Articles and Blogs

Earlier this month, the Senate passed the National Defense Authorization bill (S. 1867), which contains a provision that exempts certain TRICARE network providers from jurisdiction by the Office of Federal Contract Compliance Programs (OFCCP).  If it becomes law, this provision will undo the OFCCP’s recent efforts to require health care providers that participate in TRICARE…Read More

The Internal Revenue Service (IRS) recently announced cost-of-living adjustments to the applicable dollar limits for various employer-sponsored retirement and welfare benefit plans for 2012.  For the first time since 2009, the IRS has increased many employee benefit plan limits.  As a result, employers should update payroll and plan administration systems accordingly and review plan-related documents…Read More

On December 2, 2011, the Centers for Medicare & Medicaid Services (“CMS”) issued a Program Memorandum (“Memorandum”) clarifying equipment maintenance requirements for hospitals.  More specifically, the Memorandum addresses:  (1) alternate equipment maintenance schedules that are permitted in some instances; and (2) alternative equipment maintenance methods that are not permitted. The Medicare condition of participation for…Read More

On November 30, 2011, Daniel R. Levinson, Inspector General, appeared before the Special Committee on Aging, and testified regarding the Office of Inspector General’s (OIG) findings pertaining to the use of atypical antipsychotic drugs by nursing home residents. The OIG hired psychiatrists who are experts in treating elderly patients to review a sample of 2007…Read More

Can an incompetent, and ultimately dismissed, False Claims Act Complaint bar a future complaint under the FCA’s “first to file rule?” The Court of Appeals in Washington D.C. answered the question for the first time on November 4, 2011. Can a settlement agreement between an employer and an employee force dismissal of the employee’s whistleblower…Read More

The recent trend toward increased HIPAA enforcement is continuing with the recent announcement by the United States Department of Health and Human Services (“HHS”) that it would begin performing periodic audits to ensure covered entities and business associates are complying with the HIPAA Privacy and Security Rules and Breach Notification standards.  Section 13411 of the…Read More

The Centers for Medicare & Medicaid Services (“CMS”) announced yesterday the timeline for Round 2 competitive bidding for Durable Medical Equipment, Prosthetics, Orthotics and Suppliers (“DMEPOS”), with registration set to begin on December 5, 2011. According to the release from CMS, the 60-day bid window for Round 2 and the National Mail-Order Competition for Diabetic Supplies…Read More

Secretary of Health and Human Services, Kathleen Sebelius, announced on November 30, 2011 that Eligible Providers and Eligible Hospitals (“Recipients”) meeting the Stage 1 meaningful use criteria for the Medicare/Medicaid Electronic Health Records Incentive (“EHR Incentives”) established under the HITECH Act will not be required to meet the Stage 2 criteria until 2014.   The meaningful use final…Read More

On November 10, 2011, the IRS published private letter ruling 2011-45005.  This private letter ruling came to two significant conclusions: The IRS found that an incentive payment of a fixed dollar amount, payable upon achieving, among other things, a net operating surplus/deficit level, did not give rise to private business use.  (To our knowledge, this…Read More

Today, November 30, 2011, the Centers for Medicare and Medicaid Services (“CMS”) held a Special Open Door Forum to announce the Part A to Part B Rebilling Demonstration Project (“Rebilling Demonstration”).  As described in greater detail below, in exchange for waiving certain appeal rights, Medicare hospitals that participate in the Rebilling Demonstration will be allowed…Read More