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Health Care / Health Reform Connect®

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OIG Approves of Hospital-Physician Gainsharing Arrangement, But Details Prove Critical

Posted by: Brian M. Heaton and Andrew C. Walker on March 5, 2018

Court Decision Clears Way for Broader Use of Postnuptial Agreements

A December 2017 Office of Inspector General (“OIG”) Advisory Opinion favors a gainsharing arrangement whereby a hospital will share with specific neurosurgeons a percentage of the hospital’s cost savings from spinal surgeries performed at the hospital. [1]  This Advisory Opinion marks the OIG’s...


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Passing of Bi-Partisan Budget Act Affects Medicaid Payments

Posted by: Leah S. Mannweiler and Meghan M. Linvill McNab on February 26, 2018

Court Decision Clears Way for Broader Use of Postnuptial Agreements

On February 9, 2018, both the House and the Senate voted to pass, and President  Trump signed into law, the Bi-Partisan Budget Act of 2018 (the “Act”, House Resolution 1892).  Most notably this Act extends federal appropriations through March 23, 2018, preventing government shutdown for another...


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Recent OCR Resolution Agreement and Corrective Action Plan ... Lessons Learned

Posted by: Stephanie T. Eckerle and Susan E. Ziel on February 26, 2018

Court Decision Clears Way for Broader Use of Postnuptial Agreements

The Health and Human Services’ Office of Civil Rights (“OCR”) recently entered into yet another Resolution Agreement after investigating a serious breach incident involving the electronic protected health information (“e-PHI”) of over 2 million patients that was maintained by a Florida health...


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Ability to Prescribe Buprenorphine Expanded to Mid-Level Practitioners

Posted by: Stephanie T. Eckerle and Meghan M. Linvill McNab on February 26, 2018

Court Decision Clears Way for Broader Use of Postnuptial Agreements

On January 23, 2018, the U.S. Drug Enforcement Administration (“DEA”) issued a  final rule announcing another step to increase opioid addiction treatment.[1]  Effective January 22, 2018, nurse practitioners (“NP”) and physician assistants (“PA”) are eligible to become DATA-Waived "qualifying...


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OIG Settles Cases Involving Allegations of EMTALA Violations

Posted by: Thomas N. Hutchinson and Maggie C. Little on February 26, 2018

Court Decision Clears Way for Broader Use of Postnuptial Agreements

In December 2017, the Office of Inspector General (“OIG”) entered into settlement agreements with four hospitals to resolve allegations of violations of the Emergency Medical Treatment and Labor Act (“EMTALA”).[1]  EMTALA requires hospitals to provide an appropriate screening examination and...


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Dismissal of Non-Intervened Qui Tam Lawsuits

Posted by: Marc T. Quigley, Thomas J. Costakis, and Lauren C. Sorrell on February 2, 2018

A Department of Justice internal memo dated January 10, 2018 reflects a significant policy change regarding the DOJ’s election to dismiss certain qui tam lawsuits in which the government declines to intervene.  The Memo (a copy of which can be found here) notes that the number of qui tam actions...


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D.C. District Court Clarifies Lab Requirement for Establishing Medical Necessity

Posted by: Stephanie T. Eckerle and Andrew C. Walker on February 2, 2018

Court Decision Clears Way for Broader Use of Postnuptial Agreements

A June 2017 decision by a federal district court in the District of Columbia determined that a reference laboratory cannot rely on the ordering physician’s determination to establish medical necessity for testing paid for under Medicare, Medicaid, or other federal health care programs.[1]  In...


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