On September 17, 2019, the U.S. Court of Appeals for the Third Circuit revived three whistleblowers’ claims alleging that the University of Pittsburgh Medical Center (UPMC) and neurosurgeons employed by three subsidiary...more
10/1/2019
/ Appeals ,
Dismissals ,
Employment Contract ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Medicare ,
Remand ,
Reversal ,
Stark Law ,
Universities ,
Whistleblowers
On June 21, 2019, CMS finalized a decision memo updating the national coverage policy for Transcatheter Aortic Valve Replacement (TAVR), a procedure used to address aortic stenosis. The decision changes the volume...more
On February 28, 2019, CMS issued a 48-page request for public comment (the Request) on several potential updates to and future considerations for the methodology used in the Overall Hospital Quality Star Rating. As explained...more
On January 22, 2019, twenty-two (22) Senators sent a bipartisan letter to HHS (the Letter) to voice their concerns over a change in the national liver distribution policy adopted on December 3, 2018 (Revised Policy), by the...more
On November 30, 2018, CMS launched the Procedure Price Lookup tool that enables consumers to search the tool by type of procedure to compare the national average cost for procedures performed in both ambulatory surgery...more
CMS has issued guidance documents addressing how hospitals can (1) qualify an off-campus provider-based department (PBD) for the “mid-build” exception set forth in the 21st Century Cures Act and (2) request from their CMS...more
On August 2, 2016, CMS released a final rule (Final Rule) with updates to the Hospital Inpatient Prospective Payment System (Hospital IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) affecting...more
8/10/2016
/ Administrative Procedure Act ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Hospitals ,
IMPACT Act ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Medicare ,
Provider Payments ,
Two-Midnight Rule ,
Value-Based Purchasing
On June 30, 2016, Senate Finance Committee Chairman Orrin Hatch released a white paper examining potential reforms to the Federal Stark law. The white paper, entitled “Why Stark, Why Now? Suggestions to Improve the Stark...more