StatLaw – February 2015

CMS to Shorten 2015 Attestation Reporting Period: The Centers for Medicare & Medicaid Services (“CMS”) has announced it intends to give providers a “reprieve” by issuing a new rule which would “update” the Medicare and Medicaid Electronic Health Records (“EHR”) incentive programs, and shorten the attestation period in 2015 from 365 to 90 days, in […]

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StatLaw – January 2015

Medicare Penalties Starting to Take a Toll on Hospitals: More than three dozen hospitals across the U.S. will be penalized more than 3% on most of their CMS reimbursements in 2015, the first year in which the agency’s three (3) Medicare quality and safety incentive programs will be in effect. New this year is a […]

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StatLaw – December 2014

US Justice Department Recovers almost $6 Billion in False Claims Act Cases: In fiscal year 2014, ending September 30, 2014, the US Department of Justice (“DOJ”) recovered nearly $5.69 billion from settlements and judgments in False Claims Act Cases. The DOJ had the assistance of over 700 whistleblowers. In 2009, the Attorney General and the […]

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StatLaw – November 2014

Supreme Court Grants Certiorari in Affordable Care Act Subsidy Case: The U.S. Supreme Court will hear the case of King v. Burwell, which upheld regulations adopted by the Internal Revenue Service (“IRS”) under the Affordable Care Act (“ACA”). In King v. Burwell, the United States Court of Appeals for the Fourth Circuit upheld IRS regulations […]

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StatLaw – October 2014

CMS Reopens Submission Period for the Meaningful-Use Hardship Exception: Eligible professionals are required to demonstrate meaningful use of Certified Electronic Health Record Technology (CEHRT) or obtain a waiver for failure to demonstrate meaningful use. Failure to comply with one of these requirements will result in a 2015 Medicare payment adjustment, which will reduce Medicare reimbursements […]

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StatLaw – September 2014

CMS Plans More On-Site HIPAA Audits than Originally Intended: CMS has announced an indefinite delay in the commencement of the next phase of HIPAA compliance audits. Due to the delay in implementation of this next stage, which was due to begin this fall, CMS is advising that they will be planning far more on-site compliance […]

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StatLaw – August 2014

The Cost of High Deductibles on Patient Care: Rather than addressing patient questions about the benefits of procedures, tests, drugs and specialist referrals, doctors are now beginning to field questions about the cost and inherent necessity of procedures. Recent trends in healthcare coverage require patients to bear financial responsibility for more of their medical bills. […]

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StatLaw – July 2014

OIG Special Fraud Alert: Laboratory Payments to Referring Physicians: On June 25, 2014, the Office of the Inspector General of the Department of Health and Human Services issued a Special Fraud Alert on Laboratory Payments to Referring Physicians. The Special Fraud Alert addresses compensation paid by laboratories to referring physicians and physician group practices for […]

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StatLaw – June 2014

Sunshine Act Update: Physicians and teaching hospital representatives will be able to begin registration in the Center for Medicare and Medicaid Services (CMS) Enterprise Portal beginning June 1; see “Open Payments” at CMS website. The Sunshine Act requires all applicable manufacturers of drugs, devices, biological or medical supplies (“Applicable Manufacturers”) and group purchasing organizations (“GPOs”) […]

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StatLaw – May 2014

Private Health Plans Prepare to Make Payment Data Accessible to Public: On the heels of Medicare release its payment data, a new initiative by three of the country’s largest health plans has the potential to transform the accessibility of claims payment data, according to healthcare finance experts. UnitedHealthcare, Aetna and Humana announced a partnership on […]

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StatLaw – April 2014

Temporary “Doc Fix” Agreement Delays ICD-10 Implementation: Although CMS adamantly opposed any delay to the October 1, 2014 ICD-10 implementation date, the Protecting Access to Medicare Act of 2014 contains a provision where CMS will have no choice but to postpone implementation of ICD-10 for at least one year. The American Health Information Management Association […]

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StatLaw – March 2014

Federal Regulators Looking to Improve Testing of Generic Medications: Issues regarding safety concerns over generic medications produced overseas were raised at a recent briefing in Washington. Specifically, some generic heart medications produced by companies based in India do not work in the same way as their brand-name counterpart. Preston Mason, a researcher at Brigham & […]

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StatLaw – February 2014

 Injunction Against United Healthcare Upheld but Modified: A federal appeals court has denied United Healthcare’s request to toss out a lawsuit by two medical societies but modified the injunctive relief. The preliminary injunction granted by a federal district court that prevented United Healthcare from dropping numerous members of the plaintiff medical associations from United’s Medicare […]

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StatLaw – January 2014

EHR Donation Rule Extended through 2021: Final regulations issued by the Centers for Medicare and Medicaid Services (CMS) extend the expiration date of the electronic health record (EHR)exception to the federal Stark Law from December 31, 2013 to December 31, 2021 (as well as extending the comparable safe harbor under the federal Anti-Kickback Statute). Among […]

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