Articles and Blogs

An Important Update on the 2-Midnight Rule CMS continues to provide frequent updates on its “2-midnight rule,” which establishes a benchmark and a presumption that an inpatient admission is generally appropriate and payable under Medicare Part A if the admitting physician expects a Medicare beneficiary to require a stay that crosses at least 2 midnights, and…Read More

SGR Repeal Passes House but DOA in Senate On Friday, the House voted to permanently repeal the Sustainable Growth Rate (“SGR”) formula.  The Republican proposal (H.R. 4015), which was supported by 12 Democrats, pays for replacement of the Medicare physician payment formula by delaying enforcement of the Affordable Care Act’s individual mandate penalties for five…Read More

On March 7, 2014, the U.S. Department of Health and Human Services (“HHS”) announced that it reached a settlement with a county in Washington state (the “County”) stemming from alleged violations of the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy, Security and Breach Notification Rules.  The settlement comes after the County reported a breach…Read More

HHS Releases FY 2015 Budget On March 4, HHS released its fiscal year 2015 budget as part of the Obama Administration’s overall budget request to Congress.  The HHS portion of the request is $77.1 billion, which is $3 billion less than what was requested last year. 

The OFCCP recently published regulations that significantly revise the affirmative action requirements for qualified individuals with disabilities (“IWDs”) and protected veterans.  The new regulations, which apply to covered federal contractors, become effective on March 24, 2014. 

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 14-01 (“Advisory Opinion”) approving an arrangement between a placement agency and several senior residential communities that allows the senior communities to compensate the placement agency for the referral of new residents to a participating community (the “Proposed Arrangement”).1 The OIG believed…Read More

President Obama introduced his fiscal year (“FY”) 2015 budget yesterday, and there are many proposed cuts to post-acute care providers.  Some of the highlights include a number of bundled payment initiatives, a $100 co-pay for home health patients not discharged from a hospital and re-admission penalties for skilled nursing facilities (“SNFs”) with high hospital re-admissions….Read More

Overview Since the U.S. Department of Health and Human Services (“HHS”) announced on October 30, 2013 that it does not consider Qualified Health Plans (“QHPs”) purchased on a federal or state marketplace established under the Affordable Care Act (“Marketplaces”) to be “Federal health care programs,”1 there has been significant debate in the health care industry…Read More

As the EEOC continues to focus on the use of unpaid leave beyond policy limits as a potential reasonable accommodation and employees continue to request leave extensions, I am frequently asked: “How do I know when enough is enough?”  Unfortunately, the determination of an undue hardship is a factual issue, and the only way to…Read More

CMS Releases DSH Allotments On February 27, CMS posted its fiscal year 2014 preliminary funding allotments to states for Medicaid Disproportionate Share Hospitals (“DSHs”).  DSH funds were slated to be cut this year under the Affordable Act (“ACA”), but the cuts were delayed in December when Congress passed the Bipartisan Budget Act of 2013.