Articles and Blogs

At a recent roundtable, the Senate Special Committee on Aging criticized the Medicare claims review process, suggesting it unfairly burdened providers and failed to improve program integrity. The senators blamed the current payment system for the auditors and suggested moving from an arrangement that currently incentivizes recovery of overpayments to one that incentivizes reducing improper…Read More

On July 14, 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued the Outpatient Prospective Payment System Proposed Rule for Calendar Year 2015 (“Proposed Rule”), but the Proposed Rule also addresses issues unrelated to OPPS.  Among other changes, the Proposed Rule eliminates the physician certification statement requirement for most inpatient stays paid under Medicare…Read More

S.2501 Eliminates Readmission Penalties Related to Patient Socioeconomic Status On June 19, 2014, U.S. Senators Manchin, Wicker, Kirk and Nelson introduced Senate Bill 2501 entitled The Hospital Readmissions Program Accuracy and Accountability Act of 2014 (“S.2501”) to ensure that hospitals experiencing excessive readmissions are not financially penalized for serving low-income patients.  S.2501 was referred to…Read More

Hall Render Protests Possible Changes to Medicare Group Appeals Process On July 9, Hall Render attorneys John Williams and Elizabeth Elias met with staff at the Senate Finance and House Ways and Means committees to raise awareness of a provision buried in the FY 2015 Hospital IPPS proposed rule that could make it more difficult…Read More

On July 1, 2014, the Centers for Medicare and Medicaid Services (“CMS”) published the home health prospective payment rule (the “Proposed Regulations”) for calendar year 2015.  Importantly, the Proposed Regulations contain the biggest change to the “face-to-face” requirement to date. This article will explain proposed changes to this requirement, as well as discuss other highlights…Read More

The Food and Drug Administration (the “FDA” or “agency”) recently released a draft guidance document (“Draft Guidance”) in which the agency proposes to stop enforcing the regulatory requirements applicable to several types of devices and software that transfer, store, convert, format and display medical data.  This Draft Guidance, if finalized, will apply to Medical Image…Read More

This Health Care Tax News article is Part IV in a series discussing the proposed regulations under Code Section 501(r).  Part I provided a general overview of why Hospital Organizations should move forward to comply with the proposed regulations, Part II provides an overview of preparing for a Community Health Needs Assessment and Part III reviews the…Read More

This Health Care Tax News article is Part III in a series discussing the proposed regulations under Code Section 501(r).  Part I provided a general overview of why Hospital Organizations should move forward to comply with the proposed regulations and Part II provides an overview of preparing for a Community Health Needs Assessment. The financial…Read More

The Fifth Circuit rejected the government’s attempt to expand the FCA’s reach to include non-government funds overseen by a non-governmental entity simply because the government had the ability to exert a modicum of control over the entity.

A private employer planning on downsizing or implementing a reduction in force (“RIF”) has many items on its checklist to consider.  The employer that intends to offer severance pay benefits must understand how Employee Retirement Income Security Act of 1974 (“ERISA”) may impact the RIF.  Severance pay arrangements fall into one of three classifications under ERISA…Read More