Articles and Blogs

Wisconsin Act 70 makes major changes to Wisconsin Statutes that regulate nursing homes and facilities that serve individuals with developmental disabilities. Signed into law on November 16, 2011 and effective December 2, 2011, the Act benefits federally certified nursing homes in the form of reduced fines and all nursing homes and facilities serving the developmentally disabled…Read More

The Centers for Medicare & Medicaid Services (“CMS”) has recently instructed contractors to reopen certain claims that were previously denied for failure to meet the “face-to-face” requirements in certain circumstances and assuming all content requirements of the certification and the face-to-face documentation are otherwise met.  It came to CMS’ attention that certain claims were being…Read More

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