Articles and Blogs

Executive Summary The Department of Health & Human Services Office of Inspector General (“OIG”) recently released a Supplemental Special Advisory Bulletin (“Supplemental Bulletin”) on the potential fraud and abuse implications of prescription drug patient assistance programs (“PAPs”).  The Bulletin updates OIG’s 2005 Special Advisory Bulletin (“2005 Bulletin”) on PAPs for Medicare Part D enrollees and…Read More

The Eleventh Circuit ruled last week that a conviction for criminal health care fraud against the owner of nursing home facilities was constitutional. The Court held that the government’s “worthless service” theory of fraudulent billing was not unconstitutional. In United States vs. George Houser, the government alleged that the defendant conspired to defraud the government…Read More

OCR Chief Regional Counsel for Region V, Jerome Meites, has warned that enforcement activity over the past year will “pale in comparison” to the next 12 months. While Mr. Meites was not specific as to this pronouncement being limited to Region V, it may be important to note that Region V covers Illinois, Indiana, Michigan,…Read More

Hall Render Coalition Weighs in on Expansion of Telemedicine and Telehealth Technology On June 16, a coalition, created by Hall Render, of hospitals and health systems sent a letter to the House Energy and Commerce Committee in response to a request for public comment on what Congress can do to expand the use of telemedicine…Read More

Executive Summary On May 23, 2014, the Centers for Medicare and Medicaid Services (“CMS”) published a final rule addressing various changes to the Medicare Advantage (Part C) and Medicare Prescription Drug Benefit (Part D) Programs (“Final Rule”). Among other changes, the Final Rule enumerated new Medicare enrollment or opt-out requirements for prescribers of Part D covered drugs,…Read More

Another Case of Reconsideration for the NLRB Recently we wrote about the NLRB’s decision protecting profanity directed toward a boss during a heated argument in the bosses office.  That decision came after a federal appeals court told the NLRB to reconsider its earlier decision providing protection to the boss-cussing worker.  The NLRB did reconsider but…Read More

Executive Summary CMS issued a proposed rule that, if finalized, may make it harder for hospitals to file cost report-based appeals or possibly reimbursement-related appeals from the Federal Register.  Hall Render has already submitted comments to CMS on behalf of its client hospitals, but hospitals are welcomed and encouraged to submit their own comments to CMS…Read More

Recently, the Sixth Circuit Court of Appeals (which has jurisdiction over courts in Kentucky, Michigan, Ohio and Tennessee) held that allowing a disabled employee to telecommute could be a reasonable accommodation under the Americans with Disabilities Act.

On Wednesday, May 21, 2014, in a letter to American Hospital Association President Richard Umbdenstock, Health and Human Services (“HHS”) Secretary Kathleen Sebelius confirmed that private, not-for-profit foundations can use properly structured premium support programs to make premium payments to Qualified Health Plans (“QHPs”) on behalf of QHP enrollees.1  In this latest guidance on the issue…Read More

The Impact of Cantor’s Loss on Health Legislation On Tuesday, June 10, shockwaves rippled through Washington as House Majority Leader Eric Cantor (R-VA) was defeated in a Congressional primary.  The result led to the announcement of his immediate resignation as the House Majority Leader effective July 31.  Tuesday’s stunning results could impact the direction and…Read More