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…
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…
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…
The HIPAA Security Rule requires Covered Entities and their respective Business Associates to maintain certain Administrative, Physical and Technical safeguards to protect Electronic Protected Health Information (“e-PHI”). Specifically, these safeguards are designed to ensure the Confidentiality,…
On December 19, 2017, the U.S. Department of Justice (“DOJ”) announced settlements with two separate physician groups, one in Texas and one in Pennsylvania relating to allegations that the groups received illegal remuneration in exchange for patient referrals to hospitals owned by the now-defunct…
A December 28, 2017 CMS memo to state surveyors clarifies CMS’ position as it relates to texting of orders by physicians or other health care providers as well as utilizing text messaging as a means of communication among the healthcare team.[1] In its memo, CMS holds that the practice of texting…
CMS’ November 1, 2017 Outpatient Prospective Payment System (“OPPS”) Final Rule (the “Final Rule”) implemented sweeping changes to the 340B Discount Drug Program, including a 28.5% payment reduction in certain 340B covered entities’ Medicare Part B drug reimbursement.
In response, three hospital…
Beginning January 1, 2018, Indiana professional corporations (“PCs”) will no longer be required to apply for a certificate of registration or renew such certificate of registration with the Indiana Professional Licensing Agency (“PLA”).
House Enrolled Act 1308 (“HEA 1308”) went into effect January…
CMS published its 1,250 page 2018 Physician Fee Schedule Final Rule (“PFS”) on November 2, 2017.[1] In addition to the finalized changes to payment for non-excepted off-campus provider-based departments (discussed in detail here), the following are other important PFS changes, effective January 1,…
340B covered entities are facing major changes in the way the discount drug program is reimbursed and administered. On November 1, 2017, CMS made available its 2018 Outpatient Prospective Payment System Final Rule (“Final Rule”).[1] The Final Rule implements, in total, drastic reimbursement cuts to…
On November 1, 2017, CMS published its 2018 Outpatient Prospective Payment System OPPS Final Rule (“Final Rule”).[1] In addition to numerous changes to the 340B Discount Drug Program, the Final Rule finalizes other important rule changes requiring providers’ close consideration. Barring unexpected…
In May 2017, the Texas Senate passed Senate Bill 1107,[1] which cleared a path for the State’s various heath care professional boards, including the Texas Medical Board (“TMB”) and Texas State Board of Pharmacy (“TBP”), to offer greater, easier access to telemedicine services. On September 15,…
