Articles and Blogs

On August 19, 2013, the Centers for Medicare and Medicaid Services (“CMS”) published in the Federal Register the 2014 acute care hospital and long-term care hospital inpatient prospective payment system final rule (“Final Rule”) effective on October 1, 2013.  As part of the Final Rule, CMS formulated a “2-midnight presumption” and a “2-midnight benchmark” (collectively…Read More

EEOC and NLRB Are Idle With the failure of Congress last night to fund the federal government, several of the agencies responsible for the investigation and enforcement of federal labor and employment laws have gone idle. Except for life threatening emergencies, property preservation and actions to accept filings to avoid statutes of limitations, most other services,…Read More

Executive Summary On September 23, 2013, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule (“Proposed Rule”) enumerating the details of the pending prospective payment system (“PPS”) for Federally Qualified Health Centers (“FQHCs”).  This Proposed Rule was developed in response to a mandate established in the Patient Protection and Affordable Care Act…Read More

State Attorneys General Criticize EEOC Guidance on Criminal Background Checks Ever since the EEOC issued its “updated” Enforcement Guidance on the use of criminal background checks in April 2012, employers have struggled to understand exactly what could be asked and used in screening candidates for employment.  (See our article “Arrest and Conviction Records – EEOC…Read More

On August 19, 2013, the Centers for Medicare and Medicaid Services (“CMS”) published the acute care hospital and long-term care hospital inpatient prospective payment system final rule for fiscal year 2014 (“Final Rule”).  Under one new provision in the Final Rule, if a Medicare Part A claim for inpatient hospital services is denied because the…Read More

House Votes to Defund ACA The U.S. House voted this morning (230-189) to attach a permanent defunding of the health care law to a continuing resolution (“CR”) spending bill.  The spending bill (H.J. Res. 59) would fund the federal government for a limited time and also block all federal funds for the 2010 Affordable Care…Read More

On September 13, 2013, the Centers for Medicare & Medicaid Services (“CMS”) issued a Medical Learning Network Letter (“Letter”) addressing new guidance for meeting the annual reporting requirements for physician-owned hospitals.1  The Letter affects hospitals with physician ownership and/or investors wishing to rely on the whole hospital or rural provider exception to the Stark Law…Read More

HIPAA Violation Was a Pretext A hospital employee’s violation of patient privacy as protected by HIPAA is a serious matter.  An intentional violation can and should lead to discipline up to and including discharge.  But a case that was decided by the NLRB is an object lesson for health care employers on what is and what…Read More

The Eighth Circuit’s recent decision adds to a growing body of case law rejecting FCA relator allegations of regulatory noncompliance as the basis for FCA claims. It reinforces the position that when health care providers reasonably interpret complicated and confusing billing guidelines and regulations, they cannot violate the FCA.

 House Releases Plan to Extend Federal Funding to December 15 On September 10, the House Appropriations Committee released the text of a stopgap funding bill that would extend this year’s spending level for federal programs through December 15. The extension would give Congress time to work out a larger fiscal package before the end of the…Read More