. Due to concerns of prescription drug abuse and…Read More

Background The Centers for Medicare & Medicaid Services (“CMS”) recently issued two advisory opinions regarding arrangements where for-profit clinical laboratories would provide certain devices without charge to physicians, including physicians that made referrals to the entities.1 These advisory opinions were the first issued by CMS in over two years. Though the arrangements discussed in the…Read More

This month, the Department of Health and Human Services (“HHS”) announced it is redefining the 2014 certification criteria for Certified Electronic Health Record Technology (“CEHRT”) for the Meaningful Use Incentive Program. The previous 2011 CEHRT criteria required that eligible providers have complete CEHRT capable of meeting all certification criteria for an inpatient or ambulatory setting….Read More

OMB Reviewing Final Rules on Anti-Kickback Statute, Stark Law Protections for EHR Deals Earlier this week, CMS and HHS sent two final rules to the White House Office of Management and Budget (“OMB”) that would extend safe harbor protections for arrangements that provide electronic health record (“EHR”) products to physicians until the end of 2016….Read More

On October 30, two Medicare Administrative Contractors, Palmetto GBA and CGS, announced their intent to focus on certain hospice claims for patients located in Skilled Nursing Facilities (“SNFs”). Palmetto GBA announced that it has identified top providers with a large number of beneficiaries receiving hospice services in SNFs, and it intends to initiate a service-specific…Read More

The Internal Revenue Service (“IRS”) is warning consumers about a telephone scam that targets taxpayers, and specifically immigrants, throughout the country.  During the scam phone call, victims are threatened with arrest, deportation or suspension of a business or driver’s license if they do not promptly pay money allegedly owed to the IRS through a prepaid…Read More

As part of the 2014 inpatient prospective payment system final rule, CMS formulated a “2-midnight presumption” and a “2-midnight benchmark” (collectively the “2-Midnight Rule”) to guide admitting practitioners and review contractors on when it is appropriate to admit a patient as a hospital inpatient.  In the last few days, CMS posted a series of documents…Read More

Recently, the North Dakota Supreme Court found a son liable for his parents’ $104,276 unpaid nursing home bill under North Dakota’s filial responsibility law.