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New Stark Rules Bring Major Changes - 08/08
Health Care
August 27, 2008
Sandra K. Herron
On August 19, 2008, the Centers for Medicare and Medicaid Services published the latest changes to the Stark Law. The Stark Law regulates the types of arrangements into which physicians may enter. Violations of the Stark Law bring hefty civil fines and penalties.
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Congress Passes New Ethics, Lobbying, and Earmark Requirements - 08/20/07
Health Care & Advocacy & Government Relations
August 20, 2007
Cynthia E. Berry
Before recessing for the month of August, the U.S. House of Representatives and the U.S. Senate passed the "Honest Leadership and Open Government Act" (S. 1), which would tighten ethics guidelines, restrict lawmakers' interactions with lobbyists, increase lobbying disclosure, and impose new requirements on earmarking of federal funds.
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Third Circuit Ruling: When Does the Fiduciary Exception to the Attorney-Client Privilege Not Apply? 04/09/07
Health Care
April 10, 2007
Paige Arden Stanley
Under the common-law evidentiary rule known as the "fiduciary exception" to the attorney-client privilege, certain fiduciaries who obtain legal advice during the execution of their fiduciary obligations may not thereafter assert the attorney-client privilege against their beneficiaries.
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Legislation Proposed to Restrict DOJ Practices on Waiver of Attorney-Client Privilege - 11/28/06
Health Care
November 28, 2006
R. Joseph Burby, IV
On November 21, 2006, Senator Arlen Specter (R-Pa.) introduced a bill that would prohibit the U.S. Department of Justice ("DOJ") from compelling companies to waive their attorney-client and work product privileges to avoid indictment or otherwise receive credit for cooperating with a federal investigation. Because health care fraud enforcement remains a top priority for the DOJ, the issue of waiver of attorney-client privilege is critical for health care providers because it affects providers' expectations that they can retain the confidentiality of internal investigations conducted by counsel and legal advice on compliance matters.
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Congress Fails to Reach Health IT Agreement - 10/10/06
Health Care
October 10, 2006
Lawmakers involved in negotiating the differences between two health information technology (Health IT) bills (H.R. 4157, S. 1418) failed to reach an agreement prior to Congress' recess. The bills may still go to a conference committee if lawmakers can reconcile the differences.
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Medicaid Commission Hears Testimony on Medicaid Financing Issues - 09/08/06
Health Care
September 8, 2006
On September 6 and 7, the Medicaid Commission met in Arlington, Virginia. One of the presentations focused on Medicaid reimbursement, financing issues, and the Bush Administration's budget proposals. The 28-member body, appointed by Department of Health and Human Services ("HHS") Secretary Michael Leavitt, was tasked in 2005 with advising HHS and Congress on ways to reform and modernize the Medicaid program. The Commission is comprised of current and former governors, state Medicaid officials, health policy academics, business leaders, patient advocates, and representatives from the provider community.
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Final CMS Report on Specialty Hospitals Sent to Congress - 08/22/06
Health Care
August 22, 2006
The Centers for Medicare and Medicaid Services (CMS) recently issued a report to Congress on physician investment in specialty hospitals. The report, mandated under the Deficit Reduction Act of 2005, addresses a range of issues relating to specialty hospitals, including investment transparency, Medicare reimbursement, and fraud and abuse.
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CMS Releases Quality Standards for DMEPOS Suppliers - 08/22/06
Health Care
August 22, 2006
Alan K. Parver
On August 14, 2006, the Centers for Medicare and Medicaid Services (CMS) issued quality standards for suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Read details in our alert.
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Tenet Agrees To Pay $900 Million in Settlement - 07/24/06
Health Care
July 24, 2006
Nearly two months after Tenet Healthcare Corporation ("Tenet") agreed to pay $21 million for illegal kickbacks to physicians and sell Alvarado Medical Center in San Diego, Tenet, the nation's second largest hospital chain, has reached a $900 million dollar settlement with the federal government ending a four-year investigation by the U.S. Justice Department into allegations of unlawful billing practices. Tenet has not admitted any wrongdoing.
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Supreme Court Allows ERISA Plan to Bring Suit to Recoup Payments Under § 502(a)(3) - 06/13/06
Health Care
June 13, 2006
In a recent unanimous opinion, the Supreme Court has held that an ERISA fiduciary may bring suit under ERISA § 502(a)(3) seeking reimbursement of medical payments it had made on behalf of its beneficiary where the beneficiary has received a tort settlement from a third-party on the same incident.
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Problems with Physician Recruitment Agreements: Hospital Avoids Medicare Exclusion - 06/01/06
Health Care
June 1, 2006
On May 17, 2006, Tenet Healthcare Corporation has agreed to divest itself of Alvarado Medical Center ("Alvarado") in San Diego, protecting Alvarado from a possible exclusion from participation in Medicare, Medicaid and all other Federal health care programs.
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Electronic Medical Records on the Fast Track - 10/10/05
October 10, 2005
This Health Care Update discusses a new series of Health and Human Services regulations that will accelerate the use and the implementation of electronic medical records ("EMR") and electronic prescribing.
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Hurricane Response: Government Suspends Certain Healthcare Laws - 9/12/05
Health Care Client Alert
September 12, 2005
Sandra K. Herron
In the wake of what many are calling the greatest disaster in United States history, both the Federal and the Louisiana State governments have suspended the application of certain healthcare laws to the extent necessary, in the words of the Secretary of Health and Human Services, "to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Medicare, Medicaid and SCHIP programs, and to ensure that health care providers that furnish such items and services in good faith, but are unable to comply with one or more of these requirements as a result of the effects of Hurricane Katrina, may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination."
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Sale of Non-Profit Hospitals in Bankruptcy - 06/30/05
Health Care
June 30, 2005
Wendy L. Hagenau
It is not uncommon in a bankruptcy case for the debtor to sell its assets, either as part of a plan of reorganization or liquidation or pursuant to section 363 of the Bankruptcy Code. The Bankruptcy Code provides that such a sale occurs after notice to all creditors and an opportunity for a hearing.
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OIG Demonstrates Increased Willingness to Allow Physician Malpractice Insurance Subsidies - 01/12/05
Health Care
January 12, 2005
The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) is the Federal agency that is charged with enforcing the Federal Medicare/Medicaid Anti-Kickback Statute, which makes it a criminal offense to knowingly and willingly offer, pay, solicit or receive any remuneration for referrals of items or services paid by Federal health care programs.
In the past, OIG has expressed a deep distrust of arrangements in which hospitals or other entities subsidize malpractice insurance premiums for physicians. In the agency's view, physicians are potential referral sources and subsidies could be considered payments to influence referrals to hospitals.
The OIG's first departure from this position was the creation of a safe harbor for obstetrical malpractice insurance subsidies on November 19, 1999. The safe harbor provision permits hospitals and other entities in rural or urban underserved areas to pay for some or all of the obstetrical malpractice insurance premiums for obstetrical practitioners, including physicians and certified nurse midwives. However, at the time, it was not clear that the agency would allow such subsidies in other areas.
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Department of Health and Human Services Task Force Releases Report on Prescription Drug Importation - 12/23/04
December 23, 2004
Cynthia E. Berry
In this edition of the Advocacy & Government Relations Client Alert we discuss the final report (released on December 21) of the Department of Health and Human Services Task Force on Drug Importation. Reiterating that access to safe and affordable prescription drugs is an important policy goal, the Task Force concluded that drug importation would be costly to implement, provide little overall savings and, if not restricted to commercial importation from Canada, could be dangerous to consumers. The Task Force advised that all aspects of achieving safety, quality and cost-effectiveness must be comprehensively examined before imported drugs can be considered safe.
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New Stark Rules Bring Major Changes - 08/26/08
Health Care
Sandra K. Herron
Sandra K. Herron
On August 19, 2008, the Centers for Medicare and Medicaid Services published the latest changes to the Stark Law. The Stark Law regulates the types of arrangements into which physicians may enter. Violations of the Stark Law bring hefty civil fines and penalties.
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