Medicare Access & CHIP Reauthorization Act of 20151
On April 27, 2016, the Centers for Medicare and Medicaid Services (“CMS”) issued a Notice of Proposed Rulemaking to implement parts of the Medicare Access & CHIP Reauthorization Act of 2015 (“MACRA”). MACRA is part of an initiative…
The Franciscan Alliance and Christian & Medical Dental Associations joined six states in a lawsuit filed against Health and Human Services (“HHS”) in a Texas federal court on August 23, 2016, challenging the regulations that the HHS’ Office of Civil Rights (“OCR”) finalized this past May (“Final…
On July 17, 2015, CMS released a proposed rule to revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. The proposed rule included a requirement regarding binding arbitration agreements. In the commentary CMS expressed concern that…
As many of you may know, the statewide home health reimbursement rates for Indiana Medicaid, are calculated based on the most recently completed Medicaid cost reports required from all home health providers billing Indiana Medicaid for services. (IHCP Bulletin 201625, May 17, 2016). As a result of…
The Balanced Budget Act of 2015 (“BBA”) passed on November 2, 2015 provides that, effective January 1, 2017, “applicable items and services” (other than items and services furnished by a dedicated emergency department) furnished by an off-campus outpatient department of a provider (“Off-Campus…
The Health and Human Services’ Office of Civil Rights (“OCR”) recently published a final Regulation (“Regulation”) that implements the nondiscrimination requirements of Section 1557 of the Patient Protection and Affordable Care Act.[1] Beginning on July 18, 2016, discrimination in health care…
Following up on a previous client alert item, a federal jury recently found W. Carl Reichel, former president of Warner Chilcott, not guilty on June 17, 2016 of conspiring to pay kickbacks to doctors in exchange for writing prescriptions. The jury deliberated two days before delivering a not guilty…
The Indiana General Assembly passed legislation during the 2015 General Session directing certain boards to establish protocols and standards for prescribing controlled substances for pain management treatment that “complement” existing rules for physicians.[1] Those boards include: the Board of…
Hospitals which have discovered violations in their submissions for payment under Medicare and Medicaid may now pause before reporting the mistake and determine if the violation was “material” to the government’s conditions for payment. If the mistake was not material, then the False Claims Act…
Aetna has claimed victory in a four year-old lawsuit against Bay Area Surgical Management, LLC, after a civil jury hit the California medical group with a $37.4 million dollar judgment.
The victory capped a month-long trial against 10 defendants, including surgical centers and the organization's…
On November 2, 2015, the Centers for Medicare and Medicaid Services (“CMS”) issued a Final Rule titled “Medicaid Program; Methods for Assuring Access to Covered Medicaid Services” following the recent Supreme Court case, Armstrong v. Exceptional Child Care Center, where the Court held that a…
On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015 (Pub. Law 114-74) into law. The Act includes many provisions aimed to reduce federal debt, but only a few specifically affect health care. Perhaps one of the most significant health care implications involves a change in…
