Showing 40 posts from 2014.
Cracking Down on Fraud and Waste: OIG Releases Recommendations to Increase HHS Program Efficiency
In March of 2014, the Office of the Inspector General ("OIG") released the "OIG Compendium of Priority Recommendations." The recommendations offered are designed to help current programs for the Department of Health and Human Services ("HHS") run more effectively. The recommendation discussed twenty-five "opportunities" which, if addressed, would help to eliminate fraud and waste among HHS programs. The “opportunities” include the following: Read More ›
Categories: Compliance, Fraud & Abuse, Medicare/Medicaid, Providers
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New requirements for tax exempt hospitals imposed by the Affordable Care Act
The Affordable Care Act, enacted on
March 23, 2010, has established a number of new requirements that nonprofit
hospitals must meet to maintain tax exemptions. Some of these new obligations,
all codified in Section
501(r) of the Internal Revenue Code, include community health needs
assessment and implementation, financial assistance and emergency care policies,
limits on charges, and billing and collection restrictions.
In June 2012, the IRS released proposed regulations offering guidance to tax-exempt hospitals relating to certain provisions of Section 501(r). Although, the proposed regulations do not have the force of law, hospitals may rely on these to assist in implementing the requirements.
Below is a brief summary that highlights some of the new requirements for tax-exempt hospitals. Please refer to the full rule, Section 501(r) or contact us, to explore the extent of the new requirements in more detail.
Community health needs assessment and implementation (CHNA)
Effective for tax years beginning after March 23, 2012, hospital facilities must conduct a CHNA and adopt an implementation strategy at least once every three years. Read More ›
Categories: Health Care Reform, Hospitals
HHS Changes Policy, Expands Coverage for Physical Therapy
The New York Times (We have identified that the following link is no longer active, and it has been removed) recently reported that the Health and Human Services Department ("HHS") is changing its stance regarding Medicare payments for physical and occupational therapy treatments. Previously, coverage was only afforded for treatment that actually helped to improve a patient's condition. Read More ›
Categories: Medicare/Medicaid
CMS Finalizes Changes to Unnecessary, Obsolete, Counterproductive or Excessively Burdensome Regulations
On May 7, 2014, the Centers for Medicare and Medicaid Services (“CMS”) issued a Final Rule to reform Medicare regulations identified as “unnecessary, obsolete, counterproductive or excessively burdensome” to hospitals and other health care providers. The changes are part of the Obama administration’s “regulatory lookback” in connection with Executive Order 13563, “Improving Regulation and Regulatory Review.” The Final Rule makes a number of clarifications and revisions to policies set forth in both the May 16, 2012 final rule and the February 7, 2013, proposed rule. CMS estimates the reforms could save providers nearly $660 million annually and $3.2 billion over five years.
Below is a brief summary that highlights some of the issues CMS is attempting to address. Please refer to the Final Rule, or contact us, to explore the full extent of the changes in more detail. Read More ›
Categories: Compliance, Hospitals, Medicare/Medicaid, Providers, Regulatory
Michigan Allowed to Move Dual Eligibles to Managed Care
Approximately 9 million people in the United States are covered by both Medicare and Medicaid, including seniors with low income and younger people with disabilities. These so-called "dual eligibles" often have complex and costly health needs, and lawmakers have been seeking ways to reduce costs while maintaining and improving care for this segment of the population. Traditionally, coverage and care for dual eligibles has tended to be fragmented and expensive given the challenges posed by separate entities (Medicare and Medicaid) with separate coverage policies.
A number of states, including Michigan, have been working with the Centers for Medicare and Medicaid Services (CMS) to develop proposals to address these challenges, based on new authority in the Affordable Care Act. Through this initiative, 15 states were granted federal funding to help them better coordinate care for dual eligibles. Each of the states, including Michigan, was awarded up to $1 million to help develop new strategies and programs addressing these challenges. Read More ›
Categories: Health Care Reform, Insurance, Medicare/Medicaid, Providers
Obama Administration Makes Changes to Medicare to Accommodate Same-Sex Marriages
On Thursday, April 3, 2014, the Obama administration announced that it was taking steps to bring its Medicare rules in line with the United States Supreme Court's ruling in US v. Windsor. Specifically, the Department of Health and Human Services (“HHS”) announced that same-sex marriages would be recognized for determining Medicare entitlement and eligibility. Read More ›
Categories: Employee Benefits, Insurance, Medicare/Medicaid, Providers
Upcoming changes in the investigation and discipline of licensed health care professionals
Have you heard? Gov. Snyder signed four bills significantly changing the procedure for investigating and disciplining licensed health professionals under the Public Health Code on April 3. The four statutes take effect on July 1, 2014.
These important changes make it even more crucial for a health professional to consult with legal counsel experienced with the disciplinary process whenever he or she is contacted by the Bureau of Health Care Services (BHCS).
Learn more about the changes. Read the article here.
Categories: Licensing, Physicians, Providers
IT Contract Review
As health care providers continue to increase their use of technology, they are asked more and more frequently to enter into software or other IT contracts. While many health care providers sign these agreements without reviewing them, doing so can create unwanted liability and unexpected problems.
These issues were the topic of a recent State Bar of Michigan Health Care Law Section Webinar entitled “Software Licenses: What You Don’t Know Can Hurt You.” Sam Frederick from Foster Swift was a featured speaker. His presentation discussed important revisions that should be made to software provisions, as well as the consequences for relying on certain boilerplate provisions. In addition, health care providers must require that their software vendors with access to protected health information sign Business Associate Agreements. While many software agreements have business associate-like provisions included in them, they often do not meet all of the required elements under HIPAA. This exposes the health care provider to liability.
In summary, health care providers should have their attorney review any software or IT contracts presented to them and require that their vendors execute Business Associate Agreements. For assistance with this matters, please contact Sam Frederick at (517) 371-8103 or sfrederick@fosterswift.com
Health Insurance Providers Beware – April 15 is Quickly Approaching
The Patient Protection and Affordable Care Act requires that certain health insurance providers pay an annual fee based on the net premiums they wrote during the preceding calendar year. The providers required to pay this fee include health insurance issuers; health maintenance organizations; certain insurance companies; insurers providing Medicare Advantage, Medicare Part D, or Medicaid coverage; and multiple employer welfare arrangements.
In order to calculate the fees, the Internal Revenue Service (“IRS”) must obtain information related to the amount of net premiums written by each health insurance provider. This is accomplished through IRS Form 8963 (Report of Health Insurance Provider Information). Health insurance providers are required to submit Form 8963 to the IRS by April 15 of each year. Read More ›
Categories: Compliance, Health Care Reform, Insurance, Tax
HIPAA Compliance: Conducting a Risk Assessment
Maybe you have determined you're a Business Associate (or a subcontractor of a Business Associate) or maybe you’re a Covered Entity for purposes of HIPAA and have not gotten around to conducting or updating your risk assessment. Now is the time to do it.
HIPAA requires that Covered Entities, Business Associates, and subcontractors of Business Associates “[i]mplement policies and procedures to prevent, detect, contain, and correct security violations.” (45 CFR § 164.308(a)(1)). In order to fulfill these requirements, all entities subject to HIPAA’s Security Rule must run a risk assessment. A risk assessment is a “thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of electronic protected health information.” In the past, some of the largest penalties have been assessed against entities that had failed to conduct a proper risk assessment and subsequently experienced a breach. Read More ›
Categories: Compliance, HIPAA
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Best Lawyers® 2021
Congratulations to the attorneys of the Health Care practice group at Foster Swift Collins & Smith, PC for their inclusion in the Best Lawyers in America 2021 edition. Firm-wide, 44 lawyers were listed. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation and as lawyers are not required or allowed to pay a fee to be listed; inclusion in Best Lawyers is considered a singular honor. Health Care practice group members listed in Best Lawyers are as follows:
- Jennifer B. Van Regenmorter, Holland
To see the full list of Foster Swift attorneys listed in Best Lawyers 2021, click here.