Articles and Blogs

Reimbursement under the new Patient Driven Payment Model, staff background checks, infection control programs, facility-initiated transfer or discharge of a resident and the use of psychotropic drugs are several new skilled nursing facility (“SNF”) areas of audit and focus of Department of Health and Human Services Office of Inspector General (“OIG”). OIG publishes updates... READ MORE

On May 11, 2021, the Centers for Medicare & Medicaid Services (“CMS”) released over 90 pages of interim final regulations (the “Interim Final Regulations”) to revise the infection control requirements that long-term care facilities (Medicaid nursing facilities and Medicare skilled nursing facilities) and intermediate care facilities for individuals with intellectual disabilities (“ICFs-IID”) must meet to... READ MORE

Most of the new changes to the federal Stark and Anti-Kickback Statutes went into effect on January 19, 2021. Since then hospitals, health systems and medical groups nationwide have focused on updating their physician contracting, compensation and compliance programs to align with the new regulations. This alert focuses on specific changes to the Stark... READ MORE

Mergers and acquisitions in the health care industry present unique challenges that may not be present when undertaking similar transactions in other industries. Because of health care’s highly regulated nature, parties may falter if a health care transaction is not reviewed and negotiated carefully with respect to the distinct concerns that health care presents.... READ MORE

On Wednesday, July 29, 2020, the U.S. Department of Justice Drug Enforcement Administration (“DEA”) proposed a new rule that would require DEA registrants to electronically report “theft or significant loss” of controlled substances within 15 days of discovery of the circumstances requiring the report (“Proposed Rule”). This proposal is notable as currently there is... READ MORE

On May 21, 2020, Hall Render published “Providers Beware: Avoiding the Pitfalls in Regulatory Flexibilities and Relief Funds.” On May 26, 2020, OIG published “OIG Strategic Plan: Oversight of COVID-19 Response and Recovery.” To those who follow health care compliance and enforcement issues closely, the OIG document should come as no surprise. Over the... READ MORE

On March 23, 2020, Centers for Medicare & Medicaid Services (“CMS”) announced the preliminary results of a recent survey of a nursing home in Kirkland, Washington, the epicenter of the COVID-19 outbreak in Washington. According to a Centers for Disease Control and Prevention (“CDC”) report, 81 residents, 34 staff and 14 visitors also became... READ MORE

As COVID-19 continues to spread rapidly across the United States, emergency departments regardless of hospital size or location are being inundated with patients seeking emergency care. Providers have begun to question how they can fulfill their obligations to perform emergency screenings, stabilization and transfers in compliance with the Emergency Medical Treatment and Labor Act... READ MORE

On March 3, 2020, the Health and Human Services Office for Civil Rights (“OCR”) announced a $100,000 settlement with a physician practice (“Practice”) that it found to be significantly out of compliance with the requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). While OCR was investigating the Practice’s complaint against... READ MORE

On January 9, 2020, the Department of Justice (“DOJ”) announced that it collected over $3 billion in settlements and judgments under the False Claims Act (“FCA”) in the federal fiscal year 2019. The FCA has historically been the government’s primary tool for combatting perceived fraud, waste and abuse in the health care system, and... READ MORE