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.

reimbursements

Home Health Reimbursement in 2020

The home health industry is bracing for impact as one of the most significant changes to home health agency operations since the late 1990s is set to go into effect on or about January 1, 2020.

The Evolution of the Writing and Signature Requirements of Certain Exceptions to the Stark Law

The Stark Law is the common name for a section of the Social Security Act that prohibits physicians from referring Medicare patients for designated health services to entities with which the referring physician has a financial relationship.
blue notepad titled affordable care act

What is Happening with the ACA in 2020?

The Affordable Care Act not only continues for now, but shows signs of strengthening in some of its components.
Doctors Walking Through Shared Space

Innovative Hospitals = Micro-Hospitals in Pennsylvania

Pennsylvania might just be working toward more flexibility in its licensing of micro-hospitals, albeit CMS rules and requirements will still apply.
doctor looking at a tablet

Proposed Changes to Electronic Health Records (EHR) Exception and Safe Harbor

On October 9, 2019, two agencies of the U.S. Department of Health and Human Services each released a set of wide-ranging and significant proposed rules.
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HHS, OIG and CMS Issue Advance Copies of Proposed Regulatory Changes to Stark Law, Anti-Kickback Statute and Civil Monetary Penalties Rules

The proposed rules follow HHS’ solicitation of information via two separate notices requesting information on potential modifications to the Stark Law exceptions to promote value-based care and reduce regulatory burdens in June 2018 and potential changes to the
Payment Rates

Relief from Reduced Payments to Grandfathered Off-Campus Provider-Based Departments

A U.S. District Court vacated the portions of CMS’s Final Rule that reduced the payment rate for hospital clinic visits provided at grandfathered off-campus provider-based departments to equal the rate for similar services provided in physician office settings.
notepad on a boardroom table

Deciding on Decision-Making Processes for Health Care Joint Ventures

Often times, a sticking point in negotiations is how to divide voting rights, representation and other governance/decision-making responsibilities.
Shelf filled with manila folders

Q&A: You’re Selling Your Practice — What About the Medical Records?

Most states require that physicians provide patients with access to copies of their medical records. These obligations do not disappear upon the sale of a practice.

CMS Issued Final Rule with Comment Period Requiring Disclosure by Providers and Suppliers of Certain Affiliations

The final rule will be effective November 4, 2019 and any comments to the final rule must be received by CMS by November 4, 2019.
cyber attack on timekeeper background image

New Jersey Wage Theft Act Increases Employer Burdens

The WTA aims at penalizing employers who do not pay their workers wages due to them and expands the time period for bringing wage claims from two to six years.
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HHS Proposes Changes to Regulations Governing Confidentiality of Substance Use Disorder Patient Records

The proposed changes are intended to support better care coordination by reducing regulatory burdens to accessing and recording addiction treatment information, while maintaining privacy safeguards.
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Pennsylvania Supreme Court Articulates New Standard for Waiver of the Attorney Work Product Doctrine in Suit against Pennsylvania Health System

In connection with a case involving a peer review investigation of a cardiologist, the Pennsylvania Supreme Court recently articulated a new standard for waiver of the attorney work product doctrine.

Changes to PA Regulations on Psychiatric Outpatient Clinics and Services

The primary areas of change are in psychiatric time, staffing patterns and timeframes for developing and updating treatment plans.

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.
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