Articles and Blogs

Recently, the Centers for Medicare & Medicaid Services (“CMS”) released the results of a study of hospice general inpatient care (“GIP”) based on an analysis of Medicare Part A hospice claims for beneficiaries who received GIP in 2011.  The intent was to identify suspected abuse of GIP in hospice inpatient facilities by hospice providers because this…Read More

The Centers for Medicare & Medicaid Services (“CMS”) recently released a Survey & Certification Letter acknowledging the change in nomenclature for the professionals working in Intermediate Care Facilities for Individuals with Intellectual Disabilities (“ICF/IID”).  Formally known as Qualified Mental Retardation Professionals (“QMRPs”), these professionals are now Qualified Intellectual Disabilities Professionals (“QIDPs”).  QIDPs are required to integrate, coordinate and monitor the treatment programs…Read More

Summary On Wednesday, May 1, 2013, the U.S. Department of Justice (“DOJ”) announced that it had reached a settlement with a two-hospital, Montana-based health system (“System”) arising from financial relationships between the System and a combination of 139 employed and independent physicians and physician groups.  Under the terms of the Settlement Agreement, the System agreed…Read More

The Centers for Medicare & Medicaid Services will publish the proposed fiscal year (“FY”) Medicare payment rate in the Federal Register later today.  Announced last week, the proposed rate includes a 2.3% market basket increase; however, a forecast error correction and other mandated adjustments will reduce the market basket increase to 1.4%.  This will still result in an estimated…Read More

False Claims Act defense attorneys have been warning government contractors, particularly Medicare and Medicaid providers, of increased risks and a reduced ability to defend against whistleblower complaints since the passage of the Fraud Enforcement Recovery Act of 2009 (“FERA”). The greatest risk comes from FERA’s addition of a new kind of reverse false claim: the…Read More

CMS Releases IPPS Proposed Rule for FY 2014 On April 26, CMS issued its Fiscal Year (“FY”) 2014 proposed rule for hospitals paid under the inpatient prospective payment system (“IPPS”).  The rule would update FY 2014 Medicare payment policies and rates for inpatient stays at general acute care and long-term care hospitals (“LTCHs”).

The graduate medical education (“GME”) landscape continues to evolve, even as the basic structure of Medicare GME reimbursement remains in place. Recently, noteworthy proposals and changes include proposed legislation that would provide for 15,000 new residency positions over five years to increase the number of residents in training and a change to the regulations that alters…Read More

For the past several years, the Internal Revenue Service (“IRS”) has been devoting considerable attention to worker classification issues involving the misclassification of employees as independent contractors.  These misclassifications are important to the IRS and the federal government because they often lead to underreporting and underpayment of taxes.  Traditionally, the IRS has sought to address…Read More

Confidentiality Requirements Challenged by the NLRB Last summer, the NLRB created another stir among private employers when it found that an employer’s form used during confidential investigations of workplace issues was unlawfully broad and interfered with employee rights.  We wrote about this development in our August 7, 2012 HR Insights article Confidential Investigations – Challenged…Read More

Treating Employees the Same – Always Required? Employers have always been advised to treat their employees the same, and if they don’t, it can be evidence of unlawful discrimination.  This issue came up in a recent case involving an employer that required a black employee who was involved in an altercation to go for a drug…Read More