One could forgive the healthcare industry for thinking someone drove Doc Brown’s DeLorean time machine through One First Street when it awoke on Friday, June 28, to a blast from the past....more
7/11/2024
/ Administrative Procedure Act ,
Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Government Agencies ,
Health Care Providers ,
Judicial Authority ,
Loper Bright Enterprises v Raimondo ,
Medical Reimbursement ,
Medicare ,
Overpayment ,
Regulatory Authority ,
SCOTUS ,
Statutory Interpretation
Recently, Optum Behavioral Health (“Optum,” the services division for UnitedHealth Group) has initiated overpayment recovery actions against numerous licensed clinical social workers (“LCSWs”) across the country for services...more
Do the Right Thing — Reporting Voluntary Actions Taken While “Under Investigation” to the NPDB -
Many health care entities struggle with the dilemma of whether and when to make reports to the National Practitioner Data...more
On March 31, 2023, the United States District Court for the Eastern District of Pennsylvania dealt a blow to a trio of nursing home providers by denying their motion to dismiss a False Claims Act (FCA) claim brought by the...more
4/10/2023
/ Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Nursing Home Reform Act (FNHRA) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Medicaid ,
Medicare ,
Motion to Dismiss ,
Nursing Homes ,
Relators ,
Standard of Care ,
Worthless Services Claims
The end of 2021 brings positive indications of the continued acceptance of telehealth as an important clinical care approach post public health emergency (“PHE”). The Centers for Medicare and Medicaid Services (“CMS”), like...more
2/22/2022
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Inpatient Prospective Payment System (IPPS) ,
Medicaid ,
Medical Reimbursement ,
Medicare ,
Medicare Advantage ,
Outpatient Prospective Payment System (OPPS) ,
Payor Contracts ,
Physician Fee Schedule ,
Section 340B ,
Surprise Medical Bills ,
Telehealth
On July 1, 2021, the Departments of Health and Human Services (“HHS”), Treasury, and Labor, along with the Office of Personnel Management (collectively the “Departments”), issued the first tranche of regulations implementing...more
9/30/2021
/ Biden Administration ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Interim Final Rules (IFR) ,
Legislative Agendas ,
Medical Reimbursement ,
Out of Network Provider ,
Price Transparency ,
Provider Relief Fund ,
Regulatory Agenda ,
Surprise Medical Bills ,
Value-Based Care
The United States District Court for the Western District of Washington’s decision interpreting the Health Care Quality Improvement Act, 42 U.S.C. § 11101, et seq., (“HCQIA”), highlights specific requirements for immunity...more
Flattening the Curve: Are Vaccination Mandates a Viable Strategy for Hospitals?
Severe acute respiratory syndrome coronavirus 2 (“SARS-CoV-2”) vaccines hold promise to control the pandemic and help restore normal social and...more
7/21/2021
/ Coronavirus/COVID-19 ,
Defamation ,
Discovery ,
Employment Policies ,
HCQIA ,
Health Care Providers ,
Hospitals ,
Infectious Diseases ,
Peer Review ,
Sex Discrimination ,
Title IX ,
Vaccinations ,
Workplace Safety