Health Law Observer

Timely insights and legal commentary on various health care issues and developments surrounding regulations, employment, transactions and a range of key industry matters. This blog is maintained by the Health Care Department of Stevens & Lee.

What Should Health Care Providers be Thinking About Blockchain?

A blockchain is, in simple terms, a time-stamped series of immutable records of data that are managed by a cluster of computers not owned by any single entity.
pen laying on a clipboard

Are Restrictive Covenants in the Health Care Setting Still Enforceable?

While, generally speaking, restrictive covenants are disfavored by the courts, these types of provisions can be used to protect assets/business interests under certain circumstances.

Transgender Patient Care Guidelines Published by the American College of Physicians

The guidelines set forth recommendations relative to the provision of care to transgender patients by internal medicine and family medicine doctors.
hospital bed in hospital room

Pennsylvania Department of Health Posts Guidance on “Hospital-Observation” Beds

The new category will apply to beds in observation units located outside of or adjacent to hospital emergency department beds in units that have been identified as observation units or areas of the hospital that have been designated as observation areas.
Doctors Walking Through Shared Space

Inpatient vs. Observation Status: Finally Some Hope for Medicare Patients

The continued use of observation status as currently structured is a confusing, time consuming and costly problem for physicians, hospitals and patients alike. 
Emergency Room Sign

Recent EMTALA Guidance

CMS recently issued new guidance on EMTALA in the form of: 1) a Medicare Learning Network MLN publication on June 27, 2019; and 2) a Memorandum to State Survey Agency Directors re: Frequently Asked Questions on EMTALA and Psychiatric Hospitals.
reimbursements

Coming Later this Summer – Significant Stark Law Changes

A CMS official, Kimberly Brandt (Principal Deputy Administrator for Operations), recently announced that the long-anticipated proposed Stark Law changes will be issued by the end of this summer.

Financial Cleaning: Managing Credit Balances and Navigating Unclaimed Property Reporting/Audits

Many hospitals, health care systems and other health care providers currently have credit balances on their books representing unclaimed funds from payers, vendors and even patients.
In-home care through PACE

CMS Provides Flexibility in the New PACE Final Rule

The new final rule is the first comprehensive update to the PACE regulations since the original final rule was published in 2006. The updates under the new final rule provide operational flexibility to PACE organizations.

Will Pennsylvania Take Over the Insurance Exchange?

Pennsylvania is considering taking over the online exchange that's been operated by the federal government for individual Affordable Care Act policies since it began in 2014.
Health care law

Delaware Executive Order 25 to Address State’s High Per Capita Health Care Spending

Delaware hospitals’ revenue will likely be adversely affected by the initiative as it is designed to address over reliance on the most costly forms of care, such as that rendered by emergency departments.

Skeptical, At Best: Will the New CMS Physician Payment Models Make a Difference?

CMS continues to attempt to shift from a fee-for-service model to a value-based model offering significant upside (and now downside) risk through CMS’ newly-announced payment models called Primary Care First.
Doctors Walking Through Shared Space

Shared Space and Shared Services – Some Much Needed Flexibility from CMS

In connection with this Guidance, CMS indicated that it wants providers to have flexibility in providing care, as long as the shared space and services will not adversely affect the health and safety of patients.
Physician Prescribing Medication

Mandatory E-Prescribing for Controlled Substances Coming Soon to Pennsylvania

Practitioners who violate the law are subject to administrative penalties up to a maximum of $5,000 per calendar year.
piggy bank and money in front of a computer

CMS Innovation Center Announces Two New Payment Models

On April 22, 2019, the CMS Innovation Center announced two new Medicare payment models that will launch in 2020: the Primary Care First model; and the Direct Contracting model.
doctor opening a small red box

Reminder: There is No Stark Law De Minimis Exception

We are frequently asked about the Stark Law implications of gifts, items or services that a hospital wants to give (or, in some cases, already gave) to referring physicians.

CMS Continues to Expand Medicare Coverage and Reimbursement of Telehealth Services

The adoption of this final rule follows CMS’s recent trend of expanding coverage and reimbursement of telehealth services under traditional Medicare.

Responding to Requests for Service and Emotional Support Animals in Health Care Facilities

Health care providers must grapple with some unique challenges that arise when a patient presents at a hospital or clinic appointment with an animal.
Practical Guidance for Health Care

Federal Judge Blocks Medicaid Work Requirement Waivers in Arkansas and Kentucky

With Judge Boasberg’s narrow rulings on procedural grounds as well as the federal and certain state governments’ continued support for work requirement waivers, it is important to recognize the potential impact such waivers may have on providers.
Changes to HSR Reportability

Changes to HSR Reportability of Nonprofit Affiliation Transactions

The net effect of such guidance is that certain affiliation structures among nonprofit organizations will now be reportable for HSR Act purposes.
Home Health Agency PPS Rules

CMS Issues Display Copy of Updates to Home Health Agency PPS Rules

CMS believes the provisions of the Final Rule will strengthen and modernize the home health prospective payment system by “focus on patient needs and not on the volume of care.”
gavel

Implications of Federal Court’s Ruling Allowing AT&T/Time Warner Merger Are Less Clear in Health Care Than in Other Industries

The landmark case was the DOJ’s first suit in 40 years seeking to block a so-called “vertical merger,” i.e., a merger between a buyer and a supplier.
reports with magnifying glass

Outline of Certain Tax Reform Changes Impacting Tax-Exempt Health Care Organizations

This post includes a preliminary outline of certain key provisions that specifically affect tax-exempt health care organizations as well as some practical takeaways and outstanding questions.
Outline of Certain Tax Reform

Hospital’s 501(c)(3) Status Revoked for 501(r) Non-Compliance

The IRS recently issued a private letter ruling revoking a hospital’s Section 501(c)(3) tax-exemption on account of failing to meet Section 501(r) requirements.
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