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Structuring Clinical Practices to Prevent Pitfalls – Deeply Rooted Corporate Practice Doctrine Remains Strong

With growing patient demands, advanced technology and payer restraints, healthcare providers are increasingly exploring management agreements with experienced companies to handle the daily operations of their clinical practice. However, healthcare professionals need to be aware of the potential pitfalls in doing so, especially given the deeply rooted corporate practice of medicine doctrine in many states, … Continue Reading

Florida Emergency Power Plan Rule Requires Nursing Homes and Assisted Living Facilities to Obtain Generators

The deadline is November 15, 2017 In response to the death of eight nursing home residents after a power failure in Hollywood, Florida during Hurricane Irma, Florida regulators recently issued emergency rules requiring the state’s nursing homes and assisted living facilities to have and maintain backup generators and alternate fuel for power emergencies. However, due to … Continue Reading

Capitol Hill Healthcare Update

Democrats and Some Republicans Say Congress Must Restore Insurer Subsidies President Trump’s announcement Friday that he would stop cost-sharing payments to insurance companies triggered a firestorm on Capitol Hill, with lawmakers in both parties calling on Congress to restore the funding quickly. House Democratic Leader Nancy Pelosi (D-Calif.) said lawmakers could leverage upcoming must-pass budget … Continue Reading

Five New Team Members Join BakerHostetler’s National Healthcare Practice

Partner Mark A. Kadzielski and Counsel Jeeyoung Kim have joined BakerHostetler in our Los Angeles office. Mark focuses his practice on representing hospitals, medical staffs, managed care enterprises and institutional and individual healthcare providers through government regulatory and licensing matters, peer review, joint commission accreditations, credentialing, compliance and corporate government oversight, and Medicare certification. Jeeyoung will work closely with … Continue Reading

Capitol Hill Healthcare Update

CHIP Renewal Triggers Partisan Clash Over Offsets Although the Children’s Health Insurance Program (CHIP) enjoys broad bipartisan support on Capitol Hill, lawmakers last week sharply disagreed over how to pay for its renewal – signaling that a final vote could be delayed for months. The House Energy and Commerce Committee and the Senate Finance Committee … Continue Reading

Capitol Hill Healthcare Update

Alexander, Murray Seek Health Law Stabilization Agreement With congressional Republicans’ efforts to repeal the Affordable Care Act (ACA) on hold at least for now, the bipartisan leaders of the Senate HELP Committee are seeking to rekindle their work to shore up the health law’s troubled individual marketplace. Committee Chairman Lamar Alexander (R-Tenn.) said he hoped … Continue Reading

Preparing for the New Partnership Audit Rules

The Bipartisan Budget Act of 2015 substantially changed audit-related rules impacting entities taxed as partnerships, including both state-law partnerships and many limited liability companies (LLCs). The most significant change is that any additional tax or penalties resulting from an audit of an entity taxed as a partnership generally will be assessed and collected at the … Continue Reading

Capitol Hill Healthcare Update

GOP Divisions Threaten to Sink ACA Repeal Effort – Again Republicans’ last-ditch effort to overhaul the Affordable Care Act (ACA) suffered potentially fatal blows as GOP senators in recent days voiced either outright opposition to or serious reservations about legislation pushed by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.). The senators’ bill would repeal … Continue Reading

OIG Signs Up for Customer Loyalty Program

In Advisory Opinion 17-05, posted by the U.S. Department of Health and Human Services Office of Inspector General (OIG) on September 7, 2017, the OIG approved a pharmacy’s customer loyalty/discount program (Benefit Program). Under the arrangement, members of the Benefit Program pay a fixed annual fee for access to the following benefits: Discounts on generic drugs, … Continue Reading

Capitol Hill Healthcare Update

ACA Stabilization Effort Continues Amid Uncertain Senate Fate The chairman of a Senate healthcare committee outlined a key test for stabilizing the Affordable Care Act’s (ACA) shaky individual marketplace: Both Republicans and Democrats will have to give a little. That formula has been wildly unsuccessful not only this year but also in recent years as … Continue Reading

Capitol Hill Healthcare Update

While Some Republicans Press For New ACA Repeal, Vote This Month Unlikely Some Republican lawmakers, led by Sen. Lindsey Graham (R-S.C.), are pushing new plans to overhaul the Affordable Care Act (ACA), but other policy priorities and tight legislative deadlines this month are likely to thwart attempts to rekindle ACA repeal efforts. Congress faces a … Continue Reading

Is the Dam Breaking? Over-the-Counter Hearing Aids

The FDA Reauthorization Act (H.R. 2430), recently signed into law by President Donald Trump, included the Over-the-Counter (OTC) Hearing Aid Act, which requires the Food and Drug Administration (FDA) to develop regulations within three years for hearing aids to be sold over-the-counter to individuals with mild to moderate hearing loss. The Senate passed the legislation … Continue Reading

Breaching Physician Doubles Down on His Debt

In drafting recruitment agreements, providers should separate the employment agreement from the other agreements to help diffuse breach of employment agreement arguments as a defense to the repayment of recruitment advances. Dr. Robert Halterman entered into a recruitment agreement (Recruitment Agreement), a promissory note (Note) and a physician employment agreement (Employment Agreement) with Johnson Regional … Continue Reading

Hurricane Harvey Special Alert

Hurricane Harvey has left our Houston and Texas communities with significant recovery and restoration needs. As attorneys, we struggle with how we can be most helpful. It is in this spirit, that we have compiled a Special Alert to help our clients, friends, family and community. In the days and weeks ahead, our work will … Continue Reading

CMS Digging In on Medicaid DSH Payments

During the summer months, several developments have occurred concerning the Medicaid Disproportionate Share Hospital (DSH) policy that the Centers for Medicare & Medicaid Services (CMS) has implemented, to the detriment of a number of hospitals. These hospitals and state hospitals associations have challenged CMS in district courts all over the country and several courts ruled … Continue Reading

Back to School Rules Recap: Hospital and Physician Cheat Sheet on What CMS Did This Summer

Summer was no vacation for the Centers for Medicare & Medicaid Services (CMS). The agency released a series of significant rules that signal the nature and pace of CMS Medicare payment and policy changes for hospitals and physicians under the Trump administration. For anyone who did take a vacation, this article provides a rulemaking cheat … Continue Reading

Capitol Hill Healthcare Update

Editor’s Note – The next Capitol Hill Healthcare Update will be published after Labor Day when Congress reconvenes following its August recess. Republicans Contemplate Next Steps Amid ACA Flameout Congressional Republicans and President Donald Trump face a series of key questions about how or whether to fortify the Affordable Care Act – particularly in the … Continue Reading

Capitol Hill Healthcare Update

Senate Readies for Key Procedural Vote on Healthcare Bill – Maybe Senate Republicans face a key procedural vote this week that would allow for debate of their healthcare legislation, but significant uncertainty remains about whether GOP senators can meet that procedural hurdle, what the underlying healthcare bill would be and how an impending White House … Continue Reading

CMS Proposes CY 2018 Quality Payment Program Policy Changes that Signal Intent to Reduce the Pace and Burdens of MACRA

On June 30, the Centers for Medicare & Medicaid Services (CMS) issued a much anticipated rule outlining proposed payment and policy changes to the new Medicare Part B Quality Payment Program (QPP) that was created by the Medicare Access and Chip Reauthorization Act of 2015 (MACRA). The proposed rule seeks to offer additional flexibility and … Continue Reading

Capitol Hill Healthcare Update

Delayed Senate Health Vote Boon to GOP or Just Prolonging the Inevitable? Senate Majority Leader Mitch McConnell’s announcement that he would delay a key procedural vote scheduled for this week on the Republicans’ healthcare overhaul gave the GOP yet more time to find a legislative solution that can pass the Senate. But given McConnell’s inability … Continue Reading

OIG Report Estimates CMS Paid Millions in Erroneous Meaningful Use Incentives

On June 12, 2017 the Department of Health and Human Services Office of Inspector General (OIG) released a report entitled Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did Not Comply With Federal Requirements (Report) which estimates that between May 2011 and June 2014, the Centers for Medicare & Medicaid Services … Continue Reading
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