Articles and Blogs

Hospitals, Drug Industry Argue over Outpatient Drug Discounts On February 12, a coalition of pharmaceutical industry trade groups released a report on the 340B drug discount program.  The report questioned whether hospitals and other providers receiving the discount are doing enough to benefit patients and called for the drug discounts to be more narrowly focused.

This article is Part II in a series discussing the proposed rule to revise certain Conditions of Participation, Conditions for Coverage and regulations under the Clinical Laboratory Improvement Amendments of 1998 published on February 7, 2013. This second installment provides an overview of the changes applicable to hospitals. Part I addressed changes applicable to CLIA…Read More

Executive Summary On November 15, 2012, the Federal District Court of the District of Columbia issued a decision favorably impacting disproportionate share hospital (“DSH”) patient percentage (“DPP”) calculations.  If this decision is upheld on appeal, Medicare Advantage days may be removed from the SSI/Medicare Fraction (defined below) of the DPP calculation, thereby typically increasing the…Read More

On January 25, 2013, the Department of Health and Human Services (“HHS”) formally published its Omnibus Final Rule (“Final Rule”), which includes modifications to the HIPAA Privacy and Security Rules under the Health Information Technology for Economic and Clinical Health Act (“HITECH”) and the Genetic Information Nondiscrimination Act (“GINA”).  Because the Final Rule covers a…Read More

This article is Part I in a series discussing the proposed rule to revise certain Conditions of Participation, Conditions for Coverage and regulations under the Clinical Laboratory Improvement Amendments of 1998 published on February 7, 2013. This first installment provides an overview of the changes applicable to CLIA certified laboratories and several other changes applicable to…Read More

Can the False Claims Act be used by the government or whistleblowers in quality of care cases? The Department of Justice seems to think so, based in significant part on the retention of overpayments amendments to the FCA by FERA and the PPACA. For more please read Retention of Overpayments under FERA and the PPACA.If…Read More

Over the past five years, the FMLA has been amended on several occasions. While the FMLA was amended most recently in late 2009 under the National Defense Authorization Act (“NDAA”) and the Airline Flight Crew Technical Corrections Act (“AFCTCA”), the U.S. Department of Labor Wage and Hour Division delayed in issuing proposed regulations until February…Read More

On January 25, 2013, the Department of Health and Human Services (“HHS”) formally published its Omnibus Final Rule (“Final Rule”), which includes modifications to the HIPAA Privacy and Security Rules under the Health Information Technology for Economic and Clinical Health Act (“HITECH”) and the Genetic Information Nondiscrimination Act (“GINA”).  Because the Final Rule covers a…Read More

Confidentiality, Public Relations and Blogging Policies Held to Be Unlawful As we reported in our Employment Law News article in January, the NLRB has been very active in challenging any employer policy that could reasonably be understood by an employee to interfere with rights protected under the National Labor Relations Act (“NLRA”).  The NLRA protects…Read More

House Leaders Unveil SGR Repeal Framework The Chairmen with primary jurisdiction over the Medicare payment rates announced their plan to repeal and replace the current sustainable growth rate (“SGR”)  formula.  Ways and Means Chairman Camp (R-MI) and Energy and Commerce Chairman Upton (R-MI) announced they will work together to address the SGR.