Articles and Blogs

What Is the “Compendium of Priority Recommendations”? In March 2014, the Department of Health and Human Services Office of the Inspector General (“OIG”) published the 2014 “Compendium of Priority Recommendations” (“Compendium”), a compilation of 25 of its most significant open recommendations that, in OIG’s view, would best protect the integrity of HHS programs, if implemented….Read More

Ways and Means Announces Hearing on Hospital Issues On May 13, the House Ways and Means Subcommittee on Health announced it will hold a May 20 hearing on current hospital issues in the Medicare program.  According to the committee press release, the hearing will touch on all current issues relevant to hospitals in the Medicare…Read More

Executive Summary On May 2, 2014, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule (“Final Rule”) establishing a prospective payment system (“PPS”) for Federally Qualified Health Centers (“FQHCs”).  As a result of this rule, PPS reimbursement will be mandated for both FQHC “look-alikes” and Section 330 grant recipients effective for Medicare…Read More

Members of today’s workforce generally fall into one of three classifications: employers, employees and independent contractors. Recently, federal and state agencies have zeroed in on employee/independent contractor classifications and have increased their enforcement efforts as a way to increase agency revenue.  For example, the Government Accountability Office estimates that unpaid taxes stemming from employee misclassification…Read More

Yesterday, CMS posted the following update to its Inpatient Hospital Reviews page: 

On May 2, 2014, CMS published a final rule (“Final Rule”) amending the Clinical Laboratory Improvement Amendments of 1988 (“CLIA”) by fully implementing the Taking Essential Steps for Testing Act of 2012 (“TEST Act”) and establishing three categories of sanctions for proficiency testing referral (“PT referral”).

CMS Proposes Updating Hospice Payment Rates and Rules Changes On May 2, CMS issued a proposed rule that would update Medicare payment rates and the wage index for hospices serving Medicare beneficiaries.  As proposed, hospices would see an estimated 1.3% ($230 million) increase in their payments for FY 2015.  This increase is up from 1.0% in FY…Read More

According to a Federal Register notice published on May 5, physicians and teaching hospitals will soon be able to register with the Centers for Medicare and Medicaid Services (“CMS”) to receive notices from and access to CMS’s Open Payments database.  The Open Payments database will contain information about payments and other transfers of value that pharmaceutical…Read More

On May 8, 2014, the Department of Health and Human Services (“HHS”) announced that it had reached settlements with two health care organizations arising from alleged violations of the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy and Security Rules.  The settlements result from the organizations’ failure to secure thousands of patients’ electronic protected health…Read More

The application of the Medicare therapy caps has been revised many times over the past several years.  Most recently, Congress passed the Protecting Access to Medicare Act of 2014 (“Act”), which extends exceptions to the therapy caps and continues to apply services performed in outpatient hospital departments to the therapy caps until March 31, 2015.  In…Read More