Health Care Counsel Blog

Health care lawyers are familiar with the term “underground rulemaking,” which refers to efforts by federal agencies to impose obligations on providers and suppliers informally, without using the processes required by law. That issue has recently attracted the attention of the US Senate. 

Arent Fox LLP is proud to announce that, for the thirteenth year in a row, Health Care partner Linda A. Baumann served as editor-in-chief of a comprehensive desk reference focused on fraud and abuse for lawyers in the health care industry.

Arent Fox LLP is proud to announce the publication of a comprehensive and definitive book for health care industry leaders focused on risk management and litigation.

The US Department of Health and Human Services Office of Inspector General, the Association of Healthcare Internal Auditors, the American Health Lawyers Association, and the Health Care Compliance Association jointly released an educational resource for governing boards.

On March 31, 2015, the Supreme Court of the United States issued a 5-4 decision in the case of Armstrong v. Exceptional Child Center, Inc., 575 U.S. __ (2015), holding that health care providers do not have the right to sue a state Medicaid program under Section 30(A) of the federal Medicaid Act (Se

This change in policy also could make a tremendous difference to provider operations since it would allow them to have access to certain funds during the very lengthy period while they wait for the ALJ determination.

California’s 4th District Court of Appeal issued its opinion in Gerard v. Orange Coast Memorial Medical Center, invalidating the portion of California IWC Wage Order No. 5 that permitted non-exempt health care employees to waive a second meal period for shifts longer than 12 hours.

Arent Fox partner Lowell C. Brown, head of the firm’s Health Care practice, was quoted in a recent Bloomberg BNA article following a novel and groundbreaking decision by the New Mexico Supreme Court.

When the Bylaws specifically and directly speak, for example, in matters of credentialing criteria, peer review processes, and Medical Staff hearing procedures, the pronouncements are not viewed as suggestions or hints. Rather, the Medical Staff Bylaws set forth requirements.

On February 10, 2015, in this most recent win for the federal enforcement agency, the US Court of Appeals for the Ninth Circuit affirmed the FTC’s injunction against St. Luke’s Health System and a large physician group in Idaho.

The Department of Health and Human Services (HHS) announced last week that, over the next four years, it plans to shift half of its traditional fee-for-service Medicare payments to those that create value through better coordinated care.

In a meeting with almost two dozen health care leaders on January 26, 2015, Health and Human Services (HHS) Secretary Sylvia M. Burwell outlined the clear goals and timelines for moving the Medicare program towards quality-based payments, from quantity or fee-for-service payment models.

For almost 30 years, hospitals and certain other health care organizations have been required to report to the National Practitioner Data Bank (NPDB) specified “adverse actions” regarding  physicians and dentists that they employ, contract with, or have on staff.

The beginning of 2015 brings implementation of The Joint Commission’s (TJC) newly rewritten Sentinel Events Policy (Policy) for hospitals. Released in late 2014, and effective January 1, 2015, the Policy clarifies and puts into operation new and revised definitions and expectations.

On December 30, 2014, the Department of Health and Human Services Office of Inspector General (OIG) published its annual solicitation for the development and/or modification of safe harbor provisions under the Federal Anti-Kickback Statute.

The Department of Health and Human Services Office of Inspector General posted Advisory Opinion No. 14-11 addressing a charitable foundation’s request to provide cost-sharing assistance to financially needy patients diagnosed with either Crohn’s disease or ulcerative colitis.

It will be interesting to see if the Rule survives the judicial, and perhaps even legislative, challenges it may face. If you have any questions about the Rule, please contact the authors of this post or the Arent Fox professional who handles your matters.

On November 20, 2014, the US Department of Justice (DOJ) reported that False Claims Act recoveries from civil settlements and judgments in Fiscal Year 2014 (ending September 30) reached a record $5.69 billion.

In a decision that is good news for California hospitals, the California Court of Appeal invalidated class certification when a San Diego-based hospital system proved that the only way to determine the members of an uninsured patient class was to review more than 120,000 patient records.

The government’s recent and ongoing emphasis on eliminating health care fraud, waste and abuse appears likely to increase criminal prosecutions.

The 2014 midterm Congressional elections have resulted in a significant wave of victories for the Republican Party that confers new majority status in the US Senate and expands the majority in the US House of Representatives.

On October 23, 2014, we sponsored a webinar about the escalating cybercrime threat to the health care industry, with analysis of some of the legal issues and suggestions on how to prepare for such an attack.

In an effort to encourage hospitals to take advantage of the 68 percent settlement offer for previously denied inpatient claims, [1] the Centers for Medicare and Medicaid Services (CMS) recently announced a new procedure.

Health care organizations are increasingly under attack from cybercriminals seeking to gain access to confidential data and to Internet connected medical devices. Health care cybercrime is a reality. Are you prepared?

The Seventh Circuit Court of Appeals recently affirmed a lower court’s conclusion that a doctor in a service corporation was actually an employer, and thus could not bring a claim under federal discrimination statutes based upon her termination