Health Law

Published on: July 16, 2018 | by The Health Law Partners

GUIDELINE.GOV NO LONGER AVAILABLE AFTER JULY 16, 2018 – Budget Cuts Result in Deletion of Over 20 Years of Medical Guidelines

The National Guideline Clearinghouse (NGC) website, “guideline.gov,” compiles the latest information on medical treatment for use by healthcare organizations, physicians, bulk purchasers, educational institutions, and state and local governments, while also providing guidance on medications and procedures ranging from miniscule to critical. The NGC contains over 20 years of evidence-based clinical practices and medical guidelines, […]

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Published on: July 16, 2018 | by The Health Law Partners

CMS Proposes to Amend or Delete §411.353(g) Special Rule for Certain Arrangements Involving Temporary Noncompliance with Signature Requirements

July 2018- Section 1877 of the Social Security Act, widely known as the physician self-referral law, prohibits a physician from making service referrals payable by Medicare to entities that they may have a financial relationship with. Section 50404 of the Bipartisan Budget Act (“BBA”) of 2018 added provisions to section 1877(h)(1) of the Social Security […]

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Published on: July 13, 2018 | by The Health Law Partners

CMS Proposes New Rule Change to The Medicare Physician Fee Schedule and Quality Payment Program

July 2018 – On July 12, 2018, the Centers for Medicare & Medicaid Services (“CMS”) proposed rules aimed at fundamentally improving the nation’s healthcare system and restoring the doctor-patient relationship. The proposal is “one of the most significant reductions in provider burden undertaken by any administration,” according to CMS director Seema Verma. The new proposed […]

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Published on: June 27, 2018 | by The Health Law Partners

CMS Seeks Additional Public Input on the Impact and Burden of the Stark Law

June 2018 – On June 19, 2018, the Centers for Medicare & Medicaid Services (“CMS”) issued a Request for Information (“RFI”) seeking public input on how to address any undue impact and burden of the physician self-referral law, 42 U.S.C. § 1395nn (the “Stark Law”). By way of background, the Stark Law addresses the concern […]

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Published on: April 19, 2018 | by The Health Law Partners

Please Join The HLP at the 2018 Physicians Legal Issues Conference

Please Join The HLP at the 2018 Physicians Legal Issues Conference in Chicago, Illinois The Health Law Partners (HLP) is proud to be part of the upcoming Physician Legal Issues Conference co-sponsored by the American Bar Association Health Law Section and Chicago Medical Society. The conference will take place at the Intercontinental Hotel in Chicago […]

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Published on: March 28, 2018 | by The Health Law Partners

Recent Changes to the Medicare Shared Savings (ACO) Program Aimed to Encourage Beneficiaries to be Proactive with Their Health Care

March 2018 – Recent additions to the Medicare Shared Savings Program (“MSSP”), include several changes aimed to encourage Medicare beneficiaries to take a more proactive approach with their health care. By way of background, on March 23, 2010, Section 3022 of the Affordable Care Act added section 1899 (42 U.S.C. § 1395jjj) to the Social […]

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Published on: March 27, 2018 | by The Health Law Partners

New Standard of Materiality in FCA Litigation Gives Wake to New Vigor for Defense

In the world of litigation healthcare providers can potentially fall victim to the False Claims Act (“FCA”) when they file medical claims for reimbursement from either Medicaid or Medicare. FCA claims against hospitals and other healthcare related entities usually involve allegations that the healthcare provider knowingly or recklessly filed a false claim for payment from […]

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Published on: September 14, 2017 | by The Health Law Partners

OIG Gives Green Light to Pharmacy Discount Program Under CMP and AKS

In its recent Advisory Opinion No. 17-05, OIG stated that the Proposed Arrangement (“Arrangement”) would not violate the anti-kickback statute (“AKS”) nor would it prompt administrative sanctions under the Civil Monetary Penalties (“CMP”) provision of the Social Security Act, prohibiting inducements to beneficiaries. The Proposed Arrangement discussed in the Opinion centers around a retail pharmacy […]

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Published on: July 12, 2017 | by The Health Law Partners

CMS Delays Implementation of New Rule Addressing Home Health Agency Improvements

Home Health Agencies will now have an additional 6 months to comply with a new CMS rule intended to advance the quality of patient care. CMS published a final rule on July 10th delaying the effective date for its rule addressing conditions of participation for home health agencies. CMS has moved the effective date of […]

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Published on: April 13, 2017 | by The Health Law Partners

Important New Compliance Resources for Imaging Providers/Suppliers

Compliance programs are mandatory (pending final regulations) for all health care organizations post-Affordable Care Act. In some states, and for some provider/supplier types, compliance programs are already mandatory. In any event, compliance programs in health care organizations are crucial in today’s overregulated environment, with qui tam attorneys, whistleblowers, regulators, and payors seeking any potential excuse to […]

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