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.
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.
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.
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.
Practitioners who violate the law are subject to administrative penalties up to a maximum of $5,000 per calendar year.
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.
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.
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.
The net effect of such guidance is that certain affiliation structures among nonprofit organizations will now be reportable for HSR Act purposes.
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.”
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.
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.
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.
CMS issued the long-awaited Final Rule implementing Section 603 of the Bipartisan Budget Act of 2015 relating to payment for certain items and services furnished by off-campus provider-based departments of hospitals.
In denying Section 501(c)(3) tax-exempt status to an accountable care organization (ACO) formed by a Section 501(c)(3) health system, the IRS focused on four facts.
CMS stated that the Final Rule provides needed clarity and consistency for providers and suppliers on the actions they need to take to comply with requirements for reporting and returning of self-identified overpayments.
Each of the new POS codes will be effective January 1, 2016, and neither of the new codes will have any effect on reimbursement.
The change could clear the way for hospitals and physicians to share payments for reducing or limiting medically unnecessary services provided to Medicare and Medicaid beneficiaries.
An educational resource designed to assist governing boards of health care organizations to carry out their compliance oversight obligations was published on April 20, 2015.