Perspectives on Hospitals & Health Systems
30 total results. Page 1 of 2.
Beware of Your Medicare Advantage Capitated Arrangements – False Claims Act Exposure Lurks in Your Diagnosis Coding
After announcing in December that it would intervene in a qui tam action under the False Claims Act against Sutter Health and Palo Alto Medical Foundation (PAMF), the US Department of Justice filed its complaint-in-intervention in the Northern District of California on March 4, 2019.
For California Hospitals and Medical Staffs, Exclusive Contracts Are No Substitute For Fair Hearing Obligations
California hospitals, medical staffs, and medical groups, take note: In addressing an issue that has been debated for years, the California Court of Appeal has concluded that a hospital’s directive to a group in a “closed” department to not schedule a practitioner due to competency issues constitute
In Los Angeles alone, the LA City Attorney's Office has in recent years initiated numerous lawsuits against hospitals and nursing facilities for homeless patient “dumping” – a practice generally described as discharging homeless persons without regard to their safety or ability to find shelter.
Lowell C. Brown, Debra Albin-Riley, Douglas A. Grimm, FACHE, Thomas E. Jeffry, Jr., D. Jacques Smith, Jennifer C. Terry, Sarah G. Benator, Susanna Hathaway Murphy, Diane B. Roldán
We are very pleased to announce that our Health Care attorneys will be hosting two Medical Staff Leaders and the Law Conferences in 2019.
Starting in April 2018, the Centers for Medicare & Medicaid Services will begin to implement significant changes to the look and content of Medicare identification cards.
A long time coming and after much anticipation and speculation, CMS is about to unveil an electronic reporting system in which manufacturers will report to CMS their quarterly ASP calculations.
Health Care Partner Tom Jeffry and 44 other health care executives spoke to Becker’s Hospital Review about the key trends disrupting the traditional hospital and how institutions can prepare for the future.
South Carolina Hospital Settles With OIG Over Alleged EMTALA Violations Involving Psychiatric Emergencies
AnMed Health, a hospital located in South Carolina, recently agreed to pay almost $1.3 million dollars and enter into a settlement agreement with the HHS Office of Inspector General to resolve allegations that it violated the Emergency Medical Treatment and Labor Act.
A recent California Supreme Court ruling could significantly impact trials of physician “whistleblower” claims under California Health & Safety Code Section 1278.5 – maybe.
On May 10, 2017, the US Department of Health & Human Services (HHS) announced a settlement with Texas-based Memorial Hermann Health System for $2.4 million due to MHHS’s unauthorized disclosure of patient protected health information.
In A Must Read, New OIG Guidance Provides Practical Ways to Evaluate Compliance Program Effectiveness
The Department of Health and Human Services recently issued an important new compliance guide, called Measuring Compliance Program Effectiveness: A Resource Guide.
Please join Arent Fox on Friday, February 3 from 7:00 AM – 5:00 PM Pacific for our annual Medical Staff Leaders and the Law Conference being held at the Avenue of the Arts Hotel in Costa Mesa.
California Approves First-In-The-Nation Regulation Specifically Addressing the Threat of Workplace Violence in Healthcare Facilities
The standard, which was sponsored by several labor unions, will require covered healthcare providers to develop workplace violence prevention plans, training programs, and recordkeeping procedures to track certain incidents of workplace violence.
Proposed Rule May Significantly Cut Reimbursement to Existing Hospital Off-Campus Outpatient Clinics Beyond Congressional Intent
On July 6th, CMS released a proposed rule (expected to appear in the Federal Register on July 15th) that, if it takes effect, could be devastating to hospital off-campus outpatient department reimbursement – an effect not intended by Congress, and certainly unwelcome to the healthcare industry.
CMS has finalized surveyor worksheets for assessing a hospital’s compliance Quality Assessment and Performance Improvement (QAPI).
In an important development, the Centers for Medicare and Medicaid Services (CMS) has issued additional final regulations implementing the Stark Law as part of the Physician Fee Schedule for calendar year 2016 (see 80 Fed. Reg. 70,886 (Nov. 16, 2015)).
OIG Reminds Providers that the Donation of EHR Systems with Limited Interoperability May Violate the Federal Anti-Kickback Statute
US Department of Health and Human Services Office of Inspector General released an OIG Alert reminding the public that electronic health records furnished to referral sources may not meet the federal anti-kickback statute’s EHR safe harbor if EHR system has limited or restricted interoperability.
Health care providers and their contractors have been put on notice by the Office for Civil Rights (OCR) that the next round of HIPAA compliance audits will begin in early 2016. The previous round of HIPAA audits was completed in 2014.
Stark Law is Coming: Adventist Health System Pays $118.7 Million in Third Large September Settlement
On September 21, 2015, the US DOJ and whistleblowers’ counsel announced that Florida-headquartered Adventist Health System (Adventist) had agreed to pay $118.7 million to resolve allegations that it violated the FCA by submitting claims in violation of the Stark law and by miscoding claims.
On Monday, a federal district court judge in New York issued a ruling that, if adopted broadly, will have a significant – and potentially nightmarish – impact on any provider who receives an overpayment from Medicare or Medicaid. Kane v. Healthfirst, Inc. and U.S. v. Continuum Health Partners Inc.
A recent court ruling is a good reminder to health care providers that bankruptcy may not (as is sometimes suggested) be a safe harbor for providers in danger of being forced out of business by the loss of their Medicare and Medicaid provider agreements.
Senate Finance Committee Again Approves Legislation Incentivizing Green Building Construction by Nonprofits
Earlier today, the Senate Finance Committee approved legislation which would resurrect roughly 50 expired tax incentive provisions that lapsed on December 31, 2014.
The Department of Health and Human Services Office of the Inspector General issued a Fraud Alert, reminding physicians that they will be held liable under the anti-kickback statute for compensation arrangements that do not reflect fair market value compensation for bona fide services they provide.
Lowell C. Brown, Debra Albin-Riley, Thomas E. Jeffry, Jr., Susanna Hathaway Murphy, Sarah L. Bruno, Mark R. Phillips, Diane B. Roldán
Please join Arent Fox in San Francisco for our annual Medical Staff Leaders and the Law Conference.