Articles and Blogs

Early this month, a Treasury official announced in a blog that the Obama Administration would delay implementation of certain health care coverage reporting requirements and the “pay or play” shared responsibility payments under the Affordable Care Act (“ACA”).  (See July 3, 2013 Hall Render blog post “Obama Administration Takes Its Foot off the Gas Pedal, Announces…Read More

CMS Releases Hospital Outpatient Rule On July 8, CMS published a proposed rule for the hospital outpatient and ambulatory surgical center payment systems and the electronic health records incentive program.  Under the proposed rule, total hospital outpatient payments under Medicare are projected to increase next year by nearly $4.4 billion, or 9.5% over 2013. 

On July 11, 2013, the Department of Health and Human Services (“HHS”) announced that it reached a settlement with a large national health insurance company (“Company”) stemming from alleged violations under the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy Rule. The HHS Office for Civil Rights (“OCR”) initiated its investigation after the Company filed…Read More

On June 6, 2013, the United States District Court of the Northern District of Indiana granted a motion for summary judgment for an Indiana hospital, holding the Indiana Peer Review Statute grants immunity in the earliest stages of an initial (or “pre-peer review”) investigation and during communications regarding physician credentialing. This case provides reassurance to…Read More

On July 10, 2013, the Wisconsin Supreme Court released its decision in Dane County v. Sheila W., 2013 WI 63 (per curiam), in which it affirmed the Court of Appeals’ dismissal of the case because the issues were rendered moot, or no longer in controversy, by the expiration of the underlying order appointing a temporary guardian…Read More

Late in the day on July 2, 2013, the Obama Administration announced via two blog posts that it will provide a one-year delay to the implementation of significant aspects of the Affordable Care Act (“ACA”) affecting employers.  This delay applies to: (1) the ACA’s new health care coverage reporting requirements applicable to employers, insurers and/or…Read More

On June 27, 2013, CMS released the proposed home health prospective payment rule (the “PPS Rule”) for calendar year 2014.  While refinements to the ICD-9-CM and discussions of ICD-10-CM implementation are of interest, the most notable change to the PPS Rule for 2014 is CMS’s long-awaited proposal for rebasing home health payments.  Once it is…Read More

In Indiana, a spouse can be obligated to pay for medical care received by the other spouse under the doctrine of necessaries. The modern version of the doctrine of necessaries imposes limited secondary liability upon the financially superior spouse when the other spouse is unable to pay for his or her necessary expenses using their…Read More

Providers Discuss RAC Program with Senate Finance Committee On Tuesday, June 25, the Senate Finance Committee held an oversight hearing on the Recovery Audit Contractors (“RAC”) program.  With two of the three witnesses representing provider groups, the bulk of the hearing focused on the compliance burdens accompanying RAC document requests and reviews.

On July 1, 2013, a new law comes into effect in Indiana that dramatically impacts an individual’s ability to provide greater certainty with respect to his or her end of life care planning and offers a new advance directive to individuals. Indiana recently enacted a law, Indiana Code Section 16-36-6, that establishes the use of…Read More