Articles and Blogs

Executive Summary On March 26, 2013, the Office of Inspector General (“OIG”) released a special fraud alert (“Alert”) regarding physician-owned distributorships (“PODs”). PODs are entities that sell, or arrange for the sale of, implantable medical devices that may be used by the physician-owners or others for procedures on patients in hospitals and ambulatory surgery centers (“ASCs”). The…Read More

What Employers Need to Know about the Fair Credit Reporting Act If you use a third party to conduct background checks, then you have probably heard of the Fair Credit Reporting Act (“FCRA”).  The FCRA is a federal law that imposes several very specific obligations on employers who use third parties to conduct background and…Read More

Congress Avoids Government Shutdown, Continues Work on Budget On March 20, the U.S. Senate approved a $984 billion continuing resolution (“CR”) that will fund the government through September 30, 2013, the end of the 2013 Fiscal Year.  The bill is similar to the bill that passed the House earlier in the week and is expected…Read More

U.S. Customs and Border Protection (“CBP”) announced today that it has submitted a rule to the Federal Register that will automate Form I-94 Arrival/Departure Record. Automation of the current paper-based process will streamline the admissions protocol for individuals lawfully visiting the United States. The automation means that affected visitors will no longer need to fill…Read More

During yesterday’s Open Door Forum, Jeanette Kranacs, the Director of the Division of Institutional Post-Acute Care for the Centers for Medicare and Medicaid Services (“CMS”) commented that CMS will not be issuing instructions to surveyors on evaluating compliance and ethics programs until the regulations have been promulgated.  CMS was required to have final regulations and various tools in place as of March…Read More

On March 19, 2013, the Centers for Medicare & Medicaid Services’ (“CMS”) Final Rule regarding notification and relocation requirements for closing a long-term care (“LTC”) facility was published in the Federal Register. Under the new requirements, 60 days prior to the closure of an LTC facility, the administrator must provide written notice to the following:

The Medicare Payment Advisory Commission’s (“MedPAC”) recent Report to Congress included a chapter dedicated to skilled nursing facilities (“SNFs”), which MedPAC reports received $31 billion in Medicare reimbursement in 2011.  Recently, SNFs have been under pressure from repeated reimbursement cuts; however, MedPAC’s analysis states that SNF reimbursement is adequate.  

In Laska v. General Casualty Company of Wisconsin, No. 2010AP2410, slip op. (WI App Mar. 14, 2013), the Wisconsin Court of Appeals held that charitable hospitals may, instead of billing Medicare for treatment of a patient, pursue payment by filing a statutory lien against any tort claims and any settlement or judgment resulting from the…Read More

Executive Summary On March 13, 2013, CMS concurrently released an immediately effective administrative ruling (“CMS Ruling 1455-R” or “Ruling”) and a proposed rule (“Proposed Rule”) reversing CMS policy precluding hospitals from billing on an outpatient basis for inpatient services denied payment on grounds the services should have been provided on an outpatient basis.  Under the…Read More

The Medicare Payment Advisory Commission’s (“MedPAC”) March 25th Report to Congress outlines inefficiencies they believe exist in the post-acute world and lead to excessive Medicare payments to providers. MedPAC recommendations include Congress evaluate post-acute provider reimbursement and encourage use of the lowest cost mix of services necessary to achieve the best outcomes.