Articles and Blogs

On May 17, 2019, CMS released the preliminary FY 2021 Worksheet S-3, Parts II and III wage index Public Use File (“PUF”). The PUF contains wage data based on FFY 2017 hospital cost reports – that is, cost reports with fiscal year begin dates of on or after October 1, 2016 and on or before September 30, 2017. The... READ MORE

On May 14, the National Labor Relation’s Board (“Board”) Advice Division released an advice memorandum recommending that the Board reconsider three picketing cases decided during President Obama’s administration. The memo provides insight regarding how the General Counsel’s Office, and the Board, may interpret picketing activity in the near future. This advice could affect health... READ MORE

This week, the United States Supreme Court ruled that the government’s 10-year deadline to file FCA actions could be extended to whistleblowers. The Court’s decision in Cochise Consultancy, Inc. et al. v. United States ex rel. Hunt[1] resolved a circuit split that had dogged the courts, whistleblowers and defendants for decades. Health care providers... READ MORE

Update: On November 6, 2019, a federal judge sitting in the Southern District of New York voided the U.S. Department of Health and Human Services Final Conscience Rule set to take effect November 22, 2019. For more information, click here. Update: This blog article was originally posted on May 20, 2019, and it stated... READ MORE

In November 2018, the Government Accountability Office (“GAO”) released a report (“Report”) on new laboratory payment rates established by CMS under the Protecting Access to Medicare Act (“PAMA”). In the Report, the GAO analyzed Medicare claims data to assess how CMS’s implementation of these new rates will impact Medicare expenditures and recommended CMS take... READ MORE

Lawmakers Seriously Pursuing “Surprise Medical Bill” Fix Continuing the bipartisan interest in addressing the issue of surprise medical billing, also known as balance billing, a group of bipartisan senators led by Sens. Bill Cassidy (R-LA) and Maggie Hassan (D-NH) introduced legislation on Thursday. The legislation states that providers would be prohibited from balance billing... READ MORE

The DOJ’s recent revisions to its Justice Manual created a new path for self-disclosing potential fraud to the government – one which is unique in its ability to defray the costs of potential False Claims Act violations. In 2015, Deputy Attorney General Sally Quillian Yates released a memo entitled Individual Accountability for Corporate Wrongdoing, more... READ MORE

 NATIONAL States inch forward on nurse staffing laws Bill backed by generic drug companies gets PhRMA endorsement at Senate hearing As MACRA Implementation Turns 2, Industry Leaders Call for Change Best & worst states for physicians to practice, ranked by Medscape Some hospitals turn away ambulances when the patients are more likely to be... READ MORE

The Supreme Court of the United States announced a landmark ruling about arbitration clauses on April 24, 2019. In Lamps Plus, Inc. v. Varela, the high court held that an arbitration clause does not permit class arbitration without clearly and explicitly stating so. Chief Justice Roberts delivered the opinion of the Court, reasoning that... READ MORE

This is the first in a series of articles discussing the countdown to Phase 3 skilled nursing home compliance programs. To view other articles in this series, click here. Beginning on November 28, 2019, surveyors will use the requirements detailed 42 C.F.R. Section 483.85, the Requirements for States and Long-Term Care Facilities (“Final Regulations”)... READ MORE