On December 11, 2019, the Center for Clinical Standards and Quality/Quality, Safety & Oversight Group at the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum to State Survey Agency Directors entitled “Fiscal Year (FY) 2020 Mission & Priority document (MPD) – Action” (“FY 2020 Memo”) that announced its work and intentions for the fiscal year 2020.

The Fiscal Year Mission & Priority document is an annual document that directs and outlines the work of the Quality, Safety & Oversight Group, the CMS Regional Offices and the State Survey Agencies based on regulatory changes, adjustments in budget allocations and new initiatives, as well as new requirements based on statutes such as the Improving Medicare Post-Acute Care Transformation Act of 2014 (“IMPACT Act”).

Prior Goals

In its Fiscal Year 2019 Mission Priority document, CMS announced its intention to: (1) issue these proposed regulations in areas it identified as unnecessary, obsolete or excessively burdensome on health care providers and suppliers; and (2) publish a proposed rule to fully enforce Section 1150B requirements for reporting crimes to nursing home residents, which would propose a regulation that would allow Civil Money Penalties to be imposed of up to $200,000 against covered individuals (staff, volunteers, etc.) who fail to report reasonable suspicion of crimes.

Fiscal Year 2020 Goals

The FY 2020 Memo announced the following post-acute priorities for 2020.

Nursing Homes: Finalize Regulations, Then Update State Operations Manual

Earlier in 2019, CMS released proposed regulations motivated by an intention to remove requirements for participation CMS identified as unnecessary, obsolete or excessively burdensome nursing homes. The FY 2020 Memo announced that CMS intends to finalize those regulations in 2020.

CMS confirmed that once those regulations are finalized, it will provide guidance to state agencies for surveying for compliance with the final regulations. On November 22, 2019, the Quality, Safety & Oversight Group at CMS issued a memorandum entitled “Updates and Initiatives to Ensure Safety and Quality in Nursing Homes” that announced they will release updated Interpretive Guidance for Phase 3 of the Regulations in the second quarter of 2020. At that time, CMS will also release information on training and implementing related changes to the Long-Term Care Survey Process.

Nursing Homes: Agreements to Arbitration of Disputes

Earlier in 2019, CMS issued a final rule updating the requirements nursing homes must meet to use binding arbitration agreements. The FY 2020 Memo confirms that CMS is allowing binding arbitration agreements, but will prohibit nursing homes from requiring residents to sign binding arbitration agreements as a condition for receiving care, and will require nursing homes to inform residents or their representatives that they are not required to sign a binding arbitration agreement.

CMS confirmed that it is prohibiting nursing home arbitration agreements from including language preventing residents or anyone else from communication with federal, state or local officials.

The FY 2020 Memo announced that CMS will issue guidance to state agencies for surveying for compliance with the final rule on arbitration agreements in 2020.

Nursing Homes: Facility Reported Incidents and Complaint Investigations

The FY 2020 Memo states that CMS plans to release guidance in Chapter 5 of the State Operations Manual related to the management of facility-reported incidents and complaints. The FY 2020 Memo provides that changes would include the development and implementation of policies and procedures that are consistent with federal guidelines, adherence to federal time frames for investigation, the collection of mandated elements from the initial and investigation reports and the collection of data to support the tracking of facility-reported incidents.

Home Health Agencies

CMS announced it will implement a new survey process for home health agencies in FY 2020 and will simplify procedures for moving from standard to partially extended to extended surveys.

The FY 2020 Memo states that home health surveys should include a sample of extension locations.

Hospice Agencies

CMS announced it is working on revisions to the hospice survey process with a target release date of late 2020. Under the IMPACT Act of 2014, each Medicare-certified hospice must be surveyed by the State Agency or Accrediting Organization no less frequently than every 36 months.

The FY 2020 Memo states that hospice surveys should include a sample of multiple locations in the survey process. At a minimum, the sample should be included in the record reviews and onsite visits when possible.

If you have questions or would like additional information about this topic, please contact:

• Sean Fahey at (317) 977-1472 or sfahey@hallrender.com;
• Todd Selby at (317) 977-1440 or tselby@hallrender.com;
• Brian Jent at (317) 977-1402 or bjent@hallrender.com; or
• Your regular Hall Render attorney.

More information about Hall Render’s Post-Acute and Long-Term Care services can be found here.

The post CMS Announces Post-Acute Priorities for 2020 – Final Regulations, State Operation Manual Updates, Home Health and Hospice Survey Process Revisions appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

Under the federal Stark Law, hospitals may provide non-monetary compensation to physicians up to an aggregate amount of $423 for calendar year 2020. The dollar limit for “medical staff incidental benefits” (e.g., meals, parking and other items or incidental services that are used on the hospital’s campus) is less than $36 per occurrence. Other requirements of the Stark Law’s exception for non-monetary compensation and medical staff incidental benefits also need to be met. Hospitals should take inventory of such non-monetary compensation and benefits to confirm they are meeting the law’s requirements.

Detailed Analysis

The Stark Law provides that if a hospital has a financial relationship with a physician, the physician may not refer to the hospital for the provision of “designated health services” (including inpatient and outpatient hospital services) and the hospital may not bill for such services unless an exception is met. A “financial relationship” under the Stark Law is construed very broadly, which means all remuneration from a hospital to a physician must be considered, including in-kind compensation.

Pursuant to the Stark Law regulations at 42 C.F.R. § 411.357, there are exceptions for non-monetary compensation. Generally, the non-monetary compensation exception may be used to protect items or services provided to a physician such as entertainment, meals and other non-cash equivalent benefits. Specific detail about the exception is outlined below. Hospitals should review and ensure they are meeting these exceptions.

Non-Monetary Compensation up to $423

Compensation from an entity in the form of items or services (not including cash or cash equivalents such as gift cards) that do not exceed an aggregate of $423 per year, if all of the following conditions are satisfied:

• The compensation is not determined in any manner that takes into account the volume or value of referrals or other business generated by the referring physician.
• The compensation may not be solicited by the physician or the physician’s practice (including employees and staff members).
• The compensation arrangement does not violate the Anti-Kickback Statute or any federal or state law or regulation governing billing or claims submission.

Where an entity has inadvertently provided non-monetary compensation to a physician in excess of the $423 limit, such compensation is deemed to be within the $423 limit if the value of the excess non-monetary compensation is no more than 50 percent of the $423 limit and the physician returns to the entity the excess non-monetary compensation (or an amount equal to the value of the excess non-monetary compensation). The return must be made by the end of the calendar year in which the excess non-monetary compensation was received or within 180 consecutive calendar days following the date the excess non-monetary compensation was received by the physician, whichever is earlier. This “return” option may be used by an entity only once every three years with respect to the same referring physician.

Medical Staff Incidental Benefits

Compensation in the form of items or services (not including cash or cash equivalents) from a hospital to a member of the medical staff when the item or service is used on the hospital’s campus if all of the following conditions are met:

• The compensation is offered to all members of the medical staff practicing in the same specialty (but not necessarily accepted by every member to whom it is offered) without regard to the volume or value of referrals or other business generated between the parties.
• Except with respect to identification of medical staff on a hospital website or in hospital advertising, the compensation is provided only during periods when the medical staff members are making rounds or are engaged in other services or activities that benefit the hospital or its patients.
• The compensation is provided by the hospital and used by the medical staff members only on the hospital’s campus. Compensation, including, but not limited to, internet access, pagers or two-way radios, used away from campus only to access hospital records or information or to access patients or personnel who are on the hospital campus, as well as the identification of the medical staff on a hospital website or in hospital advertising, meets this “on campus” requirement.
• The compensation is reasonably related to the provision of, or designed to facilitate directly or indirectly the delivery of, medical services to the hospital.
• The compensation is of low value (that is, less than $36) with respect to each occurrence of the benefit (e.g., each meal given to a physician while he or she is serving patients who are hospitalized must be of low value).
• The compensation is not determined in any manner that takes into account the volume or value of referrals or other business generated between the parties.
• The compensation arrangement does not violate the Anti-Kickback Statute or any federal or state law or regulation governing billing or claims submission.
• Other facilities and health care clinics (including, but not limited to, federally qualified health centers) that have bona fide medical staffs may provide compensation under this exception on the same terms and conditions applied to hospitals.

Practical Takeaways

Hospitals should update 2020 non-monetary compensation tracking tools to reflect the new non-monetary compensation limit of $423 and medical staff incidental benefits limit of $36 per occurrence. Further, hospitals should review non-monetary compensation provided in 2019 to ensure that such compensation did not exceed the 2019 limit of $416 and take any necessary corrective action to repay excess amounts within the earlier of 180 days of the overpayment or by December 31, 2019.

If you have any questions or would like any additional information about this topic, please contact:

• Gregg M. Wallander at gwally@hallrender.com or 317-977-1431;
• Alyssa C. James at ajames@hallrender.com or 317-429-3640;
• Katherine M. Schwartz at kschwartz@hallrender.com or 317-977-1432; or
• Your regular Hall Render attorney.

The post 2020 Non-Monetary Compensation to Physicians (And Chance to Review 2019) appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

Massive FY 2020 Funding Bills Loaded with Health Care-Related Provisions

Just hours before another looming government shutdown, President Trump signed a two-part spending deal funding federal agencies that include CMS, FDA and NIH, among others. The funding bill contains several significant health policy provisions. Most notably, it will repeal three taxes enacted as part of the ACA – the medical device excise tax, the annual fee on insurers known as the health insurance tax (“HIT”) and the 40 percent excise tax on high-cost health insurance plans known as the “Cadillac Tax,” which is the largest cost of the bill at more than $373 billion over 10 years. The measure also delays DSH pay cuts for another 5 months and raises the minimum age to purchase tobacco products to 21.

Several Medicare and Medicaid extenders will be funded through May 22, 2020, which are: community health centers, National Health Service Corps; Teaching Health Center Graduate Medical Education Program; Special Diabetes Program and Special Diabetes Program for Indians; Work Geographic Price Cost Index; outreach and assistance for low-income programs; quality measure endorsement and selection; State Health Insurance Assistance Programs; Area Agencies on Aging; Aging and Disability Resource Centers; Certified Community Behavioral Health Clinic demonstration, along with some additional funding for substance-use disorder treatments; spousal impoverishment protections; and the Money Follows the Person demo. The May 2020 deadline is intended to create pressure for a Memorial Day deal on a comprehensive health care package for items such as prescription drug pricing and surprise billing.

Other health-related provisions in the spending deal include laboratory payment data reform and a prohibition to stop the administration from barring “silver loading” or the practice allowing insurance plans to add costs to the silver-tiered insurance plans purchased on the insurance exchanges. The CREATES Act is also included, which will make it easier for generic drug companies to access samples of brand-name drugs. The funding bill also extends the Patient-Centered Outcomes Research center for 10 years and adds research priorities such as maternal mortality and developmental disabilities.

Despite all of these provisions, the legislation leaves Congress with a lengthy health care to-do list for next year. Here’s what wasn’t included in the spending bill that is expected to come up again 2020:

Surprise Medical Bills: Despite an agreement between HELP Chairman Sen. Lamar Alexander and House Energy and Commerce leadership, surprise billing provisions were not included in the spending package. Because the temporary Medicare and Medicaid extenders expire in May, Congress has time to work out the details on a surprise billing package that could be included in the extenders legislation.

Prescription Drug Pricing: The CREATES Act is the only drug-pricing provision included in the spending bill. Congress is working on a larger, more ambitious package to potentially pass in May 2020.

Price Transparency and Other Health Cost Legislation: Proposals related to health costs, such as in hospital/insurance contacts and pharmacy benefit manager provisions, were not included in this package but are expected to be addressed next year.

Administration Proposes Prescription Drug Import Plan

On December 18, HHS moved forward with its plan to allow states and drug makers to import lower-cost prescription drugs from other countries. Specifically, the proposed rule would allow states to pursue pilot programs allowing importation of drugs from Canada. However, the import rule excludes controlled substances, biological products and intravenous drugs. The FDA also issued draft guidance allowing drug manufacturers to import their own products and sell them under different drug codes.

So what would be the impact of this proposal? Todd Nova, the attorney who leads Hall Render’s pharma practice, answers, “this is really about the FDA taking more concrete steps to issue regulatory guidance using mechanisms already authorized by Congress. Ultimately, depending on what is contained in the final rule, it may be the case that the mere threat of importation could result in reduced pricing for common shortage drugs, decreasing the incentive for interested parties to go through the importation process. The true impact will really be seen once we see what barriers to entry are imposed in the final rule. To be sure, we anticipate both manufactures and purchasers will submit a large number of comments both in support of and in opposition to this rule. Those comments will be due by March 8, 2020 assuming the anticipated publication timeline is met.”

President Trump Impeached in the House

The House of Representatives voted to impeach President Trump before heading home for the holidays. Once House Speaker Nancy Pelosi (D-CA) transmits the articles of impeachment to the Senate, that body is expected to hold a trial in January to determine whether the president will be acquitted or removed from office. Given that Republicans control the Senate and it takes 67 votes to remove the president from office, it is very likely that he will be acquitted.

Health-Related Bills Introduced This Week

Rep. Jan Schakowsky (D-IL) introduced H.R. 5501 to amend the Public Health Service Act to establish an Office of Drug Manufacturing.

Sen. Tina Smith (D-MN) introduced S. 3126 to amend the Public Health Service Act to authorize a special behavioral health program for Indians.

Rep. Adam Kinzinger (R-IL) introduced H.R. 5481 To amend Title XVIII of the Social Security Act to restore state authority to waive for certain facilities the 35-mile rule for designating critical access hospitals under the Medicare program. Sen. Dick Durbin (D-IL) introduced S. 3103 for this purpose in the Senate.

Rep. Gus Bilirakis (R-FL) introduced H.R. 5473 to amend Title XVIII of the Social Security Act and the SUPPORT for Patients and Communities Act to provide for Medicare and Medicaid mental and behavioral health treatment through telehealth.

Sen. Mike Crapo (R-ID) introduced S. 3085 to amend Title XVIII of the Social Security Act to modernize payments for ambulatory surgical centers under the Medicare program.

Next Year in Washington

This Week in Washington’s motto for 2020 is “New Year, New You.” Congress returns on January 7, and this publication will return on Monday, January 13, reporting on the first week back as The Week in Washington. The Week in Washington will publish on Mondays and have a new format while reporting on all of the exciting health policy developments in 2020.

Readers – we wish you happy holidays and a happy new year!

For more information, please contact:

• John Williams III at (202) 370-9585 or jwilliams@hallrender.com;
• Andrew Coats at (202) 370-9587 or acoats@hallrender.com;
• Abby Kaericher at (202) 780-2989 or akaericher@hallrender.com; or
• Your regular Hall Render attorney.

The post Hall Render’s This Week in Washington – December 23, 2019 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

We previously wrote about the “quickie” election rules here. On December 13, 2019, the NLRB released new election rules that significantly dialed back several previous amendments. Under the quickie election rules, or “Old Rules,” the median number of days from petition to election had decreased by a total of approximately 15 days.[1]

Union Election Basics and the 2014 Amendments

To start the election process, the union or employees who want a union must file a petition for election with the nearest National Labor Relations Board (“NLRB”) Regional Office showing interest in the union from at least 30 percent of employees in the proposed unit. The NLRB regional office then investigates the petition,[2] after which the employer and the Union often negotiate the terms of the election in an election agreement. If the employer and the union are unable to agree on the election or its terms, depending on the subject of the disagreement, they proceed to what is called a “Representation” or “R-Case” hearing.

As a cumulative result of the “quickie” election rules, which were roughly 25 separate regulatory amendments, the median time between petition and election had gone from 38 to 23 days in the case of an election agreement, and 59 days to as low as 36 days where there was a contested hearing.[3] The changes were seen as particularly unfavorable to employers since they had far less time to prepare for elections, educate employees and handle their election-related obligations.

The New Rules

The New Rules were released in response to concerns that the time frame created under the “quickie rules” was too short for employers to meet various obligations while educating employees before the election. The New Rules addressed this issue by creating more time between the filing of the petition and the actual [contested] election. Here are some of the most significant changes:

1. Under the New Rules, elections can be set no fewer than 20 business days after the direction of an election. The Old Rules had eliminated the pre-2014 requirement of a 25-day gap between the day the board ordered an election and the day it was conducted. The New Rules reinstate a modified version of the gap by further providing “unless a waiver is filed, the regional director will normally not schedule an election before the 20th business day after the date of the direction of election.”[4]
2. Under the New Rules, issues of unit scope and employee eligibility should be litigated before the election. Under the Old Rules, “[d]isputes concerning individuals’ eligibility to vote or inclusion in an appropriate unit ordinarily need not [have been] litigated or resolved before an election [was] conducted,” and pre-election testimony was limited to items “relevant to the existence of a question of representation.” This is in great contrast to the New Rules, which suggest that disputes concerning unit scope, voter eligibility and supervisory status will normally be litigated and resolved by the regional director before an election is directed.
3. The New Rules reinstate the right of the parties to submit post-hearing briefs after pre-election hearings. Under the Old Rules, post-hearing briefs were not allowed absent “special permission” from the regional director.
4. Under the New Rules, the pre-election hearing will be scheduled to open 14 business days from the notice of hearing. Under the Old Rules, this was only 8 calendar days.
5. Under the New Rules, the employer will now be required to post and distribute the Notice of Petition for Election within 5 business days after service of the notice of hearing. The Old Rules required posting and distribution within 2 business days.
6. Under the New Rules, non-petitioning parties are now required to file and serve their Statement of Position within 8 business days after service of the notice of hearing, and regional directors will have the discretion to permit additional time for filing and service for a good cause. Under the Old Rules, non-petitioning parties were formerly required to file and serve the Statement of Position one day before the opening of the pre-election hearing (typically 7 calendar days after service of the notice of hearing).
7. The New Rules require the employer to provide voter lists within 5 business days; under the Old Rules, they had only 2 business days.

Practical Takeaways

The New Rules are a considerable step back from the “vote now, decide later” framework that characterized the 2014 quickie election rules that were more focused on the need for speed in elections. Despite the New Rules being welcome news, celebrations may not yet be in order:

• The New Rules are not expected to take effect until mid-April, 2020, some 120 days after they are scheduled to be published in the Federal Register.
• Under the New Rules, particularly where there are contested issues, employers will have more time to educate their employees.
• Since the NLRB issued the final rule without going through the full notice and comment rulemaking process, “pursuant to its authority to change its own representation case procedures,” the controversial changes may nevertheless be subject to further judicial review.
• Time will tell whether the additional time before an election will significantly alter election outcomes.

If you have any questions or would like additional information, please contact:

• Brad Taormina at (248) 457-7895 or btaormina@hallrender.com;
• Bruce Bagdady at (248) 457-7839 or bbagdady@hallrender.com;
• Saniya Khare at (248) 457-7852 or skhare@hallrender.com; or
• Your regular Hall Render attorney.

The post NLRB Curtails “Quickie” Election Rules appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

NATIONAL

• Electronic Health Records Creating a ‘New Era’ of Health Care Fraud, Officials Say
• ‘Epidemic’: 75% Of Workplace Assaults Happen To Health Care Workers
• Despite privacy concerns, 88% of Americans would share data for cancer research
• Nonprofit hospitals get bump in Moody’s ratings for 2020
• HHS proposed rule adds new performance measures for organ procurement
• 21 notable phishing attacks of 2019
• Medical breakthroughs, looser FDA made biotech stocks one of the decade’s best investments
• ‘Food pharmacies’ in clinics: When the diagnosis is chronic hunger
• Hospitals across the country look to expand housing for homeless patients
• Do Breach Remediation Efforts Affect Patient Outcomes?
• Top 5 healthcare supply chain stories of 2019
• Hospital Group Mum As Members Pursue Patients With Lawsuits And Debt Collectors
• Why Amazon Makes A Big Pharmacy Move In 2020
• Health Data Security: Federal, State Trends for 2020
• Dignity Health’s $100M ERISA class-action settlement was largest of 2019
• In 2019, social determinants of health got the attention they deserve
• Value-Based Care, Hospital Chargemasters Dominated 2019 Headlines
• Tenth Circuit Upholds HHS Risk Adjustment Methodology
• Physician group will refund Medicare $829K to resolve improper billing case
• Patients don’t factor in hospital’s religious affiliation when choosing care, study shows

NORTHEAST

(Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont)

CONNECTICUT

• • Legislators Support $1.8 Billion State Hospital Settlement
  • Primary Care Torrington relocates to Sky Top Plaza
  • Hospital agreement is a road map for funding community nonprofits
  • Tax changes, mental health parity among new Connecticut laws
  • Connecticut lawmakers ratify $1.8B settlement with hospitals

MAINE

• • An era ends at Stephens Memorial Hospital
  • Target date for Mid Coast, MaineHealth merger delayed, but moving ahead
  • Proposed Mayo Regional Hospital, Northern Light Health Merger Faces Legal Challenge
  • USDA grant will support telehealth care in central and western Maine
  • Merger of Dover-Foxcroft hospital and Northern Light Health one step closer to completion
  • Northern Light Eastern Maine Medical Center welcomes new president
  • As urgent care centers expand, small hospitals feel the pinch
  • With DHHS approval, MaineHealth, Mid Coast-Parkview move closer to merger
  • Hospital mergers across US have raised health care prices. Now, another is pending in Maine.

MASSACHUSETTS

• • Lowell General Hospital Turns Amazon’s Alexa Into an mHealth Coach
  • Partners vowing to end surprise billing
  • Massachusetts’ Largest Health Care Provider Plans Expansion
  • Partners HealthCare to expand in Westwood
  • Many Massachusetts healthcare workers are refusing flu shots, regulators say
  • Another option for family caregivers

NEW HAMPSHIRE

• • As urgent care centers expand, small hospitals feel the pinch
  • New Hampshire health care providers face long waits for VA reimbursement
  • River Valley Community College adds nursing program to Claremont campus
  • Opioids, financial turbulence alter health care landscape
  • Partners Healthcare announces plans for outpatient center in Tuscan Village
  • New Hampshire hospitals claim VA owes millions in unpaid bills

NEW YORK

• • In NY, number of nursing home monitors in decline
  • NYU Langone Health Opens Biotech Incubator In Manhattan
  • New York hospital giant gains FDA approval for PET agent to diagnose Parkinson’s
  • St. Mary’s Healthcare in Amsterdam continues string of expansion projects
  • News10NBC Investigates: Wesley Gardens CEO addresses mass evacuation
  • Upstate hospitals falling behind in quality, report finds
  • Cuomo unveils plan for health care cost website
  • 2 New York hospitals merge
  • Feds deny New York hospital’s application for CAH status
  • New York-Presbyterian mobile stroke units cut 30 minutes from treatment time
  • Massena Memorial Hospital denied conversion to Critical Access Hospital
  • NY lawmakers call for minimum staffing rules at hospitals, nursing homes
  • Interim head of Nassau University Medical Center to resign
  • Garrison named facilities director at Finger Lakes Health
  • Ellis Medicine to close surgery program
  • NYC Health + Hospitals/Coney Island names Svetlana Lipyanskaya CEO
  • Crouse Health selects Kevin Randall as CFO

RHODE ISLAND

• • Wood River Health is working to improve efficiency
  • Health insurance mandate takes effect in Rhode Island
  • Miller honored by RI Health Center Association

VERMONT

• • Community Health names Don Reuther CEO
  • Group that provides care in Vermont county has new leader
  • Vermont ACO whistleblower plans to abandon False Claims case
  • U of Vermont Medical Center names veteran doc new president
  • Health Care: In effort to save money, hospitals might get too tight
  • Stephen Leffler named president of UVM Medical Center
  • As urgent care centers expand, small hospitals feel the pinch
  • Duchene appointed VP of Patient Care and Chief Nursing Officer
  • Empowering patients, improving the care experience

MID-ATLANTIC/EAST                                                                 

(Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia, West Virginia)

DELAWARE

• • Beebe Healthcare campaign brings in record number of dollars
  • Hospital group: Pre-existing conditions protection remain in place in Delaware after Affordable Care Act ruling
  • Healthcare programs in Sussex continue to expand
  • How Pennsylvania, New Jersey and Delaware fare in healthiest state rankings
  • NIIMBL funding limit lifted by Congress

DISTRICT OF COLUMBIA

• • The next big project at St. Elizabeths East? Parking.
  • D.C. Ranks Among The Country’s Fittest Cities, Yet There’s A Dearth Of Gyms In Wards 7 And 8
  • Walter Reed Hospital Redevelopment Lands Whole Foods As Grocery Anchor
  • Lawsuit accuses UHS of improperly diverting $100M from hospital

MARYLAND

• • Maryland’s suburbs hit harder by prescription opioids
  • Dr. Sherry Perkins named president of Anne Arundel Medical Center
  • University of Maryland Medical Center in downtown Baltimore to get a new face
  • Governor Hogan Announces New Appointments to UMMS Board
  • Anne Arundel Medical Center gets new leadership
  • Maryland medical center names Brian Bailey CEO
  • UMMS audit spotlights board members’ self-dealing

NEW JERSEY

• • Hackensack Meridian Health joins genome initiative
  • Survey: Physicians struggle with data privacy, opioid crisis, reduced reimbursements
  • New Jersey hospital auxiliary donates $1.5M to hospital’s surgery center fund
  • Survey: NJ doctors spending less time with patients, not by choice
  • Why New Jersey Outranks Neighbors in Overall Health
  • FDA seeks more data before making decision on South Jersey pharma firm’s generic drug
  • New Jersey drugmaker files for bankruptcy
  • South Jersey health care startup raises $3.5 million
  • Doylestown Hospital $54M heart center readies for debut. Here’s a look inside.
  • Four NJ entities to lead new pediatric payment model with $15.8M CMS award
  • How Pennsylvania, New Jersey and Delaware fare in healthiest state rankings

PENNSYLVANIA

• • Lehigh Valley Health Network acquires Coordinated Health, makes inroads into Lackawanna County
  • Former Penn Health System CEO lands a new job
  • Paoli Hospital Recognized As Age-Friendly Health System
  • Geisinger enrolls more than 250K in precision medicine initiative
  • This Philly lab wants doctors to try a new medicine: listening
  • Wage payments still coming for Ellwood hospital workers
  • Shapiro petitions to defend rights of Ellwood City Hospital workers
  • Philadelphia-area hospitals, health systems kept builders busy in 2019
  • UPMC whistleblower lawsuit can proceed, appellate court reaffirms
  • Allegations Include Services Provided to Patients in Middle Tennessee Hospitals
  • Court revives whistleblower lawsuit against UPMC neurosurgeons
  • Punxsutawney Area, Tyrone Hospitals Agree to Participate in Pennsylvania Rural Health Model
  • Rural health group gets $1M boost
  • Eight more hospitals join PA’s rural health model
  • Uniontown native serving as president of the Pennsylvania Medical Society
  • Pennsylvania hospital lays off 152 employees, falls behind on payroll
  • Top health care story of 2019: Hahnemann University Hospital shuts down
  • Dermatology practice operator expanding Philadelphia-area footprint
  • 3rd Circuit tosses arbitrator’s award that said hospital could not deny vacation days
  • Larry Kaiser resigns as Temple Health CEO
  • New regulations are changing which drugs Medicaid covers in Pennsylvania. Here’s what that means for consumers.
  • Doylestown Hospital named one of the nation’s 50 Top Cardiovascular Hospitals in 2020
  • Hospital chain files for bankruptcy
  • Penn State Health St. Joseph names new vice president for medical affairs
  • How Pennsylvania, New Jersey and Delaware fare in healthiest state rankings
  • Allegheny Health abruptly closes cancer center months before UPMC deal
  • UPMC drops tax appeal after announcing hospital will close

VIRGINIA

• • Ballad Health: Emergency room services to end at Mountain View Regional Hospital January 5
  • Virginia Physicians For Women Plans Medical Office
  • Community Health Systems Completes Divestiture of Virginia Hospitals
  • Sentara to expand living wage initiative all employees by 2022
  • 2 Virginia hospital systems pledge $15-an-hour wage by 2022
  • Bon Secours Mercy Health ups minimum wage to $15

WEST VIRGINIA

• • WVU Medicine makes major impact for West Virginians on daily basis
  • WVU Medicine Children’s Teaming Up With Wheeling Hospital for NICU Care
  • Mountain Laurel Medical Center names CEO
  • Hospital to start new year with 24/7 NICU services

CENTRAL

(Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota)

IOWA

• • Hawarden nursing home sued for negligence
  • Northeast Iowa health clinics to receive over $1 million in federal grant
  • An Iowa doctor raises more than $8,000 for pediatric mental health
  • Former longtime Iowa hospital CEO, president dies
  • Ryan Meyer: Healthy relationships key for hospital exec

KANSAS

• • Feds: Kansas Mental Hospital at Risk of Losing Medicare Cash
  • 1 Year After Losing Its Hospital, A Rural Town Is Determined To Survive
  • Rural Hospitals Continue To Close
  • Wichita VA hospital fires doctor under scrutiny in Missouri
  • Kansas hospital’s future still murky
  • ‘We will not have ― or do we need ― a hospital,’ Kansas city leader says after closure
  • Dealing With Hospital Closure, Pioneer Kansas Town Asks: What Comes Next?
  • Kansas lawmakers want stronger law on mental health coverage
  • Olathe health care staffing agency redefines rural care

MINNESOTA

• • HealthPartners continues southwestern expansion with merger plans
  • Former Mayo doctor’s Bloomington startup helping hospitals with complicated prior authorization process
  • Mayo will test robotic heart procedure for rural patients
  • Mayo Clinic Health System long-standing patients donate to clinic’s facility dog program
  • Healthcare executives on topics to follow in 2020
  • Tentative deal averts strike at northeast Minnesota hospital
  • St. Luke’s Hospital cited for ‘maltreatment by neglect,’ denies staffing is the issue

MISSOURI

• • SSM Health, MU Health Care announce end to exclusive negotiations
  • Cardinal Glennon Children’s Hospital gets top nursing recognition
  • Hospital chain files for bankruptcy
  • MO HealthNet director reflects on agency challenges
  • Wichita VA hospital fires doctor under scrutiny in Missouri
  • Hospital backs Medicaid petition
  • New county director of public health appointed

NEBRASKA

• • Preliminary ACA signups rise more than 3% in Nebraska
  • Editorial: Many Nebraska nursing homes face major financial pressures

NORTH DAKOTA

• • ND hospitals grapple with poor patient safety grades
  • Government quality rating for Altru: Two stars out of five

SOUTH DAKOTA

• • Sanford Health launches ‘returnships’ to attract back experienced workers
  • Mayo Clinic extends its expertise, keeping patients close to home
  • Sanford Health program aimed at those out of the workforce

MIDWEST

(Illinois, Indiana, Kentucky, Michigan, Ohio, Wisconsin)

ILLINOIS

• Two Illinois Hospitals Ranked Among The Best Rural Hospitals
• Are doctors washing their hands enough? These Illinois hospitals install technology to track hand hygiene.
• Uptown Psychiatric Hospital Losing Federal Funding Gives First Comments
• Lurie Children’s Hospital notifies some patients about unauthorized access to medical records
• Advocate Aurora taps Terika Richardson as president of Chicagoland patient service area
• Libertyville begins discussions on $52 million rehab hospital proposal
• Law changes to healthcare coverage in Illinois
• Data breach at Sinai Health System put personal info of nearly 13,000 people at risk
• Sinai Health System alerts 12,500 patients of data breach
• Keith Parrott is Amita Health’s new CEO

INDIANA      

• • Big Investment: IU Health bought 137-acre lot for $5.3 million
  • IU Health to add surgery center in Allen County
  • Indiana hospital loses longest-serving board member
  • Indiana looks to create healthcare price transparency database
  • IU Health eyes local hospital
  • Indiana Medicaid Waiver Allows for Expanded Mental Health Care
  • Hospital auxiliary contributes $2.19 million to Highpoint Health
  • Lutheran Health loses on appeal
  • Indiana hopes to end surprise medical billing
  • Newburgh Hospital Named ‘Top Hospital’ for 2019

KENTUCKY

• • K-TECH Program Launches in NKY, is State’s Third
  • Baptist Health adds precision medicine tools to Epic EHR
  • Jury awards $10.5M for sponge left in woman
  • Gov. Beshear makes decision on $8 billion in Medicaid contracts
  • Local long term care center recognized nationally
  • St. Claire HealthCare surgery team, physicians honored

MICHIGAN

• • Children’s Hospital CEO departs amid DMC plan to cut asthma services
  • West Michigan Surgery Center receives re-accreditation
  • Detroit Medical Center names new CEO
  • World-Renowned Neurosurgeon Selected To Lead Nationally-Recognized Henry Ford Medical Group
  • Studies: Michigan’s Medicaid expansion proving successful in expanding health care access
  • Health system hires VP of primary care
  • McLaren Hospice awarded CHAP Accreditation
  • Telehealth for rural residents latest tool in opioid fight  
  • U-M’s Mott Children’s, Von Voigtlander hospitals name new chief operating officer
  • Healthcare nonprofit names Dan Takens as new leader

OHIO

• • Nurses say proposed Ohio bill could improve access to care, but not everyone is for it
  • University Hospitals names Dr. Cliff Megerian new CEO
  • Summa agrees to pay $10 million
  • New bill in Ohio would allow surveillance cameras in nursing home resident rooms
  • Nurses defend former Mount Carmel doctor charged in deaths at hospital
  • New $10M Ohio’s Hospice facility will expand care in Troy area
  • Ohio Hospitals Investing More In Community Programs
  • MetroHealth’s Parma Emergency Department designated as Acute Stroke Ready Hospital
  • UTMC’s future to be discussed at community meetings
  • Trumbull Regional has made improvements
  • Former Mount Carmel doctor facing murder charges sues for defamation
  • Ohio Hospitals Invest More Than $6 Billion in Community Issues, Study Finds
  • Report: Health Care in NE Ohio Is a $22B Business
  • Health care key to Northeast Ohio economy
  • Firm acquires $18.4M Ohio medical office building
  • Ohio bill would allow cameras in nursing homes to reduce abuse
  • Roth tabbed by Ohio hospital group
  • 8 Cincinnati biotech companies with big steps to watch in 2020
  • Summa Health provided almost $111M in community benefits

WISCONSIN

• Aspirus Riverview Hospital & Clinics names new president
• New Health Center Planned for Greenfield
• Gundersen, Marshfield health systems call off merger talks
• Barnes & Noble in Greenfield will close; Ascension Wisconsin micro-hospital to move in
• UW Hospital nurses seek union recognition
• Report: Tomah Health provides $5 million to area communities
• Health experts report opioid deaths have declined statewide in Wisconsin
• Health system’s online assistant helps patients find the right kind and level of care
• Health systems want to grow. That’s a problem when it comes to controlling health care spending.
• Wisconsin Nurses Unionize, Join Fight Against Corporatization

SOUTH/SOUTHEAST

(Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee)

ALABAMA

• • Russell Medical talks technology, more at chamber luncheon
  • United reverses decision to drop Alabama hospitals from Mississippi Medicaid coverage plans
  • Rural healthcare isn’t easy. Here’s how one Alabama woman bridges gaps in the Black Belt
  • Encompass Health appoints three to board of directors
  • Patients File Lawsuit Against DCH Health System After Cyber Attack On Their Records
  • DCH Health System patients file federal suit over ransomware attack

FLORIDA

• • Memorial Hospital closes strong year with sports partnership
  • Naples medical practice pays $85,000 to close probe of potential privacy violation
  • After suffering ‘extensive business losses,’ Smart Pharmacy lays off most of its workforce
  • Tampa General is bringing back house calls
  • Bipartisan Florida House bill to address Pharmacy Benefit Managers’ ‘predatory practices’
  • Braden Hospital could break ground in Ave Maria sometime next year
  • Southwest Florida Hospital Eyes 2020 Construction
  • Boca Regional Hospital Foundation receives $25 million donation
  • Nemours to soon open this part of $29 million expansion
  • UNF medical nexus funding faces budgetary hurdles
  • UF Health acquisition of Central Florida Health hospitals could lead to growth
  • Holy Cross Hospital to lay off 63 in 2020
  • Florida hospital extends Cigna agreement for ‘last time’ after talks collapse
  • Local hospitals tout major improvements, look forward to 2020
  • Florida hospital to close billing department, lay off 63 employees

GEORGIA

• • South Georgia Medical auxiliary donates laser
  • Georgia’s Top 10 health care stories of 2019
  • Georgia’s Key Health Care Stories Of 2019
  • Ga. ambulance company pays $65K HIPAA settlement
  • Columbia County hospital license faces another hurdle
  • Georgia health system, Anthem near payment agreement
  • Emory buys two plots from city government for ASC
  • Georgia hospital to abruptly close operating room
  • Georgia hospitals get new transparency rules
  • Georgia Medicaid Provider Ordered to Pay $10.1 Million
  • Georgia governor tours Grady Memorial Hospital following massive flooding
  • Emory Healthcare, Verily partner for data-driven improvements to lab, medication ordering

MISSISSIPPI

• • United reverses decision to drop Alabama hospitals from Mississippi Medicaid coverage plans
  • Mississippi city now owns closed hospital, seeks medical use
  • UMMC pediatric expansion ahead of schedule, hospital official says
  • UMMC Breaks Ground On State’s First Children’s SNF

NORTH CAROLINA

• • North Carolina healthcare provider warns 4,500 patients of data breach
  • Cone Health to pay its executives after changes to Atrium agreement
  • Duke, UNC join $16M partnership for child wellness program
  • Rural NC community that lost its maternity services to get a freestanding obstetrics clinic
  • From Mission Health To The Opioid Crisis: Looking Back On WNC Healthcare In 2019
  • Plymouth hospital to stay open; employees will get paychecks
  • What stories grabbed you in 2019? NC Health News most-read stories of the year
  • Novant Health clinic to stop accepting new patients who do not vaccinate children
  • Stitching Wake Forest Baptist-Atrium?
  • Southeastern Health gets $450,000 grant renewal
  • Novant Health and NHRMC expand medical care
  • Forsyth Medical opens obstetrics emergency department to handle high-risk births
  • North Carolina hospital secures loan to pay employees

SOUTH CAROLINA

• • South Carolina health system forced to reschedule procedures after malware attack
  • Editorial: Charleston County’s hospital deal could help heal old wounds
  • MUSC’s board spends more than half its time in secret meetings not open to the public
  • MUSC opens a new Charleston campus inside a former J.C. Penney
  • Bon Secours St. Francis to raise minimum wage to $15 an hour
  • Molina Healthcare opens first Molina Closet in South Carolina to provide families with food, hygiene necessities on ongoing basis
  • Medical University of South Carolina opens practice with surgery center
  • AnMed Health CEO Bill Manson to retire
  • Mount Pleasant facility becomes the first to debut new cataract surgery technology
  • South Carolina hospital closes primary care practice

TENNESSEE

• • Electronic Health Records Creating a ‘New Era’ of Health Care Fraud, Officials Say
  • Covenant takes ownership of LMU Medical Clinic
  • Nashville General leads $120M settlement with Momenta, Sandoz
  • Nashville emergency room sues 700 patients over unpaid bills
  • Tennessee DAs take state’s opioid battle to courtroom
  • One year after opening, Children’s Hospital at Erlanger’s new outpatient center continues to boost care in Chattanooga
  • BCBS of Tennessee specialty drug change brings physician backlash
  • New Tennessee law stiffens punishment for elder abuse
  • Allegations Include Services Provided to Patients in Middle Tennessee Hospitals
  • Paychecks late at Tennessee hospital
  • Vanderbilt helps Epic with EHR tweak aimed at ICU delirium
  • Tennessee Hospital Association names Will Cromer COO
  • TeamHealth’s ER billing scrutinized at Nashville General
  • Community Health Systems Completes Divestiture of Virginia Hospitals
  • Hospital chain files for bankruptcy

SOUTH-CENTRAL/SOUTHWEST

(Arkansas, Arizona, Louisiana, New Mexico, Oklahoma, Texas)

ARKANSAS

• • Arkansas nursing home in receivership shuts its doors
  • Hospital chain files for bankruptcy
  • Charity ball raises $1.1M for Mercy Health Foundation
  • Arkansas hospital to change management companies in February
  • For foreign patients, long path leads to Little Rock hospital
  • Sheridan woman named president-elect for Arkansas Health Information Management Association

ARIZONA

• • Musical chairs for top Banner Health leaders
  • BRMC Outpatient Surgery Center Breaks Ground
  • Phoenix ranks among top US cities with unfilled physician jobs
  • Arizona hospital responds to ‘women don’t do well here’ physician job posting
  • Phoenix Rehabilitation acquires new physical therapy clinic
  • Arizona Attorney General’s health care fraud, abuse section ranked second highest in the nation

LOUISIANA

• • Children’s Hospital New Orleans Inches Closer To Completion
  • Our Lady of Lourdes reaches purchase agreement for Heart Hospital of Lafayette
  • Our Lady of the Lake Ascension earns 2019 award
  • Louisiana woman helps invent tool for nurses

NEW MEXICO

• • New Mexico hospital tells patients to monitor bank statements after malware infection
  • Tenth Circuit Upholds HHS Risk Adjustment Methodology
  • Navajo Nation plans to create ‘one-of-a-kind’ Medicaid program in New Mexico

OKLAHOMA

• • Electronic Health Records Creating a ‘New Era’ of Health Care Fraud, Officials Say
  • Oklahoma startup streamlines medical records
  • Oklahoma could see big spending in expansion campaign
  • Shuttered Oklahoma hospital to be converted to urgent care center

TEXAS

• • Cummins returns to Plainview, joins Covenant Health
  • Behavioral Hospital in Texas Nears Mid 2020 Opening
  • Texas health commission to pay $15 mil in SNAP settlement 
  • Methodist Health System Names CEO
  • Houston Methodist Adds Rejuvenation Station In ER
  • Micro-hospital to open on San Antonio’s Southwest Side
  • Owner, COO of Texas urgent care clinics charged in bribery scheme
  • 100,000 UnitedHealthcare members on verge of losing network access to Houston Methodist hospitals
  • Solving Texas’ rural health care crisis will require more collaboration
  • Tenet’s $350M divestiture deal faces opposition
  • Texas leans on Lyft and Uber to get Medicaid patients to the doctor
  • Judge set to rule Thursday on baby life support case
  • Health Care Deserts
  • Patient data management in 2020 and beyond: Key notes on Texas Children’s Hospital’s approach
  • 3 leaders depart from Texas Medical Center
  • Texas children’s hospital posts first profit

NORTHWEST

(Alaska, Idaho, Montana, Oregon, Washington, Wyoming)

ALASKA

• • Hospitals Prepare to be Earthquake-Ready
  • A lot has happened over the past year at Alaska Psychiatric Institute. Here’s where things stand now.

IDAHO

• • Utah And Idaho Set To Expand Medicaid Programs
  • Idaho Medicaid expansion signups lower than expected so far
  • Saint Al’s kicks off year-long celebration for 125th anniversary
  • Man given 5 percent chance to live survives thanks to Idaho’s only burn center

MONTANA

• • Montana chiropractor ordered to pay $100K for Medicaid fraud
  • Shodair Children’s Hospital to open outpatient mental health clinic in Missoula
  • Montana one of only three states to receive $2.3 million mental health grant to train counselors for rural areas
  • UM, state partnership garners $16M to provide health care for Montana families

OREGON

• • Health system, nonprofit launch new approach to tracking needs of vulnerable clients
  • Family sues Bend hospital for $26.5 million after woman died following breast infection
  • Health system, nonprofit launch new approach to tracking needs of vulnerable clients
  • Inside Legacy Salmon Creek’s fight against malnutrition
  • OHSU researcher pioneers ‘tooth on a chip’ for personalized dentistry
  • Health Share approves back payment to transportation providers

WASHINGTON

• • Nurses on verge of ‘largest healthcare strike in recent history’ in Washington state, union says
  • How UW Health’s population health chief is moving the needle to address social determinants of health
  • UW Hospital nurses revive union, ask board to recognize it
  • Seattle nurses inch closer to strike, cite ‘severe’ staffing issues, overpaid CEO
  • Virginia Mason Memorial receives certificate to do heart procedure on elective basis
  • Swedish Medical Center nurses could send notification of strike by year’s end
  • Pullman Regional Hospital acquires Palouse Health Center
  • Northwest Hospital becomes UW Medical Center’s 2nd campus

WYOMING

• • Wyoming’s two largest hospitals urge feds to reject Wyoming’s air ambulance plan
  • Hospitals Deal With Cybersecurity Threats
  • Wyoming hospital alerts nearly 18,000 patients of data breach

WEST

(California, Colorado, Hawaii, Nevada, Utah)

CALIFORNIA

• • Health system pays $575 million to settle anti-trust lawsuit
  • Roseville’s Adventist Health to manage Stockton’s struggling Dameron Hospital
  • Antitrust settlement pushes Sutter Health to quarterly loss
  • Kaiser Permanente’s disaster preparedness playbook
  • Adventist Health to take over 20th California hospital
  • Sharp HealthCare taps Brett McClain as COO
  • Care coordination notifications help reduce opioid deaths by 32% at county hospital
  • Hospital workers voice concerns about workplace violence amid contracts talks

COLORADO

• • Urgent care services now offered every day of the week in Vail
  • Colorado human services department warns 12,000 of error
  • Denver VA hospital curtails some surgeries for maintenance
  • DaVita Kidney Care welcomes new CMO
  • Colorado HIEs pool data-sharing services, expand reach to millions of patients
  • UCHealth pledges $250,000 to help create Health Care Careers Center in Fort Collins
  • Memorial Regional Health Population Health Management enhances local care
  • The Innovations That Will Revolutionize Health Care in Colorado
  • Vail Health doubles down on behavioral health
  • Middle Park Health names new CEO
  • SCL Health to apply analytics to improve surgical outcomes, costs
  • Checkup Denver: Our top Colorado health stories of 2019
  • SCL Health Announces Partnership With Empiric Health

HAWAII

• • Heroes Next Door: Institute for Human Services nurse is dedicated to treating homeless patients
  • Physician shortage worsens in Hawaii
  • Hawaii health care’s transition to value-based care
  • Report: Hawaii’s Doctor Exodus Grew In 2019

NEVADA

• • Nevada receives funding from the Department of Justice to battle the opioid crisis.
  • Nevada distance learning, telemedicine projects get nearly $1 million in grants

UTAH

• • GE Healthcare plans to expand operations in Cache Valley
  • Utah receives approval for Medicaid expansion with work requirements
  • Utah And Idaho Set To Expand Medicaid Programs
  • Utah hospital OR shut this summer for unsanitary conditions, but patients never told

The post Health Provider News – January 3, 2020 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

On December 30, 2019, the Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced a resolution agreement with an ambulance company (“Company”) covered entity that provides both emergency and nonemergency transportation services. The Company employs only 64 workers. The Company will pay $65,000 and enter into a Corrective Action Plan (“CAP”) to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).

The Settlement

The Company filed a breach report with OCR in 2013 when an unencrypted laptop fell off the bumper of an ambulance. The unencrypted laptop held the protected health information (“PHI”) of 500 individuals. OCR investigated and uncovered multiple failures to comply with HIPAA’s requirements. Such failures included:

• Lack of a risk analysis;
• Failure to provide security training to the Company’s workers; and
• Failure to implement policies to comply with the HIPAA Security Rule, including failure to have a HIPAA security training program.

OCR indicated that it provided technical assistance to the Company, but the Company did not implement such technical assistance.

The CAP

The Company entered into a two-year CAP with HHS. The CAP requirements include the completion of a risk analysis. The Company is also required to adopt, implement and train its workforce on adequate policies and procedures. The CAP additionally includes a requirement for the Company to install “HIPAA compliant encryption software on all of its computers.” This is notable given encryption’s status as an addressable rather than a required safeguard within the HIPAA regulations.

Complying with Technical Assistance from OCR

A covered entity’s alleged failure to comply with OCR’s technical assistance or other recommendations has been a common theme in recent HIPAA settlements. See our previous articles here and here.

Implementing technical assistance received from OCR provides one means for a covered entity to address compliance concerns to OCR’s satisfaction, sometimes in lieu of engaging in a protracted negotiation with OCR over a fine or penalty. Failure to comply with technical assistance could be interpreted by OCR as a covered entity’s disregard or inability to comply with HIPAA requirements, absent mitigating factors. When a covered entity undertakes efforts to implement such technical assistance, there may be instances where a number of individual factors could impede, delay or prevent a covered entity from complying with such technical assistance, such as a good faith misunderstanding or financial difficulties. If a covered entity determines that it is unable to comply with technical assistance from OCR, it may be worthwhile for the covered entity to seek assistance from legal counsel to communicate with OCR to find alternate solutions to address OCR’s concerns or to negotiate an alternative resolution.

Practical Takeaways

In light of this settlement, covered entities should keep the following in mind:

• While OCR automatically investigates breaches that affect over 500 individuals, reporting any breach to OCR can trigger an investigation into a covered entity’s HIPAA compliance that can extend beyond the scope of the breach. Such investigations may uncover additional compliance issues, in addition to those that led to a breach. It is advisable for covered entities to take the time to assess HIPAA compliance more broadly whenever a reportable breach occurs in order to address issues, mitigate harm and prevent further breaches.
• Encryption, especially encryption of portable devices like laptops, flash drives and cellular phones, can help prevent the compromise of PHI. This is especially important with devices that contain or connect to systems containing enormous amounts of PHI. Encryption is an “addressable” standard and not technically a “required” standard under the HIPAA Security Rule. This means that a covered entity must implement encryption or an equivalent alternative measure whenever reasonable and appropriate. If a covered entity determines that encryption is not reasonable or appropriate, it must document: the determination and its reasons for such determination; whether an alternative safeguard was implemented; and if not, why such alternative safeguard was not implemented. This documentation should include discussion of the factors that were considered and the results of the risk assessment on which the decision was based. Additionally, covered entities should confirm that lack of encryption does not impact any cybersecurity insurance coverage.
• A covered entity’s workforce is the front line for preventing, identifying and addressing security incidents, especially when they are related to lost or stolen devices. A security awareness and training program should be specifically tailored to the covered entity’s security framework, business operations and identified risk areas.
• A risk analysis should be conducted at least annually, and a risk management plan based on the risk analysis results should be drafted, implemented and monitored.
• Violations of the HIPAA Security Rule may give rise to HIPAA privacy breaches. Security policies and procedures should be in place, available to appropriate workforce members and reviewed and updated at least annually, particularly to address items identified as part of the annual risk analysis and risk management plan.

If you have any questions or would like additional information about this topic, please contact:

• Mark Swearingen at (317) 977-1458 or mswearingen@hallrender.com;
• Stephane Fabus at (317) 977-1406 or sfabus@hallrender.com;
• Patricia Connelly at (317) 429-3654 or pconnelly@hallrender.com; or
• Your regular Hall Render attorney.

For more information on Hall Render’s HIPAA, Privacy & Security services, click here.

The post Failure to Encrypt Laptop and Failure to Comply with Technical Assistance from OCR Leads to $65,000 Settlement appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

NATIONAL

• Hospitals Exploring Short-Term Housing For Homeless Patients To Free Up Beds
• VA drops its star ratings system for hospitals
• TEVA Agrees to Pay $54 Million to Settle McEldrew Young False Claims Act Qui Tam Whistleblower Lawsuit
• 43% of older patients seek out physician ratings
• CMS releases 2021 Medicare Advantage risk adjustment payment changes
• Brad Smith to head CMS innovation center
• Study: Bundled payments lowered costs for hip, knee replacements, but not for other conditions
• Pharmacies: Prescribers Bear Responsibility In Opioid Crisis
• 15 things to know about Amazon’s healthcare strategy heading into 2020
• ‘No guarantee of payment’: Healthcare cost-sharing ministries face growing scrutiny
• 4 new surprise medical billing laws to know
• Beyond the ACA: Healthcare legal fights to watch in 2020
• Medical paperwork costs $812B per year in U.S.
• CMS Grants to Help States Use Telehealth, mHealth for Pregnant Moms, Kids
• The Sneaky Genius of Facebook’s New Preventative Health Tool
• CMS releases MIPS results for 2018: 5 things to know
• Sen. Grassley renews drug-pricing battle

NORTHEAST

(Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont)

CONNECTICUT

• • Denver company acquires one of CT’s fastest-growing med-tech firms
  • 6 Connecticut nursing homes fined $30K+ by state
  • Connecticut lawmakers pass settlement with state hospitals
  • Raising hospital taxes not enough for CT to survive next recession
  • Report: CT ranks 10th in healthcare affordability
  • Newest Stats On Connecticut Behavioral Health

MAINE

• • Maine Voices: Looming doctor shortage demands action
  • After more than 20 years at the helm, Bar Harbor hospital’s CEO to retire at end of year
  • 2 Maine health systems will allow physicians to not participate in ‘death with dignity’ programs
  • Brunswick hospital to participate in opioid care model
  • Mills, Democrats unveil health care bill as lawmakers return
  • Art Blank to retire as CEO of Maine hospital
  • Maine Hospitals Are Tasked With Figuring Out How To Implement The State’s Death With Dignity Law
  • Federal grant will help pregnant women in Maine who have opioid use disorder
  • Brunswick hospital to participate in opioid care model
  • Bangor considers removing hospitals’ exemption from city’s polystyrene ban

MASSACHUSETTS

• • The Massachusetts Medical Society declares ‘health care is a basic human right’
  • Trinity Health Of New England expands clinically integrated network of care
  • Two Boston Health Systems Enter the Growing Direct-to-Consumer Gene Sequencing Market by Opening Preventative Genomics Clinics, but Can Patients Afford the Service?
  • Newton-Wellesley Hospital plans $58M expansion, renovation
  • Trinity Health of New England expands CIN
  • How UMass Memorial cut executive payroll in half
  • Dr. Assaad Sayah is the new CEO of Cambridge Health Alliance

NEW HAMPSHIRE

• • Catholic Medical Center lands $15M donation for new building
  • The 2 Largest Health Care Providers File for Merger
  • New Hampshire’s 2 largest health care providers file for merger
  • Frisbie’s HCA hospital merger plan unveils $20M foundation
  • Report Details Widespread Use of Restraint Against Children In State Care
  • With New State Funding in Place, Hospitals Add Mental Health Beds
  • Dartmouth-Hitchcock and GraniteOne seek AG’s approval

NEW YORK

• • Nursing homes in New York grapple with Medicaid reimbursement reduction
  • Catholic Health continues to build executive team
  • New York hospital rankings: Why Empire State has worst quality, safety ratings in U.S.
  • Vassar Brothers Medical Center in Poughkeepsie has new president
  • New York asked to approve sale of four nursing homes following bankruptcy filing
  • Catholic Health Services plans $525M expansion
  • Kaleida Health wants to sell part of DeGraff Memorial to keep it afloat
  • U at Buffalo launches EHR training program for medical students
  • Meeting Monday Called By Mt Vernon Hospital Supporters
  • Startup raises $6.2M to give patients a lift
  • Northern Westchester Hospital names new chief nursing officer
  • Text reminders prompt fewer missed appointments at NYC Health + Hospitals

RHODE ISLAND

• • Outgoing BHDDH director Rebecca Boss reflects on accomplishments, challenges
  • New clinical study to test retinal screening processes for early detection of Alzheimer’s disease
  • St. Anthony’s, Morton Plant launch $5 million Alzheimer’s study
  • RIDOH mandates masks for unvaccinated health workers
  • Rhode Island Hospital Tests mHealth Wearable to Track Eating Habits

VERMONT

• • State settles with residential care home for $120K over consumer protection violations
  • Vermont psych hospital to close or be sold due to financial troubles
  • Community Health Centers of Burlington announce national search for CEO
  • Shortage of primary care doctors threatens Vt. health care reforms
  • Fay Homan: Lack of primary care providers a looming crisis

MID-ATLANTIC/EAST                                                                 

(Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia, West Virginia)

DELAWARE

• • Nanticoke Health Services merges with Peninsula Regional
  • Delaware, Maryland health systems merge
  • ChristianaCare acquires Union Hospital in Elkton
  • Mergers help save smaller hospitals in and near Delaware
  • ChristianaCare makes its biggest expansion outside of Delaware

DISTRICT OF COLUMBIA

• • Advantia Health nabbed a $45M investment to accelerate its expansion
  • Vital signs: Checking in on DC’s maternal health care crisis
  • Participants in Ardent Health Services DC plan file ERISA suit

MARYLAND

• • Harbor Hospital gets $500,000 grant to connect bike, pedestrian paths in Anne Arundel County, Baltimore City
  • UM Shore Regional Health purchases land to build new medical campus in Cambridge
  • Delaware, Maryland health systems merge
  • Union Hospital completes merger with ChristianaCare, changes name
  • Suburban Hospital to open new building on March 2
  • Former United Way exec with ties to Pugh takes on new role at UMMS
  • Sinai Hospital president to step down, launch telemedicine startup
  • LifeBridge Health Announces New President for Sinai Hospital of Baltimore

NEW JERSEY

• • RWJBarnabas appoints behavioral health and addictions service line SVP
  • RWJBarnabas Health taps Dr. Frank Ghinassi to lead behavioral health and addictions service line
  • Prime Healthcare withdraws bid to buy Bayonne Medical Center

PENNSYLVANIA

• • Tower Health adds 110 Drexel Medicine clinicians, support staff
  • Philadelphia Hospital Bankruptcy Puts Doctors’ Medical Licenses at Risk
  • Retiring CEO John Morahan has shepherded St. Joseph through many changes
  • Philadelphia hospital bankruptcy leaves 1,000 physicians scrambling
  • State ordered to turn over nursing home chain’s ownership records
  • Report: Geisinger placed premature infants in ‘immediate jeopardy’
  • Jefferson said it would acquire Einstein Healthcare over a year ago. Why is it still pending?
  • Philadelphia health tech firm raises $1.75M, plans to double headcount
  • Geisinger exec: How to make sure innovation is actually innovative
  • Philadelphia health clinic pays $1.65 million to settle fraud allegations
  • Genesis HealthCare Centers recognized for improving long term care
  • CBS21 News continues searching for answers as private health care workers remain unpaid
  • Butler Health center coming to Ellwood City area
  • Why a Philadelphia landlord says offering telehealth to tenants is a ‘no-brainer’
  • Pennsylvania hospital patients claim collector seeks bills they never received
  • Holy Redeemer opens first Philadelphia outpatient care center, eyes further expansion

VIRGINIA

• • CHS names new CFO, completes sale of 3 Virginia Hospitals
  • Virginia says it closely monitors Ballad, but reports are not available to the public
  • Newport News medical device company appoints new CFO
  • Virginia Hospital Center is Now Operating As a Trauma Center
  • Reston’s SOC Telemed names new Chief Medical Officer
  • Sentara to pay $2.2M settlement for potential violations of patients’ privacy rights
  • Advantia gains $45M for new women’s health practice, more M&A

WEST VIRGINIA

• • WVU Medicine Reynolds Memorial Hospital to offer outpatient psychiatry services
  • West Virginia attorney general introduces law to ban healthcare restrictions

CENTRAL

(Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota)

IOWA

• • U of Iowa Hospitals & Clinics CEO: ‘Everything in healthcare doesn’t need to be done by a hospital CEO’
  • UnityPoint leads funding for medical transportation platform
  • Denison, Iowa hospital settles wrongful-death lawsuit for $3.5 million
  • Iowa medical school first to require coursework on mental healthcare
  • Auditor decries ‘bad data’ on Iowa Medicaid home health care
  • Iowa auditor slams state Medicaid program for “flawed” data
  • Former Iowa medical center director sues, claims hospital permitted gender discrimination

KANSAS

• • Best and worst south-central Kansas nursing homes: List reveals those cited for abuse
  • KU Health announces new proton therapy center location
  • Rural Kansas struggles to attract psychiatrists
  • Horton hospital bankruptcy continues
  • New Kansas proposal breaks impasse on expanding Medicaid
  • Gov. Laura Kelly, Sen. Jim Denning announce bipartisan Medicaid expansion deal
  • Prime Healthcare fills regional CEO’s seat after 7-month vacancy

MINNESOTA

• • There’s a 25% pay gap in medicine. Here’s how Mayo almost closed it.
  • Minnesota hospital warns nearly 50,000 patients of data breach
  • Medical Info of Roughly 50K Exposed in Minnesota Hospital Breach
  • Mayo Clinic embarks on project to create genomic database
  • Lifesprk Partnership Helps North Memorial Lower Its Re-Hospitalization Rate by 47%
  • Report: We’re struggling to pay for health care
  • Rural western Minnesota hospitals looking to improve mental health care services
  • Avera Marshall Medical Center buys Minnesota hospital
  • Mayo Clinic, Sleep Number form $10M collab to study link between sleep, heart health

MISSOURI

• • Payroll delayed for St. Alexius Hospital employees following bankruptcy filing
  • Mercy Springfield Communities names new health CEO
  • Sports medicine group splits, joins competing hospitals
  • Delayed hospital sales tax discussed in city council
  • Siteman Cancer Center to open Metro East facility next week
  • Missouri hospital ordered to stop performing surgery
  • Health Forward Foundation Names Kansas City Native Qiana Thomason As Its New Leader
  • Boone Hospital president to retire at year’s end
  • CFO David Prather retires from Missouri health system
  • Craig McCoy is the new president of Mercy Springfield Communities

NEBRASKA

• • Nebraska hospital relocating surgery center as part of $6M project
  • Pioneer Heart docs no longer able to do procedures at heart hospital
  • How Nebraska Medicine Boosted Revenue Cycle Efficiency
  • UNMC creates new division for Allergy and Immunology

NORTH DAKOTA

• • Schools calling for health help
  • EDA awards BSC Health Sciences with $830,000 grant

SOUTH DAKOTA

• • Sanford Health accused of patent infringement over giant inflatable heart
  • South Dakota health system plans to open telehealth education center
  • South Dakota Lawmakers Eye Telehealth for Emergency Psych Consults
  • USD Sanford School of Medicine Dean Announces Retirement
  • New Sioux Falls VA director ‘focused on patient care’

MIDWEST

(Illinois, Indiana, Kentucky, Michigan, Ohio, Wisconsin)

ILLINOIS

• New Owner Is Selected After $146 Million Nursing Home Collapse
• Chicago Lakeshore Hospital plans to move patients from facility in January
• Advocate Health Care implements AI tech to detect stroke more quickly
• Molina expands Illinois footprint with $50M acquisition
• U of I hospital plans $191 million outpatient center
• Midwest Express Clinics Expands in Chicago
• Lawsuit: Doctor Fired After Blowing Whistle on Medicare Fraud, Other Violations

INDIANA      

• • Good Samaritan names CNO
  • Community Health Network accused of filing false Medicare claims
  • Indiana Health Facility Wraps Revamp
  • Health care at forefront of Indiana’s upcoming legislative session
  • Hospitals set own policy on flu shots
  • Shekhar Leaving IU Med School for Pitt
  • Midwest Express Clinics Expands in Chicago
  • Reid Health Opens Relocated Outpatient Services

KENTUCKY

• • Molina Healthcare Pursues Passport’s West End Site Along With State Contract
  • New Inspector General named at KY Cabinet for Health and Family Servies
  • Baptist Health Louisville Holds Nursing Expo Amid Nationwide Shortage
  • Nashville’s HCA Healthcare completes deal to buy Galen College of Nursing in Louisville
  • Methodist Hospital in Henderson Launches Home Visiting Program
  • Lake Cumberland Regional Hospital names new COO
  • Passport Health Plan restarting stalled west Louisville health campus
  • Humana sets membership expectations ahead of investor meetings
  • Publicly traded company moves HQ out of Louisville area

MICHIGAN

• • Summa, Beaumont Health enter agreement over Akron hospital system
  • McLaren Greater Lansing purchases majority stake in 2 ASCs
  • Hospital creates SVP of operations role
  • Jose Kottoor is Lake Huron Medical Center’s new CEO
  • Michigan Medicine AI boosts accuracy, precision of brain tumor diagnosis
  • New Lake Huron Medical Center CEO brings more than 20 years of experience to role
  • ProMedica Coldwater Regional Hospital president to retire
  • Michigan Republican pushes to deregulate health care. Some hospitals call foul.
  • Top MI Health Information Exchange Networks Complete Integration
  • State health department distributes $17.5 million to help Michigan’s opioid epidemic
  • ‘Remote’ pharmacies bill OK’d by Michigan Legislature

OHIO

• • Summa, Beaumont Health enter agreement over Akron hospital system
  • Cincinnati Shriners Hospital takes next steps in relocation to Dayton
  • Cincinnati hospital finalizes plan to close
  • MetroHealth Adding Telehealth to Discount Drug Retail Health Clinics
  • Cleveland Clinic names first chief research information officer
  • Mercy Health Hospital investigating patient data breach
  • Pure Healthcare unveils new facility in Centerville
  • Developer sets timeline for $12M senior living facility near Dayton
  • Cleveland Clinic’s Hillcrest and Fairview hospitals earn new stroke center designation
  • Adena Health System: 2019 delivers achievements, expands advancement of partnerships for close-to-home care
  • Judge won’t compel health system to fund Husel’s defense
  • Cleveland Clinic names first chief research information officer
  • Former nurses sue Mount Carmel, defend physician charged with murder

WISCONSIN

• • Fond Du Lac Hospital Settles $10M Federal Lawsuit
  • Study: WI hospitals & health systems critical for state, local economies
  • Agnesian HealthCare in Fond du Lac to pay $10 million to settle whistleblower case
  • See construction of Advocate Aurora’s $228M medical center near Foxconn project
  • Addressing a shortage of physicians in rural Wisconsin
  • Plans move forward for $35 million Ladysmith hospital
  • Aurora Health Care reflects on its 2019 commitment in Manitowoc County
  • Bill would increase access to alternative health care

SOUTH/SOUTHEAST

(Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee)

ALABAMA

• • Rural health care a priority in 2020 Ala. legislative session
  • Brookwood Baptist Health System names new chief strategy officer
  • Health clinic to take space in Homewood

FLORIDA

• • South Florida hospital develops novel approach to coronary bypass surgery
  • Citrus Memorial Hospital gets new CEO
  • Here are 3 health care trends to watch in Orlando this year
  • Tampa General Hospital sets new record with nearly 600 organ transplants in 2019
  • Palmetto Bay hospital zoning battle in court
  • Here’s how many people AdventHealth will hire when this $13M project is completed
  • AdventHealth hospital names new CEO
  • Bay hospital ended 2019 with more beds, workers as planned
  • Golisano Children’s Hospital was gifted $3 million for new pediatric eye institute
  • Orlando Health acquires local orthopedic firm, to build $250 million downtown hospital
  • Florida community hospital CEO Ginger Carroll leaving for new job
  • Florida faces $70.4 million drop in Medicaid money for hospitals
  • AdventHealth taps Justin Birmele to helm Winter Park hospital
  • Tampa General to deploy new platform for mobile scheduling, provider matching

GEORGIA

• • CTCA hospital in Newnan names new president
  • Doctor at Rush performs Mississippi’s first spine surgery with patient specific spinal implant
  • Piedmont joint venture acquires 9 urgent care centers
  • Baptist Health executive named to innovation C-suite job at Augusta University Health
  • Piedmont Quitting Georgia Hospital Association
  • Georgia Hospital Association disputes writer’s claims
  • CTCA hospital in Newnan names new president
  • Christ Community acquires Belz shopping center for expansion, revitalization effort
  • 200,000 Georgia medical center patients affected by data breach may file class-actions
  • Reducing drug costs is goal of Georgia proposal to rein in pharmacy benefit managers
  • Georgia high court stalls Augusta University Health’s 100-bed county hospital
  • Atlanta health system building $113M ASC
  • St. Francis Hospital entering joint venture with Emory Healthcare
  • Lawmakers struggle to buoy pharmacies
  • Richmond Hill man charged with creating scheme to cause HIPAA violations
  • Grady Memorial still diverting patients after flood, affecting local hospitals and ERs

MISSISSIPPI

• • Rural hospital improves meds reconciliation via AI automation into EHR
  • Mississippi Medicaid director staying in new administration
  • Mississippi to vote on medical marijuana in 2020
  • As $180 million children’s clinic opening nears, PGA event makes record donation

NORTH CAROLINA

• • Horton hospital case continues
  • Upstate Carolina Radiology Joins US Radiology, Expanding National Physician Practice
  • Commercial attacks Mission Hospital for its billing practices
  • 2 cars destroyed in fire at Cone Hospital parking deck in Greensboro
  • Cape Fear Valley Health System CEO Mike Nagowski returns from medical leave
  • Nurse Family Partnership programs guide first-timers through transition to motherhood
  • NC health trends and policies to watch for in 2020
  • Union ad targets North Carolina hospital’s billing practices
  • NC dentists join AG Josh Stein in effort to fight opioid epidemic

SOUTH CAROLINA

• • Clemson and MUSC: Working to improve health in rural South Carolina
  • Upstate Carolina Radiology joins national group
  • Hospital Not Liable for Physician’s Lack of Adequate Insurance

TENNESSEE

• • Ballad Health says it will expand access to free and discounted care
  • THA names former TennCare director as COO
  • CEO Greene leaving Dickson’s Horizon hospital for Skyline
  • Nashville pharma company could reduce opioid use with its newest creation: ibuprofen in an IV bag
  • CHS reaches $53M deal in class-action stock drop lawsuit
  • Nashville’s HCA Healthcare completes deal to buy Galen College of Nursing in Louisville
  • HCA names CEO for Skyline Medical
  • Nashville hospital companies back challenge to transparency rule
  • Ballad Health to absorb more out-of-pocket expenses

SOUTH-CENTRAL/SOUTHWEST

(Arkansas, Arizona, Louisiana, New Mexico, Oklahoma, Texas)

ARKANSAS

• • Washington Regional names new chief operating officer
  • Arkansas hospital names Birch Wright COO
  • Northwest Arkansas hospitals struggle to add neurosurgeons
  • LHC Group finalizes transactions expanding joint ventures in Texas, Arkansas, and Louisiana
  • Arkansas Department of Human Services brings new CFO on board
  • Arkansas hospital adds 1st neurosurgeon in years, 2nd to follow
  • Arkansas Business Names Finalists for Health Care Heroes Awards

ARIZONA

• • Arizona urgent care to launch Epic EHR at 100+ clinics
  • Banner Health integrates AI-powered digital triage tool to improve patient experience
  • Blue Cross Blue Shield of Arizona enters Medicaid market with health plan purchase
  • Arizona’s Banner Health offers unique, life-saving kidney donor program
  • University of Arizona to use big data to seek Alzheimer’s insights
  • Arizona hospital introduces GPS-guided spine surgery robot — 5 highlights

LOUISIANA

• • Louisiana Health Chief Leaving as Edwards Starts New Term
  • Louisiana continues Medicaid services with emergency deals
  • LHC Group finalizes transactions expanding joint ventures in Texas, Arkansas, and Louisiana
  • Emergency deals keep Louisiana Medicaid services on life support
  • Rebekah Gee, Louisiana health department head, resigns; read her letter to John Bel Edwards
  • Tulane Health System removes ‘interim’ from CEO Dr. Bob Lynch’s title: 4 things to know
  • Health Inequity in New Orleans: An Ongoing Issue

NEW MEXICO

• • UNM HSC Health Hackathon now accepting applications
  • Program meant to curb repeat hospital stays fails big test

OKLAHOMA

• • Sports medicine group splits, joins competing hospitals
  • Oklahoma hospital implements telehealth program for critical care patients
  • More cutting edge technology is coming to Wagoner Community Hospital

TEXAS

• • A Texas judge says hospital can take 11-month-old girl off life support despite her family’s wishes
  • LHC Group finalizes transactions expanding joint ventures in Texas, Arkansas, and Louisiana
  • Dallas startup raises $25.7 million to launch hospital readmission-reducing software nationwide
  • OSF HealthCare, Children’s Health join $25M funding for social determinants software
  • Texas children’s healthcare provider alerts patients of ransomware attack
  • Hospital in Houston’s Texas Medical Center to close
  • Baylor Scott & White to open its first Austin hospital this month
  • Texas A&M awards technical assistance to St. Luke’s
  • University Health System facing lowest blood supply in 14 years
  • Houston health systems seek to fill nearly 3,000 jobs

NORTHWEST

(Alaska, Idaho, Montana, Oregon, Washington, Wyoming)

IDAHO

• • St. Luke’s first in Idaho for accredited allogeneic stem cell transplants (access required)
  • St. Luke’s Cancer Institute gets accreditation
  • Tim Trottier is Idaho hospital’s new CEO
  • HAZMAT team responds to East Idaho hospital to investigate ‘unknown white substance’
  • Idaho health insurance enrollment down as expected
  • Rules outlining Medicaid expansion approved

MONTANA

• • Kalispell hospital faces second lawsuit over data breach
  • Shodair Children’s Hospital opens new clinic in Missoula
  • BCBS of Montana accused of providing kickbacks to municipal leaders

OREGON

• • Oregon hospitals, first responders launch augmented reality program
  • Oregon healthcare provider warns 25,000 patients of malware attack
  • Nurses Association calls for more funding for financially strapped Unity Center
  • Oregon Dives Into Thicket of Rising Health Care Costs
  • Governor Brown Commends Smooth Transition To CCO 2.0 On Southern Oregon Health Care Tour

WASHINGTON

• • Northwest Hospital changes name, integrates with UW Medical Center
  • Strike threat looms at Providence sites in Washington state
  • New COO Hired At EvergreenHealth
  • Family awarded $24M from Washington hospital after infant was born with brain damage
  • Providence Sacred Heart reaches tentative agreement with nurses, healthcare workers
  • Seattle’s Northwest Hospital rebranded as second UW medical campus
  • Deadly mold infestation spurs class-action lawsuit against Seattle Children’s Hospital
  • Yakima to lose 1 of 2 hospitals; Astria closing Regional as part of bankruptcy
  • Astria Regional Medical Center in Yakima to close
  • Providence expands investment in patient-provider matching startup

WYOMING

• • Wyoming Department of Health seeks creative healthcare solutions
  • Hospital getting mental health machine

WEST

(California, Colorado, Hawaii, Nevada, Utah)

CALIFORNIA

• Two San Diego doctors pay $950,000 to settle Medicare billing fraud allegations
• St. Vincent Hospital teeters on closure after sale falls apart
• Sutter Santa Rosa Regional Hospital names Dan Peterson CEO
• Owner petitions court to close Los Angeles hospital
• Hospital known for glamorous patients opens new doors to its neediest
• Dan Peterson named CEO of Sutter Santa Rosa Regional Hospital
• Bright Health to buy California health plan, further growing its MA reach
• California governor to announce state-run generic drug company
• Patient sues San Francisco over hospital’s abuse scandal

COLORADO

• VA Western CO Health Care System virtual health care
• How a Colorado hospital’s IT department prevented a ransomware attack
• New healthcare scorecard evaluates Colorado’s cost-saving policies
• Denver company acquires one of CT’s fastest-growing med-tech firms
• Colorado law to protect patients from surprise medical bills went into effect on Jan. 1
• 23 rural Colorado hospitals could close under public option, report suggests
• Former Colorado Hospital Association CEO named president of Healthcare Institute

HAWAII

• HMSA pays $180K to settle disability discrimination lawsuit
• Medicare Trims Payments To 8 Hawaii Hospitals
• Investigation reveals violations at Molokai Community Health Center

NEVADA

• CES 2020 health gadgets support remote exams, stroke patients
• More than 77,000 sign up for insurance on Nevada health site

UTAH

• Intermountain Healthcare CEO: Civica Rx could be a game changer for Utah patients
• Steward Health Care late paying property taxes in Utah
• Utah Valley Hospital replacement project wins construction award

The post Health Provider News – January 10, 2020 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

On December 18, 2019, in a 2-1 decision, the U.S. Court of Appeals for the Fifth Circuit held that the plaintiffs in Texas v. United States[1] had standing to bring a case challenging a provision of the Affordable Care Act (“ACA”) known as the individual mandate (26 U.S.C. §5000A) and that the individual mandate requiring most U.S. citizens to purchase health insurance (i.e., minimal essential coverage) or pay a penalty is unconstitutional.[2] As to the District Court for the Northern District of Texas holding that the entire ACA must fall because the individual mandate is inseverable from the remainder of the statute, the Fifth Circuit declined to uphold this portion of the district court’s decision, having concluded that the district court’s “severability analysis” was incomplete.[3] The Fifth Circuit remanded the case back to the district court for a more careful and thorough analysis addressing why the remainder of the ACA is inseverable from the individual mandate.

On January 3, 2020, the U.S. House of Representatives, having intervened in Texas v. United States on February 14, 2019, and 21 appellant Democratic states (“Petitioners”) filed a petition for a writ of certiorari with the Supreme Court asking the Supreme Court to review the case. The Petitioners also requested expedited review of the certiorari petition as well as expedited merits briefing and oral argument, if certiorari is granted. The Petitioners hope for resolution of the case in 2020 given the high stakes nature of a  lower court decision that would overturn the entire ACA. In a quick response on January 6, 2020, the Supreme Court directed the Trump administration and the states opposed to the ACA to file a response to the request for expedited review with the Supreme Court by Friday, January 10, 2020. [4] The fate of the ACA hangs in the balance.

Background

Texas v. United States – Another Challenge to the ACA

On February 26, 2018, multiple states filed a lawsuit challenging the ACA in the District Court for the Northern District of Texas. This lawsuit was filed two months after Congress passed the Tax Cuts and Jobs Act of 2017 (“TCJA”)[5], and named the United States, the Department of Health and Human Services (“HHS”), Alex Azar as the Secretary of HHS, and the Internal Revenue Service along with its Acting Commissioner as defendants. Later, the eighteen state plaintiffs were joined by two individual plaintiffs.

The plaintiffs in Texas v. United States reasoned that since the penalty for not purchasing health insurance pursuant to Section 5000A was now zero, the individual mandate no longer could be considered constitutional as an exercise of Congress’s authority to tax and spend, as articulated by Chief Justice John Roberts in National Federation of Independent Businesses v. Sebelius[6] (“NFIB”) because the penalty no longer produced revenue for the federal government – an essential feature of a tax. Nor, the plaintiffs contended, was the individual mandate sustainable under the Interstate Commerce Clause, which gives Congress the power to regulate commerce. And, since the remainder of the ACA relied on the existence of the individual mandate as an essential feature of the ACA, the individual mandate was inseverable from the remainder of the ACA; accordingly, if the individual mandate was no longer valid, the ACA must fall with it.

On December 14, 2018, the District Court for the Northern District of Texas issued its opinion ruling in favor of the plaintiffs. The court held that: (1) the individual plaintiffs had standing to file suit because the individual mandate compelled them to buy insurance (an injury) even though they would not have been penalized had they failed to do so; (2) setting the shared responsibility payment to zero dollars rendered the individual mandate unconstitutional because the payment could no longer properly be viewed as a tax pursuant to Congress’s taxing power; and (3) the unconstitutional individual mandate could not be severed from the remainder of the ACA. The court granted the plaintiffs’ claim for declaratory relief, declaring the individual mandate to be unconstitutional and the remaining portions of the ACA inseverable from the individual mandate and therefore invalid. This decision effectively struck down the ACA. The district court stayed judgment pending appeal.

The Appeal

In January 2019, Democratic attorneys general who had intervened in the lower court case in May 2018 and the Department of Justice appealed the Texas trial court decision to the Fifth Circuit. [7] Additional states and the House of Representatives moved to intervene to defend the ACA. A three-judge panel of the Fifth Circuit considered the following questions:

1. Whether there was a “live case or controversy” before the court as required by Article III of the Constitution, even though the federal defendants had conceded many aspects of the dispute;
2. Whether the plaintiffs, intervenor defendant states, and the House of Representatives had standing to bring the appeal;
3. Whether the individual mandate was constitutional given that the associated penalty for failing to purchase minimum essential coverage (i.e., health insurance) was amended to zero dollars by the TJCA; and
4. Whether the individual mandate, if determined to be unconstitutional, could be severed from the remainder of the ACA or whether other provisions of the ACA also would be invalidated.

The Fifth Circuit issued its opinion on December 18, 2019 and revised it on December 20, 2019. It held the following:

1. There is a live case or controversy because the intervenor defendant states had standing to appeal (they would lose funding under the ACA if it were struck down as standing requires a showing of “injury, causation, and redressability”[8]), and even if they didn’t, there was a live case or controversy between the plaintiffs and the federal defendants.
2. The individual plaintiffs had standing to challenge the ACA-the individual mandate injured them by requiring them to buy insurance they didn’t want (even though there would have been no monetary penalty if they declined to comply with the law). The mandate also injured the state plaintiffs by increasing their costs of complying with the reporting requirements that relate to the individual mandate. The matter of the U.S. House of Representatives’ standing to intervene was questionable but was not necessary to resolve as other parties in the case were deemed to have standing and sought the same “ultimate relief” as the House.[9]
3. The individual mandate is unconstitutional because it cannot be viewed as a tax under Congress’s spend and tax powers as the penalty for noncompliance is zero. Related, the shared responsibility payment no longer possesses the “essential feature of any tax” because it does not produce revenue for the government.[10] No other provision of the Constitution supports the individual mandate.[11]
4. The case must be remanded to the district court for additional consideration and analysis of the severability question. Specifically, the district court must explain what provisions of the ACA are inseverable from the individual mandate. The Fifth Circuit opined that the district court opinion did not explain with sufficient precision how particular provisions of the extensive and complex ACA are “inextricably linked to the individual mandate”[12] and “rise or fall on the constitutionality of the individual mandate.” [13] The district court was also tasked with considering the federal defendants’ new suggestions for addressing the appropriate scope of relief in this case. For example, the federal defendants suggested enjoining enforcement of only those provisions of the ACA that injure the plaintiffs or declaring the ACA unconstitutional only as to the plaintiff states and the two individual plaintiffs.

Analysis and Practical Takeaways

The ACA will remain law while the case is either reconsidered in the District Court for the Northern District of Texas or reviewed by the Supreme Court if the Supreme Court agrees to grant certiorari. If the Supreme Court agrees to hear the case, it is possible the fate of the ACA will be decided in the Supreme Court’s current term. Otherwise, this case may not be resolved for some time. In either case, the constitutional challenge to a significant piece of legislation will be certain to garner attention in this presidential election year.

Texas v. United States creates uncertainty as to whether any or all of the ACA will be struck down, which, in turn, creates operational risk for the entire health care industry, including hospitals. For example, if the ACA were struck down in its entirety, there would be far-reaching effects:

• Lost Insurance Coverage. Roughly 21 million people could lose their insurance.[14] This includes millions who purchase health insurance through the health care exchanges and millions who are insured as a result of the Medicaid expansion established by the ACA. This, in turn, could negatively affect, among other health care providers, hospitals that, likely, would have many more uninsured and underinsured patients presenting to their emergency rooms for treatment resulting in a rise in uncompensated care and a significant financial strain on hospitals.
• Heavier Burden for States. States that expanded Medicaid under the ACA would have to decide whether they could afford to continue the expansion without the federal subsidies for Medicaid expansion provided by the ACA. If states walked back their Medicaid expansion, low-income families could lose their Medicaid coverage. An election to maintain expanded Medicaid coverage, could potentially increase state taxes to make up for the federal subsidy shortfall.
• Insurance Discrimination. Roughly 133 million Americans with pre-existing conditions would lose important protections from insurance discrimination. Without statutory protections, and with the likelihood that many healthier Americans will choose to forgo health insurance altogether, patients with chronic illnesses might not be able to afford insurance due to significant increases in health plan costs. Further, patients with pre-existing conditions could be denied coverage for certain health care services. Again, loss of health coverage could severely impact hospitals and other health care providers because they will be providing more unreimbursed care and their patients will be sicker.[15]
• Removes Minimum Health Benefits. The ACA established essential health benefits that guarantee a minimum package of important benefits. Without the ACA, the robustness of health benefit plans would diminish and overall population health would be affected.
• Impact on Native American Communities. The Indian Health Care Improvement Act, which provides the legal basis for the provision of health care to American Indians and Alaska Natives, was made permanent as part of the ACA. Theoretically, this authority would fold with the ACA.[16]
• Stifles Innovation. The Center for Medicare and Medicaid Innovation (“CMMI”), which tests innovative health care programs, was created as part of the ACA. Theoretically, the CMMI would go away along with pilot programs and health care delivery models that augment focus on quality and safety in health care delivery.[17]
• Changes Fraud and Abuse Protections. Fraud and abuse provisions incorporated in the ACA would be affected. For example, the Physician Payments Sunshine Act[18] requires drug and medical products manufacturers to disclose to the Centers for Medicare & Medicaid Services, gifts and payments to physicians and teaching hospitals as well as disclosure of physician ownership or investment interests in manufacturers and group purchasing organizations.
• Effect on Medicare Trust Fund. The Medicare Hospital Insurance Trust Fund might lose several years of fiscal solvency if the ACA falls.[19]
• Contract Disruption and Increased Litigation Costs. If the ACA is invalidated, agreements between health care providers and payors could be affected. Many of these agreements allow termination and amendment of contractual relationships if federal law changes. Payors and providers could quickly find themselves litigating insurance coverage disputes to determine whether payors would be required to continue paying for previously authorized and approved long-term treatment plans of patients who lose coverage as a result of ACA invalidation.

Hall Render will continue to follow developments on Texas v. United States. Stay tuned for further updates.

If you have any questions or would like any additional information about this topic, please contact:

• Adele Merenstein at amerenstein@hallrender.com or (317) 752-4427;
• Dwayne Barrs at dbarrs@hallrender.com or (214) 615-2008; or
• Your regular Hall Render attorney.

The post Texas v. United States – House of Representatives and Defender States Petition Supreme Court for Review: Will Obamacare Fall? appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

In part 1 of this series about negotiating procurement deals, we talked about the parties to the agreement and how that easily overlooked issue can cause problems such as unlicensed use of the software being acquired. Other basic issues can cause deals to go sideways. This post addresses the first issues that an organization’s business team is likely to discuss with its vendors, which may also be under-defined in the agreement.

You might not even think about them, but they are the heart of the contract that you will ultimately sign: what are you buying, when are you going to get it, when are you going to pay for it and how much are you paying? If your agreement is clear about those issues, your company is going to avoid some of the most significant problems that can arise in procurement deals.

What are you buying?

The buyer who has spent a lot of time with the vendor’s salesperson may be taking this element for granted. After all, the salesperson may have given several product demonstrations, sent numerous emails and repeatedly called the buyer to talk about the deal. So when the buyer is ready to pull the trigger, seeing the common name of the product (Generic SaaS or Software) or service (Branded Threat Assessment Services) that you’ve discussed for months may be all that is needed for you to understand what you expect the vendor to deliver. Will the judge with no experience in your industry share that understanding if something goes wrong with the deal? Perhaps not.

The judge is going to look to the terms of your agreement to evaluate whether the vendor delivered what it was required to deliver. Since many parts of vendors form contracts work to eliminate everything the salesperson said from that evaluation, they need to be reviewed holistically. Consider the near-ubiquitous “AS-IS, WITH ALL FAULTS” disclaimer that many software agreements contain, or disclaimers about not meeting customer requirements, or integration clauses specifying that the contract is the entire agreement, superseding any prior discussions.

Does the common name of the product seem sufficient in light of these concerns? Probably not. Health care organizations can be left paying for software products that do not meet their needs, sometimes for significant amounts. For example, one medical group was left footing an $800,000 bill for a failed software integration when the agreement contained no commitment about the product working seamlessly with its patient management system, as the salesperson had allegedly promised.[1]

When are you going to get it?

Vendors may have very different ideas about delivery timing than their salespeople may lead their customers to believe. Does the agreement say anything about delivery? Is there an implementation period before you’ll be able to put the product into use? Whether there’s a simple disclosure of login information to start using the product or a complex implementation that the vendor needs to lead, it’s perfectly fair to put a no-later-than date in the agreement about when the product must be live.

For complex implementations, the vendor will often demur on giving such a commitment, citing all the things that it needs from the customer in order to complete the project. But that’s a discussion the parties need to be having before signing anyway; if vendors require customers to provide any resources to get the product working, they should be prepared to describe that assistance in the agreement. Once the customer has agreed to provide that particular assistance, is there a good reason to omit that deadline for completion in the agreement?

When are you going to pay for it (and how much)?

The total cost of the product or service often commands the bulk of the customer’s attention. However, the savings that you think you’re getting may evaporate if there are delivery problems. For example, if the product is expected to cut costs once implemented, but the go-live date arrives months later than expected, how much did the delay cost? Maybe there’s a prior agreement that you had to renew because the new product wasn’t delivered on time, or maybe you only had to keep paying for the existing agreement until the new product went live.

Which vendor do you think is going to be more motivated to hit your timelines: the one you’ve paid 100 percent upon signing your new agreement, or the one who has some or all of its fees withheld until completion? And which party is bearing the risk of failure? If final payment is due on completion or, say, 90 days from signing, “whichever comes first,” there’s a different incentive structure than if payment is due on the later of those two dates.

Software often requires separate maintenance and support fees in connection with a license agreement, and those fees may be just as significant as the up-front costs. Does the commencement date for those fees align with the signing of the agreement or the successful delivery of the software? Again, consider how the payment structure allocates the risk of a failed or delayed implementation.

Practical Takeaways

Your approach to the issues discussed in this post may vary across deals. Communicating your intent about them to your attorney will not only make your legal reviews more efficient, but also help to avoid disputes with your vendors.

For more information on this topic, please contact Jon Boguth at (248) 457-7845 or jboguth@hallrender.com or your regular Hall Render attorney.

For more information on Hall Render’s Health IT services, click here.

The post Do-It-Yourself Legal Review Part 2: A Guide for Helping Businesses Evaluate Software Terms appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

Welcome to the new The Week in Washington! This newsletter will publish on Monday to review the past week’s news for Congress and the administration, as well as provide a preview for the upcoming week.

Health Care on the Hill – What to Expect in 2020

Since 2020 is an election year, Congress traditionally does not take up much in the way of controversial legislation. However, with health care polling as a top issue among voters, lawmakers are feeling political pressure to deliver legislative action on some health care issues. There is a looming health care to-do list, yet a very narrow window to make progress. Last year’s spending deal extended several health programs, known as Medicare extenders, through May 22, 2020. This May deadline was intentionally created to pressure Congress for a Memorial Day deal on a comprehensive health care package that includes items such as the aforementioned Medicare extenders, prescription drug pricing and surprise medical billing.

For surprise billing, the two House committees working on the issue did not make progress over the holiday break and continue to appear on opposite ends of the issue. In December, Senate Health, Education, Labor, and Pensions (“HELP”) Chairman Lamar Alexander (R-TN) and the House Energy & Commerce Committee negotiated a surprise billing fix. The measure would set benchmark payment rates and create a baseball-style arbitration process that would allow providers to appeal claims over $750. However, despite this bipartisan, bicameral agreement, the legislation was not put in the year-end spending package because lawmakers could not come to a consensus on the proper mechanism to address the problem.

Furthermore, other committees with jurisdiction over health care have also become engaged in the debate. The House Ways and Means Committee leadership is still developing a proposal but has indicated the approach will be different from the HELP/Energy and Commerce package. Ways and Means Ranking member Kevin Brady (R-TX) said he and Chairman Richie Neal (D-MA) want their own bill to avoid “government rate-setting” and to build broad agreement on the issue. While there is not currently an agreed-upon mechanism, supporters still hope that something can be passed this year. Many congressional leaders, such as Chairman Alexander and House Speaker Nancy Pelosi (D-CA), have stressed that surprise billing is the top 2020 priority and that they will find a way to get it done. However, many stakeholders are skeptical that House and Senate leadership will want to force their members to vote on legislation that divides powerful industries in the middle of a campaign season.

Prescription drug pricing legislation has an even lower probability of passing than surprise billing. Neither the prescription drug bill from the House majority nor the bipartisan proposal in the Senate Finance Committee has a path forward in a divided Congress. However, provisions in the measures will provide starting points for negotiations on drug pricing. The House majority is insisting that any major drug price deal authorize the government to directly negotiate drug prices, which is a non-starter for many Senate Republicans. Come May, Congress is likely to pass another Medicare extenders packaged and table surprise billing and prescription drug pricing until after the election.

New Vertical Merger Guidelines Released by the DOJ and the FTC

Last Friday, the Department of Justice and Federal Trade Commission issued a proposal for new guidelines governing vertical mergers, or combinations of companies that aren’t in direct competition but are in the same supply chain. The proposed new guidelines cover topics including how vertical mergers can harm competition and how those harms will be analyzed, as well as the competitive benefits attributed to such tie-ups. Comments on the draft guidelines can be emailed to verticalmergerguidelines@ftc.gov and verticalmergerguidelines@usdoj.gov and must be received no later than February 11, 2020.

Hall Render’s antitrust team will be releasing a more comprehensive analysis on this proposal soon.

Health-Related Bills Introduced This Week

Rep. Gregory Murphy (R-NC) introduced H.R. 5582 to amend Titles XIX and XXI of the Social Security Act to require hospitals and certain other participating providers under Medicaid or the Children’s Health Insurance Program to disclose the provider’s policy on parental consent for the provision, withdrawal or denial of life-sustaining treatment for minors.

Rep. Lauren Underwood (D-IL) introduced H.R 5575, the Primary and Behavioral Health Care Access Act.

Sen. Cory Booker (D-NJ) introduced S. 3169 to direct the Secretary of Health and Human Services to carry out a Health in All Policies Demonstration Project.

Sen. Elizabeth Warren (D-MA) introduced S. 3163 to authorize the collection of supplemental payments to increase congressional investments in medical research.

The Week Ahead

• On Tuesday, the House Energy and Commerce Oversight and Investigations subcommittee holds a hearing on “A Public Health Emergency: State Efforts to Curb the Opioid Crisis.”
• On Wednesday, the House Energy and Commerce Health subcommittee holds a hearing on “Cannabis Policies for the New Decade.” The hearing will consider a half-dozen marijuana bills, ranging from medical research proposals to comprehensive legalization blueprints.
• Starting today, the 38th Annual J.P. Morgan Healthcare Conference will gather health care officials, investors, executives and more than 9,000 other attendees in San Francisco to discuss a wide variety of health care priorities such as innovative technology, data privacy and security, price transparency and data sharing.

Congressional Fun Fact: Hill of Beans

Since 1904, the House of Representatives cafeterias have served bean soup on a daily basis with one exception. Upon finding that it had been eliminated from the menu on one hot day, Rep. Joseph Cannon (R-IL), who served as Speaker from 1903 to 1911, declared that bean soup should be served every day regardless of the weather… and it still is.

For more information, please contact:

• John Williams III at (202) 370-9585 or jwilliams@hallrender.com;
• Andrew Coats at (202) 370-9587 or acoats@hallrender.com;
• Abby Kaericher at (202) 780-2989 or akaericher@hallrender.com; or
• Your regular Hall Render attorney.

For more information on Hall Render’s Federal Legislative & Regulatory Advocacy services, click here.

The post Hall Render’s The Week in Washington – January 13, 2020 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

On January 9, 2020, the Department of Justice (“DOJ”) announced that it collected over $3 billion in settlements and judgments under the False Claims Act (“FCA”) in the federal fiscal year 2019. The FCA has historically been the government’s primary tool for combatting perceived fraud, waste and abuse in the health care system, and 2019 was no different. Health care cases accounted for $2.6 billion—nearly 90 percent of total recoveries. This is the tenth consecutive year that the DOJ’s FCA health care recoveries exceeded $2 billion. The DOJ and whistleblowers brought these cases against a variety of health care providers and suppliers including drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories and physicians.

The largest health care settlements involved pharmaceutical companies. In one case, a drug manufacturer paid $195 million to settle civil allegations that it paid kickbacks to induce physicians and nurse practitioners to prescribe its drug to patients. The government alleged that the company paid kickbacks in the form of sham speaker arrangements, providing lavish meals and entertainment and setting up jobs for prescribers’ friends and relatives. In another case, the government received $500 million from the maker of an opioid addiction treatment. The payment resolved civil allegations that the maker promoted its drug inappropriately, including by making false or misleading claims that one formulation of the drug was less susceptible to diversion, abuse and pediatric exposure than other similar drugs. The DOJ also settled with seven drug manufacturers who paid a combined total of $624 million to resolve claims that they paid copays for Medicare and Medicaid patients through purportedly independent foundations.

The DOJ settled a large number of claims against health care providers, including physician clinics, nursing facilities, hospitals and health systems. In several of these settlements, the DOJ pursued individuals as well as corporations. In one case, owners of a group of companies that operates orthopedic clinics entered into individual settlements which, when combined with the corporate settlement, totaled $7.1 million. The companies and their owners further agreed to a five-year corporate integrity agreement that requires them to undertake extensive compliance efforts.

Whistleblower cases continued to be a major factor in the DOJ’s enforcement efforts. 633 new qui tam claims were filed in 2019, and the DOJ recovered more than $2.1 billion from those and existing whistleblower actions.

Practical Takeaways

Health care enforcement continues to be a profitable pursuit for the federal government. From 2016 through 2018 (the most recent period for which data is available), the Office of Inspector General reports that it collected $4.00 for every $1.00 spent on enforcement efforts.

In this environment, developing and implementing an effective compliance program has become a standard expectation within the health care industry. While even the best program cannot prevent all violations, a tailored, proactive compliance program is more likely to identify issues early. Additionally, the existence of such a program is a positive factor when negotiating with the government, should that become necessary. Finally, if any significant compliance issues are detected through your own compliance program activities, self-reporting is usually a much-preferred position as opposed to being a target in another one of these government enforcement actions.

Hall Render attorneys have years of experience in providing practical advice to all types of health care entities. For help understanding your legal obligations, designing a compliance program that is right for your organization or investigating a potential issue, please contact:

• Katherine Kuchan at kkuchan@hallrender.com or (414) 721-0479;
• Scott Taebel at staebel@hallrender.com or (414) 721-0445;
• James Junger at jjunger@hallrender.com or (414) 721-0922; or
• Your regular Hall Render attorney.

For more information on Hall Render’s Compliance Counsel services, click here.

The post DOJ’S 2019 False Claims Act Recoveries Total More Than $3 Billion appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

Under the Protecting Access to Medicare Act (“PAMA”), certain laboratories must report private payor data to the Centers for Medicare & Medicaid Services (“CMS”). This data is in turn used by CMS to establish a single, national Clinical Laboratory Fee Schedule. For a more detailed discussion on PAMA and the types of laboratories that are required to report see our previous article available here.

Laboratories that qualify as “applicable laboratories” under PAMA are required to report private payor data every three years and were supposed to report data between January 1 and March 31, 2020. However, Section 105(a)(1) of the Further Consolidated Appropriations Act of 2020 delayed the reporting requirements by one year. Accordingly, applicable laboratories must now report private payor data between January 1 and March 31, 2021. It is important to note that although the data reporting period was delayed by one year, labs must still report data from the original data collection period of January 1 through June 30, 2019. Thereafter, data reporting will resume on a three-year cycle, beginning in 2024.

CMS issued updated instructions on the PAMA reporting requirements with the revised data, which is available here.

If you have questions or would like additional information about this topic, please contact:

• Lori Wink at (414) 721-0456 or lwink@hallrender.com;
• Joseph Krause at (414) 721-0906 or jkrause@hallrender.com; or
• Your regular Hall Render attorney.

For more information about Hall Render’s Reimbursement & Payment Practices services, click here.

The post Congress Delays Laboratory Data Reporting Requirements Until 2021 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

NATIONAL

• Could Patient Privacy Awareness Drive Health IT Innovation in 2020?
• How tech will transform the healthcare workplace by 2050: 3 predictions
• Physicians will keep fighting on these 6 key issues in 2020
• How healthcare will change in 2020
• Health Plans Struggle with HIPAA Compliance, Unprepared for Audit
• AHA files another challenge to CMS site neutral payment policy
• GAO report hits lax oversight of 340B drug program
• Hospital groups sue HHS, seek to block site-neutral pay cuts
• ‘Concierge’ Medicine Gets More Affordable But Is Still Not Widespread
• Health IT to lead 2020 deals as hospital activity slows, KPMG says
• Hospitals file new lawsuit to halt 2020 site-neutral payment cuts
• HHS Reveals Draft of 5-Year ‘Strategic Health IT Plan’
• Pharma execs pitch ideas at #JPM20 to lower drug costs. None of them include dropping their own prices
• New AMA hub connects doctors with early-stage healthcare startups, investors
• Teladoc to buy enterprise telehealth solutions provider InTouch Health in $600M deal
• Major reformations of the last decade that will shape US healthcare in 2020
• State-by-state breakdown of 120 rural hospital closures

NORTHEAST

(Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont)

CONNECTICUT

• • ‘I do this with a heavy heart’: Bankruptcy judge orders closure of Connecticut nursing home following financial troubles
  • Racial disparities persist in Connecticut health care, two groups find
  • New health tracker ‘illuminated a need’ at CT hospitals
  • Bridgeport Manor operator pleads guilty to embezzlement
  • New London Hospital gets new CEO

MAINE

• • Physician group plans ownership transfer for orthopedic ASC
  • Maine receiving more than $5 million to help addicted expecting mothers
  • 20 on ’20: A view of Maine’s health care, from the street level
  • N.H. doctor convicted of sexually assaulting a patient surrenders his Maine medical license
  • Penobscot Pediatrics recognized by Let’s Go! for helping kids make healthy choices

MASSACHUSETTS

• • Flu causes ‘concerning’ ED crowding at Brigham and Women’s
  • Framingham’s Definitive Healthcare expands its data business by acquiring PatientFinder
  • Definitive Healthcare buys Florida analytics firm
  • Partners HealthCare expects to spend $6.1B in next five years on expansions
  • At major San Francisco conference, it’s Mass General Brigham, not Partners
  • Partners’ growth in outpatient services drives higher spending
  • Health Policy Commission identifies 3 troubling cost trends
  • Northampton hospital workers ratify new contract

NEW HAMPSHIRE

• • 2 New Hampshire health systems file for merger
  • $130 million Dartmouth-Hitchcock expansion wins OK in Lebanon
  • More psychiatric beds means fewer people waiting in ERs
  • Will you be covered? Patients snared in negotiations
  • Partners to meet with New Hampshire regulators over Exeter acquisition
  • New Hampshire college expands nursing program

NEW YORK

• • No easy fix for nursing home staff shortage
  • NYU Langone Health Adds Three New Practices To Its Growing Ambulatory Care Network
  • University of Rochester, Jones Memorial cancer center in Olean under review
  • NY telehealth giant Teladoc grows with $600M acquisition
  • Upper Allegheny Health System head Tim Finan looks back on tenure
  • Valley Health System taps Mount Sinai spinoff to prescribe digital therapeutics
  • New healthcare program to offer coverage to uninsured Brooklynites
  • New York health system alerts patients of phishing attack
  • Mount Vernon Hospital closure: What to know about opposition, Montefiore money, investments
  • Cuomo Announces NY Will Provide Puerto Rico Mental Health Professionals, Help For Power System
  • New York safety-net hospital getting consultant to avoid ‘fiscal crisis’
  • New York hospital system seeking state OK to close Irving campus

RHODE ISLAND

• • Staffing Shortages at RI Agency For Disabled Could Result in Federal Penalties
  • McNamara bill would exempt certain health care products from state taxes

VERMONT

• • OneCare to seek nonprofit status in order to receive $5.7 million from Vermont
  • Program Launches to Assist Rural Residents in Vermont
  • UVM Medical Center will reopen Fanny Allen operating rooms
  • Vermont children face ‘heartbreaking’ delays for dental care, pediatric dentist says
  • Medical coverage changes at the Pines Rehab and Health

MID-ATLANTIC/EAST                                                                 

(Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia, West Virginia)

DELAWARE

• • ChristianaCare partners with GoHealth on medical aid units
  • Beebe Medical Group relocates surgery unit
  • ChristianaCare partners with urgent care chain
  • ChristianaCare strives  to be the employer of choice for nurses

DISTRICT OF COLUMBIA

• • Gas line break in Northwest DC forces hospital wing and homes to evacuate
  • Beebe to anchor medical pavillion in Milton
  • DC-area health-focused startups share the spotlight at CES

MARYLAND

• • Maryland’s new prescription drug board meets for first time
  • Mercy Health Services CEO to retire, successor named
  • Novavax earns key FDA status for its flu vaccine. Wall Street took it well.
  • Sinai Hospital president to step down, launch telemedicine startup

NEW JERSEY

• • Hackensack University Medical Center First Hospital in New Jersey to Implement C-SATS – an AI-Powered Surgical Training Platform
  • Lawsuit alleges New Jersey nursing home’s negligence led to patient death
  • Valley Health System Becomes First Health System in New Jersey to Prescribe Enterprise-wide Digital Therapeutics
  • Patient falls from New Jersey hospital’s 6th floor window, survives
  • RWJBarnabas Health names new senior VP
  • Valley Health partners with Rx.Health on prescribing app
  • Clara Maass Medical Center names chief nursing officer
  • New Jersey court upholds False Claims Act settlement despite defendants’ protests

PENNSYLVANIA

• • Philadelphia hospital opens outpatient care center
  • Upper Allegheny Health System CEO Timothy Finan to retire in July
  • Allegheny Health Network finalizes affiliation pact with Grove City hospital
  • Children’s Hospital of Philadelphia considers adding beds to new inpatient hospital in King of Prussia
  • St. Luke’s Anderson Campus Opens New Women & Babies Pavilion
  • Hidden camera found in employee bathroom at Pennsylvania hospital
  • Pa. is paying hospitals to get patients into opioid treatment after overdosing — and it’s working
  • What hospitals can learn from a Philadelphia hospital closure
  • Penn Medicine’s new sponsorship with Flyers, Wells Fargo Center goes beyond signage
  • AHN acquires Grove City Medical Center
  • James Kanuch named CFO of new Allegheny Health Network hospital
  • Proposed False Claims Act could affect providers outside of Medicaid system, group says
  • Main Line Health adopts orphaned Hahnemann urology residency program
  • Welltower, Jefferson Health JV Would Integrate Health System with Senior Housing
  • Jefferson pursues sale of some of its health care real estate holdings
  • Partnership gives Guthrie heart patients access to Temple transplant surgeons
  • UPMC Enterprises commits $1 billion to life science investments
  • Pennsylvania hospital prepared to join WVU Medicine
  • 32 things to know about CHS, Tenet, HCA and UHS
  • Allegheny County Medical Society steps up focus on supporting independent doctors

VIRGINIA

• • Federal officials: Sentara set to pay millions for patient privacy breach
  • Donor says more nurses could fix healthcare system, gifts UVA nursing $20M
  • Bon Secours Mercy Health completes acquisition

WEST VIRGINIA

• • Thomas Health System to file Chapter 11 bankruptcy
  • Thomas Health board of directors vote to seek Chapter 11 protection
  • Uniontown Hospital announces intent to join WVU Medicine
  • West Virginia hospital group eyes bankruptcy, not closing
  • WVU Medicine adding pediatrics in Greene, Uniontown Hospital to system
  • WVU Medicine to Take Ownership Of Wetzel County Hospital
  • First Thomas Health bankruptcy hearing set for this week
  • Pennsylvania hospital prepared to join WVU Medicine
  • 20 employees furloughed at bankrupt West Virginia hospital

CENTRAL

(Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota)

IOWA

• • Nurses authorize union leaders to call strike in Sioux City
  • State settles two cases alleging ‘medical negligence’ at UIHC for a total of $7 million
  • Iowa Specialty Hospital expands Fort Dodge clinic
  • Virus Causing Iowa Hospital to Cancel All January Maternity Tours

KANSAS

• • Prime Healthcare names regional CEO of 4 area hospitals
  • Company closes Boonville hospital with short notice
  • State settles two cases alleging ‘medical negligence’ at UIHC for a total of $7 million
  • Iowa Specialty Hospital expands Fort Dodge clinic
  • Virus Causing Iowa Hospital to Cancel All January Maternity Tours

MINNESOTA

• • Mayo Clinic launches data analytics initiative for drug discovery
  • St. Luke’s announces executive appointments
  • Clinic closings will worsen Minn. shortage of geriatric specialists
  • Minnesota nonprofit hospitals in tug-of-war with insurers over efforts to rein in costs
  • Schafer: For Mayo and other nonprofits, operating in the black is about survival, not greed
  • Record pace of drug approvals prompts cheers from patients, warnings from advocates
  • Minneapolis VA cited after another suicide of veteran
  • In rural Minnesota, a scarcity of beds for people in crisis
  • HealthPartners subsidiary releases ACO results

MISSOURI

• • Prime Healthcare names regional CEO of 4 area hospitals
  • St. Louis behavioral health services provider names new CEO
  • ‘Concierge’ Medicine Gets More Affordable But Is Still Not Widespread
  • SSM Health and Strive Health partner to transform kidney care
  • Company closes Boonville hospital with short notice
  • Outspoken critic of Missouri’s response to opioid epidemic fired after speaking out
  • Technology + Health Care: How the industry is changing
  • Prime Healthcare fills regional CEO’s seat after 7-month vacancy
  • Advanced ICU Care Announces Second Tele-ICU Launch within HSHS Health System

NEBRASKA

• • UNMC creates new division for Allergy and Immunology
  • Nebraska Medicaid head steps down as state expands coverage
  • UNMC sets another record for research funding at just over $138 million
  • Nebraska hospital relocating surgery center as part of $6M project
  • Nebraska Medicaid expansion plan would rein in state costs; critics say it cuts coverage, benefits
  • ‘If you don’t use it, you lose it’: Methodist Hospital unit focuses on keeping older patients active

NORTH DAKOTA

• • Essentia Health names physician as new head of its Fargo area market
  • City of Bismarck honoring doctor who successfully sued major health care provider
  • Creating green solutions to Dakota’s healthcare challenge

SOUTH DAKOTA

• • Sanford Health expanding efforts to bring genomic insights into primary care
  • Regional Health set to become Monument Health, join Mayo Clinic Care Network
  • Color to Collaborate with Sanford Health, Expand Northshore Partnership
  • LifeScape to build new facility at USD Discovery District
  • Sanford International generates $140,000 for local charities
  • South Dakota State Rep Proposes Bill to Criminalize Gender-Transition Surgeries on Children
  • Creating green solutions to Dakota’s healthcare challenge

MIDWEST

(Illinois, Indiana, Kentucky, Michigan, Ohio, Wisconsin)

ILLINOIS

• Illinois eye ASC plans ownership change pursuant to merger
• NorthShore University HealthSystem buys Chicago hospital
• Advocate BroMenn Sold To Carle
• Advocate Bromenn and Eureka Hospital acquired by Carle Health
• UIC proposes $191M outpatient care center in Chicago
• 8 ER physicians quit Chicago hospital
• Chicago hospitals ready for uptick in marijuana-related ER visits
• Advocate Aurora Health moves to double revenue in 5 years
• How Advocate Health Care is driving better outcomes with a focus on social determinants of health
• Advocate to close 7 Walgreens clinics in suburban Chicago, prompting allegations of unfair labor practices
• Willowbrook Memory Care recognized for improving quality of care

INDIANA      

• • Indiana Doctor, Siblings Accused of Medicare Fraud
  • Park Center to buy Lafayette Medical Center
  • Tim Tarnowski rejoins IU Health as CIO
  • IU Health develops app to help physicians search patient data
  • IU Health Names Senior VP
  • New hospital to expand existing clinic’s offerings
  • Parkview Health to Invest in New Facilities
  • New Trial Ordered in Cook Medical Lawsuit
  • Highpoint Health laid off or reduced the hours of 80 workers today

KENTUCKY

• • U of L lowers request for state loan on Jewish Hospital acquisition to $35 million
  • Med Center seeks dismissal of Greenview’s ambulance plan
  • Mary & Elizabeth Hospital names new chief administrative officer
  • U of L says it needs $35 million — rather than $50 million — from state to prop up struggling health facilities
  • U of Louisville lowers state loan request to finance Jewish Hospital
  • Court combines hospital chain’s 11 bankruptcy cases
  • Andy Beshear picks nursing home exec as watchdog of troubled nursing home industry
  • Lake Cumberland Regional Hospital names Brian Springate COO
  • Signature Healthcare exec selected as inspector general for Kentucky’s nursing home industry
  • Baptist Healthcare buys Jeffersontown building for $15M — here’s what it’s planning
  • Louisville health tech company acquired by Florida firm
  • Louisville Metro Government opens 2nd Wellness Center

MICHIGAN

• • Memorial Healthcare expands neurological treatment to mid-Michigan
  • Inside Michigan’s $17.5M Grant To Fight The Opioid Epidemic
  • Michigan Medicine leader tapped as president of Vanderbilt University Adult Hospital
  • Business manager of shuttered Kalamazoo OB-GYN pleads guilty to health care fraud
  • Spectrum Health Ludington birthing center unveils multi-million dollar expansion
  • Head of Alma, Mt. Pleasant health provider assumes Clare duties
  • Beaumont Health Reclaims Pediatric Hospice Program
  • Ex-Sioux City plastic surgeon pleads not guilty to federal fraud charges

OHIO

• • OptumRX says Ohio didn’t play fair in drug-pricing negotiations
  • Ohio’s Hospice opens $10M care center
  • Okapi Medical Names CEO
  • Nationwide Children’s, a gene therapy leader, launches manufacturing spinout
  • Dayton Children’s Hospital buys more property near health campus
  • How Cleveland Clinic manages its medical waste
  • Welltower, Jefferson Health JV Would Integrate Health System with Senior Housing
  • Greater Cincinnati hospital lays off dozens, reduces hours for other workers
  • Nursing home calls strain Ohio city’s EMS capacity
  • Bon Secours Mercy Health and Lirio Announce Partnership and Investment

WISCONSIN

• • UW Hospital among first centers to perform new kind of heart transplant
  • New Prevea Menomonie Health Center to open next week providing urgent care, expanded services
  • Advocate Aurora Health moves to double revenue in 5 years
  • Payroll exec allegedly embezzled $476,000 from home care facility in Glendale
  • Certified nurse-midwives lead collaborative care model as solution to obstetrician shortage

SOUTH/SOUTHEAST

(Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee)

ALABAMA

• • Children’s of Alabama COO promoted to new role
  • Feds recover $3 billion in fraud cases, including $48 million from former HealthSouth

FLORIDA

• • Florida ranks 28th in health care affordability scorecard
  • Florida health systems open $152M jointly owned hospital
  • Unified Women’s Healthcare Acquires Lucina Health
  • Orlando VA Medical Center names new top executive
  • Disgruntled patient makes bomb threat to Florida hospital for 2nd time
  • Florida hospitals face $70.4M drop in Medicaid funding
  • Orlando Health acquires local orthopedic firm, to build $250 million downtown hospital
  • Ronald Bierman is Florida hospital’s new president
  • Johns Hopkins All Children’s Hospital hit with another wrongful death lawsuit
  • Fishermen’s Community Hospital Sets Sights On Winter 2020 Opening
  • New “Go-To” Hospital in Sarasota County Coming Soon
  • New medical office opens in Fort Walton Beach
  • Definitive Healthcare buys Florida analytics firm
  • Sebastian River Medical Center Announces New President
  • Tampa General Hospital Names Mark Runyon New Chief Financial Officer
  • Orange Park Medical Center reaches another milestone in $126M expansion

GEORGIA

• • Hamilton Medical Center to add open heart surgery program
  • Georgia hospital CEO Dan Jones resigns
  • Developers Tapped to Build New Surgery Center in Atlanta
  • Reduced Capacity At Grady Memorial Hospital Ripples Through Region’s Medical System
  • Cartersville native appointed Baptist Village president/CEO
  • Georgia launches new healthcare database for consumers
  • Columbus hospital now run jointly by Emory, LifePoint Health
  • State auditors examine Georgia hospitals’ expenses on lobbying
  • Flood Damaged Atlanta Hospital Under Renovation Through Oct.
  • Grady Hospital expects to operate at reduced capacity for much of 2020
  • Georgia family stuck with $325K medical bill, health plan provider refuses to pay
  • Georgia lawmakers hopeful to end surprise medical billing
  • Georgia Senate introduces Health Care Bill
  • Hospital campus selling at auction in North Georgia

MISSISSIPPI

• • Sanderson championship donates record $1.3 million to Children’s Hospital
  • Group of Mississippi physicians come out in support of medical marijuana initiative
  • ‘No money left.’ Coast hospital suffered while owner was paid millions, prosecutor says

NORTH CAROLINA

• • Hospital names VP of nursing
  • Ballad expands services to North Carolina
  • Halifax Regional becomes Vidant North
  • Atrium hospital billed North Carolina woman 18 months after visit
  • North Carolina health system building $35M medical office building with ASC
  • WakeMed Health & Hospitals Selects Health Catalyst to Transform Healthcare Delivery through Centralized Data and Analytics
  • Regional hospitals look back on 2019 growth
  • Lawsuit challenging medical regulation encounters setback
  • More patients, parking and jobs coming to UNC hospital campus in Hillsborough

SOUTH CAROLINA

• • South Carolina hospital escapes suit over physician’s lack of adequate insurance
  • Clemson and MUSC Work to Improve Health in Rural Communities
  • MUSC rolls out virtual care app for South Carolina state employees
  • Midwives in S.C. rally for equal hospital access for their mothers
  • South Carolina health system lays off 327 employees

TENNESSEE

• • Ardent Health withdraws IPO, faces class-action complaint
  • Michigan Medicine leader tapped as president of Vanderbilt University Adult Hospital
  • Ballad expands services to North Carolina
  • Midstate doctor faces federal charges connected to $7 million healthcare fraud conspiracy
  • Hospital changes are affecting patient drive times
  • Surgery Partners promotes COO to top job
  • CHS shares spike on 2020 guidance preview
  • 32 things to know about CHS, Tenet, HCA and UHS
  • Ballad Health to build new urgent care in Kingsport
  • Two Nashville health care giants team up on virtual reality program
  • Tennessee provider alerts 13,000 patients of data breach

SOUTH-CENTRAL/SOUTHWEST

(Arkansas, Arizona, Louisiana, New Mexico, Oklahoma, Texas)

ARKANSAS

• • Baptist Health, UAMS open new program to expand 120 medical resident slots
  • Partnership between Baptist Health and UAMS aims to combat physician shortage
  • UAMS study finds raising opioid dosage increases risks, ineffective for pain
  • 2 Arkansas men charged in scheme to defraud military insurer
  • Hospital bankruptcies leave sick and injured nowhere to go
  • Northwest Health’s Cindy Ruffing named HR Professional of the Year

ARIZONA

• • BCBS of Arizona acquires Steward Health Choice Arizona
  • Arizona agency names 44 others tied to alleged exam, billing fraud
  • Hacienda HealthCare will keep Medicaid contract, settlement says
  • Sinema secures $5.4 million for North Country Healthcare
  • Renovated Phoenix VA mental health care units safer, more welcoming
  • Phoenix Children’s Hospital expands East Valley footprint with Specialty Clinics building at Mercy Gilbert
  • Phoenix Children’s Hospital opens specialty clinic in Gilbert
  • Phoenix Children’s Is the First-Ever Health System in the U.S to Use Medtronic Stealth Autoguide™ Cranial Robotic Guidance Platform for Neurosurgery

LOUISIANA

• • New Orleans psychiatrist sentenced for healthcare fraud
  • Baton Rouge General Foundation completes $10 million fundraising campaign for hospital projects
  • PHOTO TOUR: Our Lady of the Lake Children’s Hospital
  • A new program to help pregnant addicts save their child and themselves

NEW MEXICO

• • Ranking system penalizes UNM Hospital unfairly, officials say
  • True Health New Mexico appoints new CEO
  • Comagine Health Invites Health Care Organizations and Additional Partners to Reimagine Health Care

OKLAHOMA

• • Oklahoma hospital names Kevin O’Brien CEO
  • Oklahoma Attorney General taking on opioid distributors in new lawsuit
  • Angi Mohr tapped as president of Oklahoma hospital
  • State Rep. McEntire addresses surprise medical billing
  • Tulsa diabetes advocate: ‘People are dying because they can’t afford their insulin.’
  • Here’s What Happened to $829M Oklahoma Was Awarded to Treat Opioid Addiction

TEXAS

• • Cynergi Health Partners’ VR tool helps patients, community hospitals
  • 32 things to know about CHS, Tenet, HCA and UHS
  • Frisco health care tech firm Valify sells to hospital giant HCA Healthcare
  • Frisco health care startup acquired by the biggest hospital chain in the country
  • HCA buys Texas company with Martin Ventures ties
  • Weems to get advice from Texas A&M grant
  • LifeCare Returns To Its Roots In Critical Care With New Ownership
  • Valley Baptist Health System opens new micro-hospital
  • A ‘Pillar of Health in SA’ Retires From Methodist Healthcare Ministries After 25 Years
  • Privia Health and Children’s Health Announce Strategic Alliance
  • Preparing for Special Pathogens: An IP Perspective
  • Rural areas struggle with health care: Research shows towns falter when a hospital closes
  • Tenet on track to meet $450M cost-cutting goal this year, CEO says

NORTHWEST

(Alaska, Idaho, Montana, Oregon, Washington, Wyoming)

ALASKA

• • Alaska out-of-hospital births more than 4 times higher than US, report says
  • Nonprofit leaders meet with Gov. Dunleavy and DHSS staff at Mat-Su Health Foundation convening
  • Noel Rea selected to manage Alaska Psychiatric Institute as interim chief executive

IDAHO

• • St. Lukes CEO announces retirement after a decade on the job
  • Idaho Falls welcomes new hospital
  • HAZMAT team responds to East Idaho hospital to investigate ‘unknown white substance’

MONTANA

• • Powell Valley Healthcare Will Be Affiliate Of Billings Clinic
  • Conflict over unreleased Medicaid audit could delay state infrastructure projects

OREGON

• • Oregon Nurses’ Association calls for increased funding
  • How Oregon’s healthiest hospitals measure up by finances and occupancy
  • Salem Health CEO hops in backhoe to kick off hospital expansion
  • How Oregon’s healthiest hospitals rank by finances and occupancy
  • Oregon governor taps OHA chief of staff as health policy adviser
  • Lawmakers Ready Bills On Prescription Drug Prices, Staffing Shortages
  • New report details the high cost of regulatory compliance for hospitals
  • Report finds ‘regulatory overload’ costs Oregon hospitals millions

WASHINGTON

• • Providence Health strikes labor deals at 3 Washington hospitals
  • Nurses union asks judge to reconsider sudden Yakima hospital closure
  • Carole Peet chosen as the new CEO of Virginia Mason Memorial
  • Seattle Cancer Care Alliance names Aaron Crane executive vice president
  • Providence St. Joseph Health Announces Same-Day Virtual Visits
  • EvergreenHealth Names Chief Operating Officer
  • Swenson Healthcare Joins Forces with Comagine Health
  • Washington introduces consumer data privacy legislation
  • Astria Regional’s closure leaves Yakima without open heart surgery provider
  • Seattle healthcare tech company SCI Solutions acquired for $190M
  • State questioned Seattle Children’s over lack of air filter in OR

WYOMING

• • Powell Valley Healthcare Will Be Affiliate Of Billings Clinic
  • Wyoming Dept. of Health announces new leadership for behavioral health

WEST

(California, Colorado, Hawaii, Nevada, Utah)

CALIFORNIA

• • Dignity Health unveils details of $320M California replacement hospital
  • Bay Area hospital facing closure may have new buyer
  • New Neurological Rehab Hospital Opens In Murrieta
  • Adventist laying off 46 employees in California
  • California hospital deploys overflow tent after flu cases double
  • Dignity Health loses appeal of Medicaid out-of-network billing case
  • At risk of closing, 127-year-old Daly City hospital may have new buyer
  • Optum taps Dr. Amar Desai to lead California operations
  • Sutter Health to offer patients, staffers individualized transportation options through Lyft
  • Sleep apnea company pays $37.5M to settle kickback lawsuits
  • California hospital CEO’s contract not renewed

COLORADO

• • Colorado Springs Children’s Hospital expanding with new clinics, additional beds
  • Children’s Hospital expands to keep up with growing community
  • Children’s Hospital Colorado kicks off new program focused on mental health
  • Health bills on the Colorado docket this session
  • ‘Get into healthcare because it’s recession proof’: Advice that pushed Children’s Hospital Colorado CIO to enter the industry
  • Vail Health says no smoking in the operating room
  • Colorado’s new law protecting patients from surprise medical bills is up and running
  • Colorado medical center to add $75M orthopedic hospital, cancer center
  • SSM Health and Strive Health partner to transform kidney care
  • Estes Park Health CEO Search: Second Candidate
  • Parkview Medical Center to add cancer center, orthopedic hospital
  • Ron Fitch named chief administrative officer of UCHealth Pikes Peak Regional Hospital
  • Colorado hospitals sue to block early collection of $40 million to lower insurance costs
  • Denver releases vision for more comprehensive mental health care

HAWAII

• • New ER to Open at North Hawai‘i Community Hospital
  • Doctor levels critically short
  • Why Hawaii Island doctors are looking for tax relief

NEVADA

• • Demand for nurses growing in Nevada
  • New CEO takes the reins at Saint Mary’s Health Network
  • Nevada health care workers join NHP troopers, state mental health employees in unionizing

UTAH

• • Utah County hospitals report decrease in opioid prescription use
  • OrthoGrid Systems Partners with the University of Utah Health, Elevating Patient Care
  • A former Utah nurse will go to prison for five years for stealing painkillers and infecting patients

The post Health Provider News – January 17, 2020 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

On January 8, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released an Informational Bulletin titled “Best Practices for Avoiding 340B Duplicate Discounts in Medicaid” (“Bulletin”). The Bulletin outlines best practices that CMS encourages state Medicaid agencies to consider to avoid the situation where a manufacturer provides both a Medicaid drug rebate and a discount under the 340B drug discount program (“340B Program”), commonly referred to as a “duplicate discount.”

The prohibition on duplicate discounts has always been part of the 340B Program. The increasing number of Medicaid managed care beneficiaries and the volume of prescriptions filled at 340B Program covered entity (“Covered Entity”) contract pharmacies, however, has made preventing duplicate discount billing progressively more difficult. Unfortunately, the size, scope and complexity of the 340B Program have prevented policymakers and the industry from finding a single workable solution to the duplicate discount problem.

The Bulletin is the latest effort by CMS and the Health Resources & Services Administration (“HRSA”) to provide potential solutions and best practices for states to consider to avoid duplicate discounts. While not all of the recommended best practices are new, and the Bulletin is not legally binding, it provides insight to 340B Program stakeholders regarding CMS’s 340B Program priorities and Covered Entities should assume that many state Medicaid agencies will eventually implement some or all of the recommendations.

In anticipation, Covered Entities should, at a minimum, review existing policies and operational procedures for preventing duplicate discounts and begin preparing for increased scrutiny by state Medicaid agencies, manufacturers, Medicaid managed care organizations and third-party auditors.

Background and the Bulletin

State Medicaid agencies are prohibited from billing manufacturers for Medicaid rebates for drugs dispensed to Medicaid patients that were already discounted under the 340B Program. In order to avoid claiming these duplicate discounts, state Medicaid agencies must be able to identify claims that include 340B drugs and exclude them from the utilization data submitted to drug manufacturers.

To help states determine whether a 340B drug was dispensed to a Medicaid beneficiary, HRSA established the Medicaid Exclusion File (“MEF”) for Medicaid fee-for-service (“FFS”). The MEF lists Covered Entities that elected to dispense 340B-purchased drugs to Medicaid patients, along with their National Provider Identification (“NPI”) numbers and Medicaid billing number. The use of the MEF to identify 340B drug claims, however, is imperfect and state Medicaid agencies are not required to use the MEF. In addition, the MEF is limited to Medicaid FFS.

State Medicaid agencies have attempted to use a variety of other mechanisms to avoid duplicate discounts. These include requiring certain modifiers on claims, using unique bank identification numbers (“BINs”) and processor control numbers (“PCNs”) and shifting Medicaid pharmacy benefits entirely to the Medicaid FFS system.

The Department of Health and Human Services Office of Inspector General (“OIG”) issued multiple reports[1] highlighting the various state Medicaid agency oversight activities and methods and the continued risk of duplicate discounts despite these efforts. A 2017 OIG report, for instance, found that the State of Wisconsin’s Department of Health Services (“DHS”) failed to properly invoice manufacturers for rebates of approximately $3 million in physician-administered drugs, resulting in improper reimbursement from federal funds over three years.[2] Specifically, the report stated that the Wisconsin DHS failed to invoice manufacturer rebates on single-source drugs and top-20 multiple-source drugs.

In response to these challenges and the OIG reports encouraging CMS to show state Medicaid agencies ways to avoid duplicate discounts, CMS developed the Bulletin outlining seven regulatory strategies for state Medicaid agencies to consider when developing their own policies. The strategies are not all new. Many of the strategies, such as the use of the MEF, represent approaches that state Medicaid agencies currently use. Below is the complete list of specific strategies recommended in the Bulletin:

1. State Medicaid agencies should consider referring to the MEF to organize information about the Medicaid Drug Rebate Program (“MDRP”) submissions to drug manufacturers and which Covered Entities billed for 340B drugs;
2. State Medicaid agencies should consider entering written, three-party agreements between the state Medicaid agency, a Covered Entity and its contract pharmacy to govern the retrospective identification of 340B Program claims. In such cases, the Covered Entity must submit a copy of the agreement to HRSA for inclusion in Covered Entity reports;
3. State Medicaid agencies should consider entering a state plan amendment (“SPA”) to limit Covered Entities’ and contract pharmacies’ abilities to use 340B Program-purchased drugs to treat Medicaid beneficiaries. SPAs may help resolve situations that can result in duplicate discounts by restricting the entities that may distribute 340B drugs or requiring the reporting of certain 340B drug distribution information;
4. State Medicaid agencies should consider using 340B Program claims identifiers such as submission clarification codes, state-specific modifiers or physician-administered drug billing modifiers to prospectively identify 340B Program claims;
5. State Medicaid agencies should consider implementing processes and procedures to exclude 340B Program claims submitted to Medicaid managed care organizations from state Medicaid agency’s MDRP rebate requests;
6. State Medicaid agencies should consider providing additional claims-level data to drug manufacturers that may facilitate rebate 340B Program claim identification; and
7. State Medicaid agencies should consider working with pharmacy benefit managers (“PBMs”) to require Medicaid managed care organizations to use specific BIN/PCN combinations unique to Medicaid products. This would help facilitate the identification and removal of such claims from state Medicaid agency’s MDRP rebate requests since states can more quickly determine whether a 340B drug was dispensed to a Medicaid beneficiary at a Covered Entity location.

Practical Takeaways

The Bulletin is not legally binding on the 340B Program or state Medicaid programs. Rather, it serves as guidance for state Medicaid agencies given their responsibility and role with respect to ensuring mechanisms that prevent duplicate discounts. It also demonstrates that CMS and manufacturers are more attuned to duplicate discounts in the Medicaid managed care space. As a result, 340B and Medicaid managed care contracting staff should be aware of the potential for increased scrutiny regarding Medicaid managed care plans and 340B Program duplicate discounts.

Adopting certain proposed strategies could significantly impact Covered Entities and contract pharmacies, as well as the corresponding 340B Program savings realized. Of particular concern to Covered Entities, for instance, is language in the Bulletin stating that state Medicaid agencies could “limit the ability of some or all of the covered entities and/or contract pharmacies in the state to use 340B-purchased drugs for Medicaid beneficiaries” via the SPA process.

Since the implications could extend to Medicaid managed care plans, Covered Entity and contract pharmacy advocacy team members should be aware of this focus and should look for opportunities to work with state Medicaid agencies in evaluating whether to adopt one or more of these proposed strategies.

If you have any questions or would like additional information about this topic, please contact:

• Todd Nova at 414-721-0464 or tnova@hallrender.com;
• Benjamin Fee at 720-282-2030 or bfee@hallrender.com;
• Kristen Chang at 414-721-0923 or kchang@hallrender.com; or
• Your regular Hall Render attorney.

The post Informational Bulletin from CMS Addresses Best Practices to Avoid 340B Duplicate Discounts appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

On January 10, 2020, the Federal Trade Commission (“FTC”) and Antitrust Division of the U.S. Department of Justice (“DOJ”) (collectively, the “Federal Antitrust Enforcers”) proposed their first new vertical merger guidelines (the “Draft Vertical Merger Guidelines”) in 36 years. The Draft Vertical Merger Guidelines, which will supersede and replace the 1984 DOJ “Non-Horizontal Merger Guidelines,” provide guidance to the business community and antitrust practitioners on the analytical processes underlying the FTC and DOJ’s enforcement decisions on vertical mergers. This updated guidance comes on the heels of the DOJ litigating and losing its first major vertical merger case in more than 40 years when it recently challenged AT&T’s merger with Time Warner.

A vertical merger combines firms or assets that operate at different stages of the same supply chain. In health care, a classic example of a vertical merger is the acquisition of a physician group by a hospital or health system. Similarly, vertical mergers can occur at different points in the supply chain, such as when a health system acquires a post-acute care provider or a health plan.

Historically, vertical mergers have been seen as procompetitive because they tend to create efficiencies in the supply chain and eliminate double marginalization. But as detailed in the Draft Vertical Merger Guidelines, the FTC and DOJ are concerned that vertical mergers may foreclose a more efficient rival post-transaction or may raise that rival’s costs. For example, if a health system acquires a large multi-specialty physician group, a more efficient rival health system may be foreclosed in the future from competing due to the loss of the physician group’s referrals.

Vertical Merger Guidelines

The Draft Vertical Merger Guidelines create a quasi-safe harbor for mergers when the parties have less than 20 percent market share for a relevant product (i.e., general acute care inpatient services) and less than 20 percent market share for a related product (i.e., physician services and the related referrals).

While the Draft Vertical Merger Guidelines are a welcome update from the 1984 guidelines and detail the current process the FTC and DOJ use to analyze vertical mergers, the Draft Vertical Merger Guidelines are squishy enough and give the FTC and DOJ enough flexibility to provide limited comfort to merging parties. Indeed, the more interesting aspect will be whether the FTC and DOJ become more active and aggressive in investigating and challenging vertical mergers. In the health care arena, the FTC and DOJ have let two large vertical mergers proceed in the last couple of years with limited concessions—CVS/Aetna and Cigna/Express Scripts. To this end, it is interesting to note that both of the FTC’s Democratic commissioners abstained from voting on the Draft Vertical Merger Guidelines. Instead, each issued statements saying that while they agreed that the old guidelines should be rewritten, these Draft Vertical Merger Guidelines were too “lax” and failed to adequately protect consumers from potential anticompetitive harm.

Comments on the draft guidelines can be submitted via email (verticalmergerguidelines@ftc.gov or verticalmergerguidelines@usdoj.gov) and must be received no later than February 11, 2020. Following the submission of written comments, the FTC and DOJ may make changes and finalize the new Vertical Merger Guidelines.

Practical Takeaways

• As lines blur in health care and more health systems look to vertically integrate through acquisitions, it is important to understand the competitive dynamics in all relevant markets and understand whether the acquisition will harm competition.
• Coupling this new guidance with the DOJ’s first litigation of a vertical merger case in 40 years, it is likely that we will see a renewed focus by the FTC and DOJ on investigating and challenging vertical mergers. This is especially true in the health care industry where more and more economic studies and academic papers conclude that both vertical and horizontal mergers are leading to increased health care costs.
• While historically antitrust enforcement has stayed above the political fray, given the partisan split among the FTC commissioners, it is possible that in the future we see a more politicized discussion surrounding the antitrust laws and perhaps even a policy shift towards a more aggressive overall enforcement environment.

If you have any questions or would like additional information, please contact:

• William Berlin at (202) 370-9582 or wberlin@hallrender.com;
• Michael Greer at (317) 977-1493 or mgreer@hallrender.com;
• John Bowen at (317) 429-3629 or jbowen@hallrender.com;
• Abby Kaericher at (202) 780-2989 or akaericher@hallrender.com; or
• Your regular Hall Render attorney.

For more information about Hall Render’s Antitrust services, click here.

The post FTC, DOJ Release Draft Vertical Merger Guidelines appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

NATIONAL

• DoJ Recovered $2.6B from Healthcare Fraud Cases in 2019
• 297%: The average difference between highest, lowest outpatient charges, study says
• SCOTUS declines expedited review of ACA case
• Uber Health plans to double in size this year
• Forbes names ‘Best Employers for Diversity’: 14 hospitals, health systems in top 100
• Surgeries are being postponed because of a surgical gown shortage
• Genomics in healthcare: How systems are using the data and whether there is a cause for concern

• Epic CEO Judy Faulkner asks hospitals to oppose HHS’ interoperability rule
• PhRMA spent record-high $29 million on lobbying in 2019
• Is volume the key to value-based care success?
• He drove a stranger home from the hospital. Now, his company’s partnered with Uber on medical transportation
• How Telepsychiatry Is Improving Access to Mental Health Care

NORTHEAST

(Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont)

CONNECTICUT

• • Pediatric Center of Stamford Joins Stamford Health Medical Group
  • OneOncology taps partnership in Connecticut
  • Gov. Ned Lamont signs executive orders seeking to rein in health care costs
  • Healthcare Costs Targeted by Two New Executive Orders
  • Pharmalittle: Connecticut lawmakers look to cap insulin prices; Glaxo halts Excedrin production

MAINE

• • Maine gives green light to Mayo joining Northern Light
  • Spectrum Healthcare notifies 11,300 patients of phishing attack
  • State grants approval for Mayo Regional, Northern Light integration
  • U of Southern Maine receives $2.5M to combat nursing shortage
  • Northern Maine Medical to add meds-to-beds program
  • New autism center in Portland will aid underserved population
  • CMHC officials pitch $35M Lewiston cancer center to the public
  • Mayo Regional, Northern Light merger receives DHHS approval

MASSACHUSETTS

• • Massachusetts seeks to regulate urgent care industry
  • Partners to integrate clinically, digitally with primary care platform
  • ‘This Will Stay With Her’: Family, Boston Children’s Hospital Offer Differing Accounts In Malpractice Lawsuit
  • Federal inspectors detail shortcomings at VA facilities in Northampton, Bedford
  • Union workers reach agreement with Steward hospitals
  • Federal inspectors flag deficiencies at VA medical center in Leeds
  • Massachusetts Nurses Association Against Proposed Closure of Leonard Morse Hospital ER, Surgical Units
  • MetroWest Medical Center to close nearly all services at Natick campus
  • Mass. Nurses Association: Dozens could lose jobs at Natick’s Leonard Morse Hospital
  • Boston Hospital Leader: U.S. Health Care Has A Bureaucracy Problem
  • Study: Critical care improvements may differ depending on hospital’s patient population
  • Boston’s Whittier Street Health Center Announces New Medical Director

NEW HAMPSHIRE

• • Cigna, HCA Healthcare strike contract renewal deal
  • Shibinette confirmed to lead New Hampshire Health Department

NEW YORK

• • Why NY hospitals have the worst quality, safety ratings in U.S.
  • Olean General Hospital Opens Comprehensive Vascular Center
  • Chief growth officer appointment among 3 NYC Health + Hospitals leadership changes
  • Northwell Announces Affiliation with The Center for Discovery
  • Mount Vernon Hospital Supporters Picket, Hold Vigil
  • Health Quest Says Patient Information May Have Been Disclosed
  • Oswego Health Appoints New Executive Director

RHODE ISLAND

• • ‘Unique’ statewide health plan unveiled in RI
  • Acute stroke response is again close at hand in Westerly area
  • New health initiative making the rounds in Rhode Island schools
  • Claims database enhances health care research

VERMONT

• • Copley Hospital’s ailing finances in recovery
  • Dartmouth-Hitchcock achieves strong standing in Centers for Medicare and Medicaid Services’ value payment program
  • A service dispute in Vermont, CON hurdles & more
  • Springfield Hospital board members deny lawsuit claims by former CEO
  • Marathon Health and OurHealth to merge
  • Hospital board members seek to dismiss former CEO’s lawsuit
  • Gifford Women’s Health Center slated to open in September
  • No Retreat? Brattleboro Mental Hospital’s Future Is Uncertain
  • Kniffin: UVM Health Network affiliation boosting Porter
  • Whistleblower won’t pursue case against OneCare Vermont
  • Vermont hospital reopens operating rooms after odor closure

MID-ATLANTIC/EAST                                                                 

(Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia, West Virginia)

DELAWARE

• • Beebe eyes Milton campus in expansion plan
  • Highmark announces $1.1 million in grants for fighting opioid crisis in Delaware
  • Delaware bill would attract new primary care doctors to the state
  • Healthcare booming in Delaware
  • ChristianaCare wins technology honor for 4th year in a row

DISTRICT OF COLUMBIA

• • More headaches for Universal Health on plan to replace DC hospital
  • 4 ways Children’s National Hospital is conquering innovation

MARYLAND

• • Patient advocate responds to Maryland Hospital Association CEO: We need more patient-centric care
  • McCready Hospital to join Peninsula Regional Health
  • Mercy’s longtime CEO to step down; downtown Baltimore hospital names new leader
  • First look: Suburban’s new hospital building readies for prime time

NEW JERSEY

• • Is this a hospital or a spa? NJ moms giving birth in luxury style
  • New Jersey passes laws to preserve ‘Obamacare’ amid court fight
  • CareOne, New Jersey’s largest family owned and operated senior living and post acute care operator, has appointed Dr. Amina Ahmed to Chief Medical Officer effective April 1, 2020
  • New Jersey Legislation to Expand Hospice and Palliative Care
  • New Jersey provider notifies patients of data breach
  • Regional hubs established to improve population health

PENNSYLVANIA

• • How a pending Jefferson deal could reshape Philadelphia’s health-care market
  • Ellwood hospital cited 40 times by PA health department under Americore
  • Six months in, prognosis for doctor’s East Liberty flat-fee practice shows promise
  • Jefferson Hospital patient claims security guard dragged him out of cafeteria
  • Ellwood City hospital had plan to reopen before bankruptcy; with no movement on plan, medical center license under review
  • WHS president adamant about remaining independent
  • Sneak peek: See inside Chester County Hospital’s $300M expansion
  • Pennsylvania health system to deploy Meditech HER
  • Pennsylvania hospital banned from reopening after racking up 40 citations
  • Locked Emergency Room, No Answers: Ellwood City Still Without Hospital
  • Allegheny Health Network, Johns Hopkins expand research collaboration
  • Sunbury hospital closing emergency room, several other departments by end of month
  • Pennsylvania hospitals cancel surgeries over surgical gown recall
  • Philadelphia hospital brings voter registration to the ER
  • NueHealth purchases part of Paoli Surgery Center
  • Final state inspection starts for AHN neighborhood hospital

VIRGINIA

• • Focused Ultrasound Foundation names chief relationship officer
  • Norfolk medical device firm receives additional $2.5M from DARPA
  • Advantia Health receives $45M investment

WEST VIRGINIA

• • WVU Medicine aims to meet rural health care needs
  • Wright: Joining WVU A ‘Win’ For Hospital
  • WMC enters collaboration agreement with WVU Medicine
  • Hearing in opioid cases set in Charleston
  • Epic EHR is ‘most important puzzle piece’ of West Virginia hospital’s merger with WVU Health
  • iTeam Investigates: What’s in store for the future of West Virginia health care?
  • iTeam Investigates: Why are W.Va. hospitals going bankrupt?

CENTRAL

(Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota)

IOWA

• • Iowa lawmakers consider measures to protect people with pre-existing conditions as ‘Obamacare’ faces legal challenges
  • Federal opioid shift could have Iowa health implications
  • Iowa’s Board of Medicine reviewing treatment at state-run facility for people with disabilities
  • Jacuzzis, security part of $10.75 million update to birthing unit at Jennie Edmundson

KANSAS

• • Taylor to retire as hospitals’ CEO
  • Judge OKs Horton hospital sale at auction
  • CEO of 2 Centura Health Kansas hospitals to retire
  • Compromise proposal made to lower healthcare costs for Kansas families
  • They paid health premiums for months, but say their JoCo employer kept the cash
  • Challenges and opportunities facing rural communities explored at Kansas Farmers Union convention

MINNESOTA

• • Genomics in healthcare: How systems are using the data and whether there is a cause for concern
  • Mayo Clinic compensation: 5 statistics
  • Allina Health hospital forms neonatal telemedicine partnership with Children’s Minnesota
  • Local NW MN leaders in healthcare, public health, EMS attend leadership course in Alabama
  • Health care groups pay tax on CEO pay

MISSOURI

• • SSM Health names new regional president
  • SSM Health names Charles J. Barnett regional president for academic ministries
  • Missouri hospital hit with class-action suit over failure to pay for employees’ insurance
  • Centene closes $17B acquisition of WellCare
  • Now-shuttered Boonville hospital didn’t pay for employees’ insurance, lawsuit alleges
  • $1 million CoxHealth grant to support opioid abuse recovery, education in rural areas
  • System Partner to Provide VR Therapy to Veterans
  • St. Louis donations wipe away $13 million in medical debt
  • Boonville community leaders want new health care options after hospital closing
  • Researchers slam hospital programs that deliver unnecessary imaging to the wealthy

NEBRASKA

• • Dr. Jill Poole named chief of new division at University of Nebraska Medical Center
  • Centene closes $17B acquisition of WellCare
  • Proposed bill would create statewide database for public health data
  • Family, physician urge Nebraska lawmakers to add rare genetic disease to newborn screening tests
  • Nebraska doctor lets patients pay for surgery by volunteering: “We want to be able to offer hope”

NORTH DAKOTA

• • Blue Cross Blue Shield of North Dakota outsources some medical claims processing to India
  • Blue Cross Blue Shield of North Dakota failed to send required mailing to 10K new customers
  • North Dakota Tribal Medical Facilities in Need of Big Updates

SOUTH DAKOTA

• • Genomics in healthcare: How systems are using the data and whether there is a cause for concern
  • South Dakota health system joins Mayo network, changes name
  • Effort begins to reduce risk of death of SD mothers during childbirth
  • Rebranding of Regional to Monument Health has begun
  • South Dakota Department of Health launches “comprehensive plan” for suicide prevention
  • South Dakota bill restricting medical treatment for transgender youth passes first major vote

MIDWEST

(Illinois, Indiana, Kentucky, Michigan, Ohio, Wisconsin)

ILLINOIS

• Major doctors’ group calls for US to assure coverage for all
• NorthShore says it now has largest U.S. clinical genomics program
• Ferrell Hospital CEO is president-elect of ICAHN board
• Rush University Medical Center opens LGBTQ health resource center
• Illinois healthcare company closes briefly to meet state law
• Regent Surgical Health Announces New Partnership with Lee Health and The Center for Specialized Surgery
• Kevin Lofton to retire as CEO of CommonSpirit Health
• Illinois hospital CEO to retire
• SSM President Jeremy Bradford elected to Illinois Health and Hospital Association board of trustees
• Advocate Medical Group to close 7 Chicago-area clinics
• Colorado healthtech company scoops up Chicago startup
• Cook County Board wants power to appoint Illinois public health system’s next CEO, determine salary package
• HSHS launches telemedicine ICU services at 2nd hospital
• 4 Chicago hospitals to unite, form single healthcare system

INDIANA      

• • NorthShore Health Centers of Indiana opening $18 million facility in Portage
  • Highpoint Health laid off or reduced the hours of 80 workers today
  • Telehealth Clinic Expands to More Rural Schools
  • Franciscan Beacon Hospital in La Porte to expand on clinic’s offerings
  • Greene County marks telehealth milestone
  • Marathon Health and OurHealth to merge
  • Indy Startup Partners with Komen Tissue Bank
  • Medical device startup targeting bed sores
  • Franciscan Health Michigan City celebrates first year in new hospital

KENTUCKY

• • Quarantined patient at Kentucky hospital was misdiagnosed, officials say
  • Mercy Health-Lourdes Joins UK Markey Cancer Center
  • TriStar Greenview Regional Hospital denied request for additional ambulance service
  • Our Lady of Bellefonte Hospital employees react to upcoming closure
  • Bill to assist UofL with Jewish Hospital acquisition clears House panel
  • Lawmakers advance U of L request for $35 million to help KentuckyOne deal
  • University of Louisville clears hurdle in quest for $35M state loan on hospital acquisition
  • Bon Secours to close Kentucky hospital, affecting 1,000 employees
  • Hospital in northeastern Ky. closing at end of September
  • Quarantined patient at Kentucky hospital was misdiagnosed, officials say
  • Mercy Health – Lourdes Hospital Announces Affiliation with UK Markey Cancer Center
  • TriStar Greenview Regional Hospital welcomes new Chief Nursing Officer
  • Humana hires away chief data officer from federal agency
  • Princeton’s hospital OK despite trend
  • Kentucky lawmakers call Bellefonte closure a ‘bombshell’
  • Kentucky hospital, Anthem reach agreement
  • Pending Kentucky hospital closure prompts outpouring of assistance for employees

MICHIGAN

• • MidMichigan Medical Center-West Branch announces new president
  • Perrigo investing nearly $14M in Holland facility
  • Detroit Medical Center won’t outsource security jobs
  • MDHHS Director discusses opioid epidemic in Michigan
  • Battle Creek’s Grace Health goes beyond the standard doctor’s visit with collaborations and teamwork

OHIO

• • Cardinal Health plans recall for contaminated surgical gowns
  • Nationwide Children’s Hospital creates for-profit gene therapy CMO
  • Mayfield doctor agrees to cooperate with feds in probe into neurological drug’s marketing
  • As rural hospitals struggle, Wayne HealthCare frames $60M expansion in Darke County
  • UTMC CEO: ‘This is not a hospital we’re shutting. This is a hospital we’re building’
  • Bon Secours Mercy Health invests in Lirio artificial intelligence platform
  • First northwest Ohio pediatric urgent care now open
  • OhioHealth O’Bleness Hospital raises minimum wage to $15 per hour
  • Nationwide Children’s asks Columbus school board for tax abatement on for-profit company
  • Cleveland Clinic names Dr. Hiroyuki Fujita chairman of Hillcrest Hospital’s board
  • Kettering Health Network makes several changes to C-suite
  • Bon Secours Mercy Health forecasts $10B in revenue this year

WISCONSIN

• • UW nurse unionization faces dire health care implications
  • Advocate Aurora Health looks to expand in eastern Wisconsin
  • Ascension micro-hospital project in Menomonee Falls to receive TIF assistance
  • Agnesian HealthCare in Fond du Lac to pay $10 million to settle whistleblower case
  • Marshfield Clinic recognized as 2020 Choice Employer

SOUTH/SOUTHEAST

(Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee)

ALABAMA

• • UAB Health System, Ascension St. Vincent’s develop strategic alliance for better health
  • Encompass Health building hospital in South Carolina
  • ’Something needs to change’: Family blasts Huntsville Hospital ER wait times

FLORIDA

• • Florida bill would lift limits on specialty hospitals
  • Top Moffitt Cancer Center doctors failed to disclose payments from China, report says
  • Kidz Medical Services of Coral Gables Appoints Wayne Brackin CEO
  • Orlando Health to buy land near Lakeland for medical campus, hotel, more
  • Florida drugmaker files for bankruptcy after recall
  • Halifax Health joins UF Health for Deltona hospital
  • New emergency care bringing help closer
  • Hospital authority to refute reasons for audit
  • Regional Medical Center Bayonet Point makes another C-suite addition
  • Tampa General Hospital names new chief financial officer
  • Report: More market power means bigger profits at Tampa-St. Pete hospitals
  • $80M surgical institute to revamp ORs, expand orthopedics at Florida hospital
  • Twin Cities Hospital breaks ground for new ER addition
  • Nicklaus Children’s to sell Miami Medical Center
  • West Marion Community Hospital names Gabe Bullaro CEO
  • Nemours Children’s Health System uses security cameras for remote patient care

GEORGIA

• • Water leak at Children’s Healthcare of Atlanta
  • Ga Ambulance Company Pays $65,000 to Settle Allegations
  • Aiken Hospital property deal falls through
  • Georgia Lawmakers Push For Transparency In Hospital Finances
  • New hospital facility plan revealed
  • Local non-profit opens new medical facility in East Atlanta
  • NGHS plans ‘neighborhood hospital’ for Lumpkin in 2021

MISSISSIPPI

• • Poll: Mississippi voters are worried about health costs. They want lawmakers to act
  • Moore wants to make positive impact

NORTH CAROLINA

• • Eastern North Carolina hospital to be sold to Texas firm
  • More care for kids: Inpatient pediatric care returns to UNC Rex Hospital this month
  • CarolinaEast opens doors on new SECU Comprehensive Cancer Center
  • Some Triangle hospitals at full capacity as flu season intensifies
  • A program Greensboro officials are considering could dramatically help the homeless
  • Hale, new CEO of Blue Ridge Regional Hospital, excited to serve hospital and community
  • Watchdog makes case against hospital sale
  • Novant secures city approval for $154 million South Charlotte hospital
  • ‘Bacteria-sniffing’ dog keeps cancer patients safe at Greenville hospital
  • North Carolina health system apologizes after billing patients for rape kits
  • North Carolina collects $176,000 in Medicaid fraud case against ResMed Corp.
  • Anchor Health Properties and WakeMed Health & Hospitals Partner to Expand Access through New Health Facilities
  • What will Fort Mill’s new hospital look like? The discussion has started.
  • CaroMont physician appointed to board of NC Institute of Medicine

SOUTH CAROLINA

• • SC’s largest hospital system lays off 327 more employees as it tries to cut costs
  • South Carolina health system launches virtual care services for ICU patients
  • S.C. midwives push for increased collaboration with health centers despite state regulation
  • McLeod Health announces leadership changes
  • Lawmakers release plan to reform healthcare in South Carolina
  • Encompass Health building hospital in South Carolina
  • MUSC plans to open SC’s only adult burn center in Charleston by early summer

TENNESSEE

• • Ballad Health reschedules some elective surgical procedures after nationwide recall
  • Tennessee hospital misses payroll
  • In Tennessee, 2% of providers write 25% of pediatric antibiotic prescriptions
  • Tennessee physician charged in $7M healthcare fraud conspiracy
  • Tennessee systems open joint 60-bed behavioral health hospital

SOUTH-CENTRAL/SOUTHWEST

(Arkansas, Arizona, Louisiana, New Mexico, Oklahoma, Texas)

ARKANSAS

• • UAMS Chancellor says 24/7 statewide digital healthcare is goal by Spring
  • Feeling sick? UAMS medical providers now just a click away
  • Rural health program obtains $750K opioid grant; includes SEA hospitals
  • MRMC among 14 south Arkansas hospitals to receive $750,000 in grant funds to combat opioid abuse
  • $750,000 grant will create regional response to opioid abuse
  • Arkansas University Launches 24-Hour DTC Telehealth Program
  • Blue & You Foundation Grants $68k to UA Little Rock to Create Continuing Education Program

ARIZONA

• • Mesa hospital invests $1M in robotic surgery unit
  • Arizona-based health care provider settles with Medicaid
  • Arizona agency names 44 others tied to alleged exam, billing fraud
  • Arizona health department defends decision to keep Hacienda Healthcare open
  • Hacienda HealthCare to keep its state license, Medicaid contract
  • Phoenix Children’s Hospital to deploy Medtronic neurosurgery robot

LOUISIANA

• • Louisiana Medicaid managed care contract awards thrown out
  • East Jefferson Hospital board takes no action on proposed LCMC deal but calls special meeting
  • Lafayette General joins ProMedica, OSF HealthCare to invest in analytics startup
  • As rumors of East Jefferson Hospital deal swirl, board set to meet Wednesday
  • ‘It’s a new day in New Orleans’: New Children’s Hospital mental health unit near completion
  • How clinical communications tech helped one hospital lower call volume by 70%

NEW MEXICO

• • New Data Book Covers New Mexico Social, Health Statistics
  • New Mexico minimum wage could affect Medicaid eligibility
  • Mental Health Advocates Gather in Santa Fe to Support Suicide Prevention

OKLAHOMA

• • Angi Mohr tapped as president of Oklahoma hospital
  • Kevin D. Gordon: Improving Oklahomans’ health through secure electronic platforms
  • NwOA meeting to feature Medicaid expansion
  • Arnold Joins Variety Care as Director of Women’s Health
  • Oklahoma legislators seek medical marijuana restrictions, transparency

TEXAS

• • San Antonio pharma rep gets 2-plus years in prison, must pay $1.7 million in national health fraud case
  • Ascension Texas Names Timothy Brierty Regional Hospital President
  • University Health System develops mobile wayfinding platform for patient navigation
  • Kindred Hospital shuttering 4 Houston locations
  • How Houston Methodist reduced opioid prescriptions by nearly 77%
  • UT Health East Texas ushers in new leadership
  • Steward Health Care to deploy Meditech EHR across 35 hospitals
  • Children’s Health planning major expansion in Plano
  • 3 Texas health systems settle lawsuit alleging they colluded to stifle nurse pay
  • Changes to Texas law clear path for hospital mergers across state
  • Texas Health Resources CFO finds focus as the finance chief role blurs
  • Texas Health Huguley Names New CEO
  • Eastern North Carolina hospital to be sold to Texas firm
  • UTPB partners with UT School of Public Health
  • CHRISTUS St. Michael Health System’s EP Lab Spotlighted Nationally for Excellence
  • Texas Health Remembers COO Dr. Jeffrey Canose

NORTHWEST

(Alaska, Idaho, Montana, Oregon, Washington, Wyoming)

ALASKA

• • Mat-Su Regional welcomes new behavioral health unit
  • State releases court-ordered plan to get waiting psychiatric patients out of jails, ERs

IDAHO

• • Minidoka Memorial offers robotic-arm assisted joint replacement procedures
  • St. Luke’s releases Community Health Needs Assessment for 2019
  • St. Luke’s Community Health Assessment Finds Two Main Health Concerns For Idaho
  • Progress on doctor shortage: Idaho’s moved up from 49th to 45th
  • Bingham Memorial residency program to shut down after losing accreditation
  • Ribbon cutting held for Idaho Falls Community Hospital

MONTANA

• • Bozeman Health, St. Peter’s Heath announce partnership with Seattle hospital
  • Western Montana Mental Health Center to Reopen in Libby
  • Director: Montana VA wait times down, expansion underway

OREGON

• • Health Share of Oregon announces local clinician and Medicaid executive as CEO
  • Morse is named specialty medical director for Providence Seaside Hospital
  • Kaiser Permanente invests in ‘deeply affordable’ housing for low-income seniors
  • Health Share hires new CEO from Kaiser Permanente to lead state’s largest CCO

WASHINGTON

• • Nurses, caregivers announce strike at Swedish hospital
  • Yakima County lawmakers look for ways to help in wake of hospital closure
  • King, Snohomish County nurses reverse course, announce intent to strike
  • Capital Medical Center taps Chris Sloan as COO
  • Washington lawmakers look to reduce Astria Regional Medical Center closure impact
  • Bozeman Health, St. Peter’s Heath announce partnership with Seattle hospital
  • Judge: No turning back Yakima hospital closure
  • PeaceHealth Southwest Medical Center caregivers earn health coach certification
  • Olympic Medical Center CEO Eric Lewis to retire

WYOMING

• • Cody’s Hospital Is Using Telehealth To Opioid Treatment Throughout The Bighorn Basin
  • Cheyenne Regional Medical Center receives chest pain certification
  • Feds Reject Wyoming Proposal To Reduce Air Ambulance Cost

WEST

(California, Colorado, Hawaii, Nevada, Utah)

CALIFORNIA

• • California physician gets 15 months in prison for $900M kickback scheme
  • Palomar Health CEO named to California Hospital Association Board
  • Ex-owner of Long Beach Pacific Hospital gets 15 months for healthcare fraud
  • Bay Area-based healthcare companies pledge millions to fight California’s homeless crisis
  • Water Line Break Forces Closure of Los Angeles Hospital
  • UC Health’s chief data scientist has some advice for startups thinking about stealth mode

COLORADO

• • Children’s Hospital Colorado Springs expands after only six months
  • Home health can be cost-effective solution for Colorado as population ages and preferences evolve
  • Hospital-linked dark money group launches pricey ad blitz in Colorado
  • Cook: How Vail Health is enhancing access to care
  • Douglas County takes top spot in Colorado health rankings
  • DaVita Celebrates 2019 Achievements
  • Colorado healthtech company scoops up Chicago startup
  • Delta hospital denies violating wage laws
  • Physicians, nurses in crosshairs of hospital lobbying efforts in Colorado
  • Estes Park Health announces new CEO

HAWAII

• • Hawaii Doctor Shortage Persists But More Training Programs Could Help
  • Hawaii hospital gets near $3M donation for facility upgrades
  • Report says Hawaii has critically low number of doctors

NEVADA

• • Nevada city drops ASC building acquisition to let health system buy it
  • Regents expected to OK funding plan for UNLV medical school building

UTAH

• • Utah HIE taps NextGate to enhance patient identification, interoperability
  • Intermountain Healthcare Launches Plan to Build Nation’s Model Health System for Children, Inspires $50 Million Gift from Gail Miller and Family
  • Second Primary Children’s Hospital to be built in Lehi
  • St. Mark’s Hospital placed on lockdown
  • University of Utah Health using OrthoGrid tech to improve surgery outcomes

The post Health Provider News – January 24, 2020 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

The USDA Hemp Producer License Rule and Framework

On October 31, 2019, the United States Department of Agriculture (“USDA”) published an interim final rule[1] with request for comments in the Federal Register regarding hemp production (“USDA Hemp Rule” or the “Interim Final Rule”).[2] The USDA Hemp Rule establishes a federal hemp producer license and related requirements for state regulation of hemp production pursuant to the Agriculture Improvement Act of 2018 (“2018 Farm Bill”). Hemp is defined as the plant species Cannabis sativa L.[3] containing less than 0.3% delta-tetrahydrocannabinol (“THC”) within a distribution, also known as the “acceptable hemp THC level.”[4] The USDA Hemp Rule establishes requirements that hemp producers must meet in order to obtain the USDA Hemp Producer License:

1. Licensing requirements;
2. Filing and maintaining information regarding the land on which hemp is produced;
3. Procedures for testing the THC concentration levels for hemp;
4. Procedures for disposing of non-compliant plants;
5. Compliance provisions; and
6. Procedures for handling violations.

Under the Interim Final Rule, but currently effective, regulatory framework, a Licensed Producer will be found to have negligently violated the licensure rules if it fails to:

1. Provide a legal description of the land (along with geospatial location) where hemp is cultivated and grown;
2. Obtain a license; or
3. Produce plants within the acceptable level THC content.[5]

That said, the Interim Final Rule does provide some degree of latitude with respect to those Licensed Producers who, despite exercising reasonable efforts to produce hemp plants that are consistently within specification (<0.3% THC content), may experience limited THC concentration variation above 0.3%. Specifically, if after following proper quality control testing a hemp sample exceeds 0.3%, but less than 0.5% THC, the Interim Final Rule contemplates that this would not necessarily violate the terms of the producer’s license.[6]

Unsurprisingly given the specific procedures required under the USDA Hemp Rule, Licensed Producers are also subject to reporting and record-keeping requirements.[7]

In addition, the Interim Final Rule establishes a process for USDA approval of state and tribal plans to license hemp producers. Notably, the USDA will deny a hemp producer’s application for federal licensure if the state has a plan pending approval or an approved plan.[8] If a state does not have a USDA-approved state plan, then the standards of the USDA Hemp Producer License will apply.[9] It is worthy of mention that the USDA Hemp Producer License does not preempt any state laws that are more stringent than the provisions of the USDA Hemp Rule.[10]

Although hemp is declassified as a controlled substance, which removes its cultivation and growth from Drug Enforcement Agency (“DEA”) oversight, the quality control laboratories that test hemp samples for THC concentration must be DEA-registered.[11] Moreover, the USDA is considering other, potentially different, mechanisms for requiring accreditation and quality standards and has requested comments on how to proceed.[12]

The Doors Open – Opportunities Budding from Hemp Producer License

The USDA Hemp Rule appears to simplify and strengthen the supply chain for obtaining hemp and hemp-derived products. Previously, hemp producers had to be DEA registered to supply hemp for research purposes and there was only one DEA registered producer in the country.[13] Following the 2018 Farm Bill and the USDA Hemp Rule, the DEA no longer controls the cultivation of hemp, leaving the industry seemingly poised to incrementally expand production and sales of domestic hemp and hemp-derived products, ostensibly in answer to the past five years of renewed consumer demand.

The Food and Drug Administration (“FDA”) has signaled that the declassification of hemp in the 2018 Farm Bill “may streamline the process for researchers to study cannabis and its dozens of derivatives, including cannabidiol (“CBD”), that fall under the definition of hemp, which could speed the development of new drugs.”[14] The FDA is beginning to recognize “the significant public interest in CBD” and the need to “work together with stakeholders and industry to fill in the knowledge gaps about the science, safety, and quality of many of these products.”[15] In fact, the FDA has indicated that it is actively working to learn about the effect of cumulative exposure to CBD, the effects of CBD on special populations and the safety of CBD for use on pets and animals.[16]

States have indicated significant interest in hemp production as well. Since the USDA Hemp Rule was published, 32 states have either submitted a State Plan to the USDA or expressed an interest in submitting a State Plan.[17] As of January 7, 2020, Ohio, New Jersey, Louisiana and three tribal governments have received approval from the USDA for their plans.[18] Additionally, 47 states have legislation permitting hemp production although states vary as to whether hemp production is limited to research purposes or permitted for commercial and industrial uses as well.[19]

The interest of the FDA and state governments is potentially promising news for companies and entities interested in research and drug development for hemp-derived products.

Slow Your Grow – Activity Since the USDA Hemp Rule Took Effect Indicates Significant Risks

But don’t get too excited. The FDA and FTC have been clear that insufficient evidence exists to support CBD products. Since the enactment of the USDA Hemp Rule, shipment of lawfully produced hemp has led to several cases involving criminal charges and seizure of the product by law enforcement,[20] indicating that local law enforcement is insufficiently trained to distinguish illegal marijuana from lawfully produced hemp. Additionally, state approaches to hemp production are widely varied.

Companies with existing hemp-derived and CBD products should be cautious: as we previously discussed here, the FDA and the Federal Trade Commission (“FTC”) have issued Warning Letters to CBD companies that have made outrageous and scientifically unsupported health claims about CBD products.[21] Following a recent flurry of Warning Letters issued in November 2019, the FDA has reiterated that only one CBD drug product – designed to treat two rare forms of epilepsy – has been approved and that, under the federal Food, Drug & Cosmetic Act, it is currently illegal to market CBD as a dietary supplement or regulated food.[22] Although the FDA has indicated support for research and drug development, companies should consult with legal counsel regarding proposed advertising and marketing claims about their cannabinoid-derived products.

The 2018 Farm Bill is clear that a state may not prohibit the transshipment of hemp or hemp products lawfully produced under the USDA Hemp Producer License or under a State Plan.[23] However, this legal protection is easier to rely on in theory than in practice. There is no roadside test to measure THC levels and evaluate the product.[24] Many jurisdictions, especially those where hemp production is illegal, permit law enforcement officers to rely on the unique scent of cannabis flower to establish probable cause for stopping, detaining, arresting an individual or seizing the cannabis flower being transported. However, law enforcement officers cannot tell the difference between hemp and marijuana plants based on differences in smell alone and are often not trained to assess if a plant is lawfully produced hemp by evaluating the producer’s license and laboratory testing of the plant’s THC content. Although some jurisdictions, like Miami-Dade county are implementing an “odor-plus” probable cause determination, most officers are unlikely to be trained in the nuances applicable to this quickly evolving area of law. This means that shipment of hemp can subject the producer to a significant risk that their lawfully produced hemp might be seized and their driver might be charged with drug trafficking charges.

Additionally, producers and businesses should not conflate the ability to grow hemp under a USDA Hemp Producer License or an approved State Plan with the ability to process, create or sell hemp-derived products in any state. For example, many states permit hemp production for research purposes, but not for commercial purposes.[25] States that do permit hemp production for commercial purposes, like Florida, have separate rules requiring permits to process, prepare and sell food containing hemp or CBD.[26] And hemp production is still prohibited in South Dakota, Mississippi and Idaho.[27]

Practical Takeaways

So, after weighing the benefits and the risks, where does this leave businesses and individuals interested in hemp production?

To benefit from this new regulatory construct, the parties involved should first identify whether their intended hemp producer is governed by a USDA approved state plan or the federal USDA Hemp Producer License by tracking approved, submitted and pending state plans here. Additionally, even though producers are relieved from DEA registration requirements, laboratories that test THC content of hemp samples must still be DEA registered and comply with forthcoming accreditation standards. The USDA has published a list of DEA registered hemp analytical testing laboratories here.

The parties should then determine the purpose for which they are interested in hemp production and ensure that their purpose aligns with the state laws applicable to hemp production, and the processing and sale of hemp-derived products. As noted previously, the FDA and FTC have indicated that a narrow path is open to research hemp-derived CBD, but CBD infused products are not otherwise FDA approved.

If the parties are interested in shipping hemp or hemp-derived products across state lines, the parties should do the following to ensure that they are protected by the 2018 Farm Bill: (1) ensure that their product is solely produced under the USDA Hemp Producer license or an approved State Plan; and (2) ensure that the product is tested by an approved, DEA registered laboratory. However, any shipping route will inevitably cross multiple law enforcement jurisdictions, each of which may have unique probable cause requirements and varying levels of officer education and training. As it relates to interstate transshipment of hemp, parties should be aware that even if they meet the requirements to gain protection from the 2018 Farm Bill, there is no guarantee that their drivers and products will not be subject to law enforcement scrutiny and the costs associated with that.

In short, anyone interested in hemp production should consult with legal counsel on the compliance and enforcement risks before engaging in the production, shipment or sale of hemp in any state. Even with the advice of sophisticated counsel, this area of law is still evolving, complicated and uncertain.

Hall Render regularly monitors regulatory and enforcement developments relating to USDA, FDA and FTC regulated products, including hemp and hemp-derivatives. If you have any questions about this guidance please contact:

• Melissa Markey at (248) 310-4876 or mmarkey@hallrender.com;
• Andrew Harrison at (414) 721-0467 or aharrison@hallrender.com;
• Kathryn Costanza at (303) 801-3534 or kcostanza@hallrender.com; or
• Your regular Hall Render attorney.

The post USDA Hemp Producer License – Do the Opportunities Outweigh the Risks? appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

Coming This Week: CMS to Release Medicaid Block Grant Plan

Expected on Thursday, CMS will announce a plan to overhaul Medicaid by letting states shift certain program funding to block grants. CMS Administrator Seema Verma has been very passionate about implementing a block grant option, as she said this was the pathway to give states more flexibility. This controversial plan would target who joined the program under the Affordable Care Act’s coverage expansion by encouraging states to apply for Section 1115 waivers to allow them to cap their spending on those patients. Provider groups and states are very likely to challenge the rule in court. Stakeholders are estimating the proposed rule could reduce Medicaid funding by up to almost $50 billion a year.

MedPAC Approves Pay Recommendations for 2021

The Medicare Payment Advisory Commission (“MedPAC”) voted unanimously last week to recommend that Congress update the hospital base rate pay by 2 percent for 2021. Additionally, MedPAC recommended that Congress “provide hospitals with an amount equal to the difference between the update recommendation and the amount specified in current law through the Commission’s recommended hospital value incentive program.” MedPAC Commissioners also recommended tying some of the pay raise to quality improvements.

The MedPAC meeting also discussed a staff analysis of the relationship between the 340B drug savings program and oncology drug costs, as requested by the House Energy and Commerce Committee in 2018. The study concluded that the 340B Drug Pricing Program doesn’t create strong incentives for participating hospitals to use more expensive drugs.

MedPAC is an independent Congressional agency created to provide Congress with analysis and policy advice on the Medicare program. While MedPAC recommendations are non-binding, their annual reports are closely reviewed by Congressional committees.

FTC to “Crack Down” on Anti-Competitive Hospital Behavior

Federal Trade Commission (“FTC”) Commissioner Christine Wilson said the agency is focusing on ending anti-competitive behavior in hospitals and hospital systems. While speaking at a health care event, Commissioner Wilson stated the FTC will be increasing oversight of Certificates of Public Advantage (“COPAs”) and urged stakeholders to comment on the newest vertical merger guidelines. Notably, Wilson stated the Commission is “intent on challenging every hospital merger and we have a number in the pipeline.” The FTC will also explore expanding the scope of practice of certain providers, such as nurse practitioners.

Health-Related Bills Introduced This Week

Rep. Gus Bilirakis (R-FL) introduced H.R. 5672 for the Commission on Sustaining Medicare and Social Security Act of 2020.

Sen. Bill Cassidy (R-LA) introduced S. 3224, the VA Research Approval Efficiency Act of 2020.

Rep. Jim Costa (D-CA) introduced H.R. 5654, the Expanding Medical Education Act of 2020.

Rep. Brett Guthrie (R-KY) introduced H.R. 5663 to amend the Federal Food, Drug, and Cosmetic Act to give authority to the Secretary of Health and Human Services, acting through the Commissioner of Food and Drugs, to destroy counterfeit devices.

Sen. Roy Blunt (R-MO) introduced S. 3216 to amend Title XXVII of the Public Health Service Act to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from imposing cost-sharing requirements or treatment limitations with respect to diagnostic examinations for breast cancer that are less favorable than such requirements with respect to screening examinations for breast cancer.

The Week Ahead

• The House Energy and Commerce Health Subcommittee holds a hearing Wednesday on improving safety and transparency in U.S. food and drugs.
• On Tuesday, the House Ways and Means Committee holds a hearing to discuss legislative proposals for paid family and medical leave.
• The House Education and Labor Committee holds a hearing Tuesday on maternal and infant health in the U.S.
• HHS’s Office of the National Coordinator for Health Information Technology is hosting its two-day annual meeting this week. Topics to be discussed include the potential for a patient identification system, patients’ right to access their records, burdens surrounding electronic health records and seamless data sharing.
• Next week, the House is likely to vote on a sweeping labor bill to amend federal workplace laws to bolster a wide range of legal protections on the job.

For more information, please contact:

• John Williams III at (202) 370-9585 or jwilliams@hallrender.com;
• Andrew Coats at (202) 370-9587 or acoats@hallrender.com;
• Abby Kaericher at (202) 780-2989 or akaericher@hallrender.com; or
• Your regular Hall Render attorney.

For more information on Hall Render’s Federal Legislative & Regulatory Advocacy services, click here.

The post Hall Render’s The Week in Washington – January 27, 2020 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

On January 21, 2020, the Supreme Court denied a motion to expedite consideration of a petition for certiorari in a case directly challenging the constitutionality of the Affordable Care Act (“ACA”).[1] Given the Supreme Court’s decision, it is likely that the fate of Obamacare will not be decided until sometime after the 2020 presidential election.

In Texas v. United States[2], multiple plaintiffs challenged the ACA in the District Court for the Northern District of Texas. On December 14, 2018, Judge O’Connor ruled that the individual mandate requiring individuals to purchase health insurance under the ACA was unconstitutional because the penalty for non-compliance was reduced to zero dollars. A zero dollar penalty could not be considered a “tax” pursuant to Congress’s taxing power. Judge O’Connor deemed the individual mandate to be a vital centerpiece of the landmark legislation and declared the entire ACA invalid because the remaining portions of the legislation could not be severed from the individual mandate.

The Department of Justice, certain Democratic states, and the House of Representatives appealed Judge O’Connor’s ruling to the Fifth Circuit.[3] In an opinion issued on December 18, 2019, the Fifth Circuit affirmed that the individual mandate was unconstitutional but declined to strike the down entire ACA. The Fifth Circuit remanded the case back to the District Court for further consideration as to whether any of the provisions of the ACA could be severed from the individual mandate and preserved.

To avoid putting the fate of the ACA back in the hands of Judge O’Connor, the Democratic states and House of Representatives filed a petition for certiorari with the United States Supreme Court and requested expedited review. Without comment, the Supreme Court announced that the request for expedited review was denied. Presumably, the Court will consider the request for cert at a later date. Click here for a detailed discussion of Texas v. United States.

Analysis

The Supreme Court’s denial of expedited review could be viewed as a political win for the Trump administration in a presidential election year.[4] A Supreme Court decision striking down, or significantly eviscerating the ACA, could cause a vitriolic backlash from the millions of individuals who would lose insurance coverage and/or providers whose uninsured populations would undoubtedly rise. It is unlikely that Judge O’Connor will issue a new ruling before November 2020.

While a Supreme Court decision may not play a role in the presidential election, the ACA is likely to remain an important issue during election season. On January 21, 2020, Senator Joe Biden tweeted his reaction to the Supreme Court’s announcement: “Coverage for millions of Americans and protections for pre-existing conditions are on the ballot. We have to protect the progress we’ve made and show up to the polls to defend the Affordable Care Act.”[5] Senator Biden’s response suggests that the ACA is a big issue for voters that will be addressed at the polls.

Although the outcome of this case remains uncertain, many commentators believe the Supreme Court would likely uphold the ACA based on its current composition.[6] If the case drags on and President Trump is reelected, some worry that another conservative Supreme Court Justice would place the ACA in greater jeopardy.[7]

Stay tuned for further updates.

If you have any questions or would like any additional information about this topic, please contact:

• Adele Merenstein at amerenstein@hallrender.com or (317) 752-4427;
• Dwayne Barrs at dbarrs@hallrender.com or (214) 615-2008; or
• Your regular Hall Render attorney.

The post Fate of Obamacare Remains Uncertain During Election Season appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

NATIONAL

• Pete Stark, congressman who reshaped health care, dies at 88
• Hospital group fights drug shortages by making needed meds
• Epic CEO Judy Faulkner asks hospitals to oppose HHS’ interoperability rule
• 4 health systems that dropped the dual-CEO model
• Health Catalyst becomes 1st healthcare member of Partnership on AI
• Joint replacement bundled payments losing their appeal in BPCI Advanced
• CMS to combine, standardize compare tools
• 4th patient charity settles Medicare kickback allegations
• HHS Secretary Azar blasts Epic’s ‘scare tactics’ in opposition to data-sharing rules
• The 34 best hospitals and health systems for diversity, according to Forbes
• Meet the top billionaires of the healthcare industry
• PhRMA spent a record $29M on lobbying in 2019
• Trump Administration Clears Way For Medicaid Block Grants
• The 407 hospitals with 5 stars from CMS
• 228 hospitals with a 1 star rating from CMS
• An ‘Epic’ pushback as U.S. prepares for new era of empowering patient health data

NORTHEAST

(Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont)

CONNECTICUT

• • Waterbury therapy business settles False Claims Act allegations
  • PhysicianOne Urgent Care Completes Acquisition of New England Urgent Care Locations in Bristol, Enfield, Manchester and West Hartford
  • PhysicianOne gobbles up Greater Hartford urgent care provider
  • Connecticut center to get a boost from new health care facility
  • Medicare expansion is Plan B for Connecticut’s health insurers
  • Hospital, U.S. attorney reach settlement over deaf patient’s complaint

MAINE

• • MaineHealth joins Northeastern U to launch AI, data institute
  • Maine CDC, hospitals preparing their response to coronavirus
  • Express medicine sites take off in Maine, fueling business for developers, builders
  • Maine lawmakers push to clear wait lists for people with intellectual disabilities
  • Maine doctors worst in the US, patient study says
  • Study to look at future of long-term care facilities in Knox County

MASSACHUSETTS

• • One year after merger, Beth Israel Lahey gets good marks from monitor
  • MaineHealth joins Northeastern U to launch AI, data institute
  • Healthcare CFO claims he was fired after questioning ambulance billing
  • UMass Memorial Health Care plans to acquire Harrington Hospital
  • Boston screens plane, preps hospitals amid national coronavirus outbreak
  • Tufts Health Plan expands telehealth amid Harvard Pilgrim merger
  • How Massachusetts became a national leader on healthcare – and how it can lead again
  • AHA News: These Doctors Want to Write ‘Farmacy’ Prescriptions
  • Governor begins push to overhaul health care in Massachusetts

NEW HAMPSHIRE

• • New Hampshire seeks input on youth psychiatric facility
  • Gov. Sununu Says Progress Being Made in State’s ER Boarding Crisis
  • Memorial Hospital responds to coronavirus outbreak

NEW YORK

• • Cutting-edge medical research is thriving in Western New York
  • Staten Island hospitals on high alert for deadly coronavirus
  • Local hospital leader is retiring
  • ER Anywhere Pilot Produces Impressive Results: 97% ER avoidance, 99% patient satisfaction
  • HSS opens 1st Florida hospital, 2nd new facility in 1 week
  • The highlights of CEO Jody Lomeo’s tenure at Kaleida Health
  • MVHS names senior vice president/chief operating officer
  • Cuomo proposes 3 percent tax on new medical facilities
  • Massena nurses want contract with St. Lawrence Health Systems settled
  • Northwell develops app to track pediatric patients’ growth
  • Carroll Hospital names seventh president, Garrett Hoover, from Corning Hospital in New York
  • New York Braces for Coronavirus: ‘It’s Inevitable’
  • NY Health System Promotes Interoperability with SMART on FHIR App

RHODE ISLAND

• • State Rep introduces legislation to establish drug affordability board
  • Rhode Island establishes state task force on coronavirus
  • St. Anthony Community Hospital Introduces 3D Mammography

VERMONT

• • Vermont governor proposes mental health mobile response unit
  • Practice Fusion to pay $145M settlement for taking kickbacks aimed at increasing opioid prescriptions
  • Electronic health records vendor to pay largest criminal fine in Vermont in opioid case
  • Vermont Hospital Reopens Operating Rooms After Odor Closure
  • Vermont offers opt-out protocol for statewide HIE
  • Health records firm agrees to $145M fine, the largest ever in Vermont
  • The Doctor Will See You Now
  • Charting separate paths proves difficult for Brattleboro Retreat and state
  • Students Turn Local Lens on Public Health Issues

MID-ATLANTIC/EAST                                                                 

(Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia, West Virginia)

DELAWARE

• • ChristianaCare planning several new urgent care centers in Delaware
  • Christiana Care rebrands home health service
  • New York-based biopharm co. to move to Del.

DISTRICT OF COLUMBIA

• • Washington D.C. braces for potential coronavirus cases
  • Cabinet Health has been selected for the Techstars Anywhere accelerator program

MARYLAND

• • GRMC continues to achieve excellent quality scores
  • ‘We’re Very Excited’ | Expansion Project At Howard County General Hospital Finishing Up, Grand Opening Next Week
  • LifeBridge taps new presidents at Carroll, Northwest hospitals
  • Carroll Hospital names seventh president, Garrett Hoover, from Corning Hospital in New York
  • Addy is new vice president at UM Shore Regional Health
  • Johns Hopkins’ university and hospital strive to hire, buy from locals in Baltimore to help reduce inequality
  • Rockville biotech opens new HQ as it goes on hiring spree
  • Get a look inside this Columbia hospital’s new $48M addition
  • First look: Suburban’s new hospital building readies for prime time

NEW JERSEY

• • Geisinger sues to prevent New Jersey health system from breaking away
  • Jersey Shore’s AtlantiCare wants to end relationship with Geisinger Health
  • New Jersey health system owners allegedly embezzled millions as hospitals’ debt swelled
  • CEO of South Jersey health system to retire
  • Mountainside Medical Center (HMMMC) CEO Retiring

PENNSYLVANIA

• • UPMC issues 154 layoff notices
  • $300M Chester County Hospital expansion incorporates latest in technology
  • Signor is appointed to lead Journey Health System
  • Geisinger sues to prevent New Jersey health system from breaking away
  • Jersey Shore’s AtlantiCare wants to end relationship with Geisinger Health
  • Tryko Partners Acquires 240-Bed Skilled Nursing Facility in Philadelphia
  • Lehigh Valley Health Network and local ambulance service partner on telemedicine stroke unit
  • Pennsylvania hospital receives takeover bids after closing money-losing units
  • UPMC closing hospital in northeastern Pennsylvania
  • False Claims and Ghost Employees: $87M Home Health Conspiracy Continues to Unravel
  • Penn Medicine signs multimillion-dollar deal for naming rights to SEPTA train station
  • Officials unsure, optimistic for future of Ellwood City hospital
  • Sources: $65M deal reached for St. Christopher’s Hospital buildings
  • Lehigh Valley Health CEO says Steward hospital is at ‘end of the road,’ but stays mum on deal

VIRGINIA

• • Patient Services Inc. to pay $3M for alleged role as illegal conduit for drug makers
  • New Women’s Center CEO seeks to expand services, impact
  • Hospitals, universities in Southwest Virginia preparing for coronavirus
  • Henrico Doctors’ Hospital names new chief medical officer
  • Virginia hospital teams selected for violence intervention initiative
  • Virginia lawmakers reject setting standards for nursing home staffing — for now
  • Fauquier Hospital earned $20-million profit in ’18
  • Virginia hospitals provided $3.34 billion in community support, report shows
  • Carilion Clinic generated more than $3.2B in 2018, study shows

WEST VIRGINIA

• • WVU Medicine aims to meet rural health care needs
  • WVU Medicine East CEO to retire
  • West Virginia considers allowing private hospitals to directly employ police officers
  • Jefferson Medical Center introduces new robot to help with knee replacements

CENTRAL

(Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota)

IOWA

• • Nurses have tentative contract deal with Sioux City hospital
  • Encompass Health and University of Iowa Health System announce joint venture for rehabilitation hospital
  • UIHC implements protocols for new Coronavirus but risk to Iowans remains low, says IDPH
  • 40-bed rehabilitation hospital to open in Coralville in 2020
  • Residency program to address doctor shortage in Cedar Rapids ending this summer

KANSAS

• • Kansas hospital buys ASC, orthopedic practice
  • Kansas hospitals, corporate HQs may get tourism incentives under STAR bonds proposal
  • KS colleges, hospitals address concerns about coronavirus

MINNESOTA

• • St. Luke’s earns new accreditation
  • MN Health Dept. designates Sanford Bemidji as trauma center
  • Essentia cuts long-term opioid prescriptions in half, in just 5 years
  • Sanford Health, Beltrami County partner on mental health clinic
  • Ryan, North Memorial Health envision 100-acre health village in Maple Grove
  • Minnesota health care companies raise $1 billion-plus in private funding in 2019
  • Search warrant: Man cut oxygen to Minneapolis-area hospital
  • Children’s Hospital Association pledges record-breaking support to Children’s Minnesota
  • ‘What Is Going On Here?’: M Health Fairview Cuts At St. Paul Hospitals Alarming Staff, Community

MISSOURI

• • SSM Health in St. Louis taking proactive steps against coronavirus
  • How a housekeeper became chief nursing officer at St. Mary’s in Missouri
  • SSM Health Foundation Reveals the Future of Medicine
  • UnitedHealth says St. Francis 2.5 times pricier than St. Louis market; hospital cites 25% price drop
  • Saint Francis: UnitedHealthcare terminated contract, in-network status in jeopardy
  • UnitedHealthcare defends contract negotiations
  • Shuttered Missouri hospital struggles to fill patients’ medical record requests
  • Another local hospital picks Children’s Mercy for NICU staffing
  • Missouri reaches settlement with health records company
  • Missouri patient tests negative for deadly coronavirus; Local healthcare facilities are on alert
  • Missouri health care system to begin screening for coronavirus

NEBRASKA

• • Nebraska surgeon starts program exchanging volunteer hours to pay off medical bills
  • Nebraska Innovation Campus home to one of a kind stomach wellness facility
  • Lincoln biotech company gets $20 million venture capital investment
  • UNMC and Nebraska Medicine join forces to fight infectious diseases

NORTH DAKOTA

• • Sanford joins partnership that makes generic drugs more affordable, prevents shortages
  • Accident atop helipad grounds Trinity Hospital helicopter
  • Trinity Health’s plan after helicopter is damaged
  • New grant expands coverage for mental health in North Dakota
  • University of North Dakota to Start Online Doctoral Program in Indigenous Health

SOUTH DAKOTA

• • Effort begins to reduce risk of death of S.D. mothers during childbirth
  • IHS failed to protect patients from physician’s abuse, lawsuit claims
  • Expanding palliative care on South Dakota reservations
  • Dept. of Health launches plan for suicide prevention
  • Man at health clinic claims he had gun

MIDWEST

(Illinois, Indiana, Kentucky, Michigan, Ohio, Wisconsin)

ILLINOIS

• History of harm: Aperion fined $367K in 2019 just in Illinois
• 4 Chicago hospitals announce tentative $1.1B merger plan
• Chicago Coronavirus Patient Receiving Treatment at Hoffman Estates Hospital
• GE Healthcare transferring up to 250 jobs from metro Milwaukee to Chicago
• OSF Children’s Hospital of Illinois opens 24-hour emergency room designed for children
• Illinois hospital adds meal, nutrition software to Epic EHR to ensure patient safety
• CommonSpirit selects Premier as sole GPO
• Lurie Children’s new CEO Dr. Thomas Shanley: We’re starting to see the consequences of ignoring pediatrics
• 3 San Antonio hospital systems settle nurses’ wage lawsuit
• Mass hires of orthopedic surgeons at 3 hospitals, health systems
• Illinois health system to add 14th hospital

INDIANA      

• • Despite promises from state leaders, Indiana families still battling home nursing shortage
  • Franciscan Health Michigan City marks first year of new $243 million hospital
  • Beacon Health Partners With Michigan Rehab Hospital
  • Mary Free Bed welcomes 2 Indiana hospitals to its rehab network
  • Methodist Hospitals developing tactical plan following survey
  • IU School of Medicine’s new global health leader draws from extensive experience in Kenya
  • Reid Health to Create State-Recognized Police Force
  • IU Med School Celebrates Another Record Year
  • IU Health Paoli to Break Ground on Facility

KENTUCKY

• • New medical director for community clinic wants to remain engaged
  • Louisville health officials start preparing for coronavirus
  • Kindred Healthcare names new COO
  • U of L Health looking to hire hundreds of nurses, doctors after KentuckyOne takeover
  • Rural Kentucky prepares for changes ahead of hospital closing
  • Catholic hospital near Ashland to close, costing 1,000 jobs
  • ER physician to head Kentucky’s Dept. of Public Health
  • Should the state loan U of L millions of taxpayer dollars to purchase fiscally failing Jewish Hospital?
  • Pending Kentucky hospital closure prompts outpouring of assistance for employees
  • Kentucky-based health company will close hospitals in Fort Worth and Dallas
  • U of L Health CEO Says Faster Billing, Savings Contributed To Lower Request For State Funding
  • Flaget Memorial Hospital named a ‘Best Place to Work’ for third year running
  • LTC’s $33M Acquisition Play; KeyBank’s $21M Purchase Loan for Kentucky SNF
  • Taylor Regional Hospital Joins Markey Affiliate Network
  • Kentucky doctors could be arrested for transgender youth treatments under a proposed bill
  • Humana hired two federal executives — here’s what they will do
  • Kentucky Health Collaborative hospitals join forces to decrease lung cancer mortality rates in Kentucky

MICHIGAN

• Michigan health system: Ex-worker stole, shared patient data
• Bronson Medical Group offers 130 jobs, six months after layoffs
• Michigan’s Medicaid expansion doubles access to primary care
• St. Joseph Mercy Ann Arbor president to become Bronson Healthcare CEO
• Mary Free Bed welcomes 2 Indiana hospitals to its rehab network
• Remote pharmacy bill signed into law
• Beaumont Health fires employee for leaking 1.2K patient records
• Michigan nurses are fighting for better protection against violent patients
• Bronson Healthcare announces new president, CEO
• Beaumont receives $1.6 million from NIH to study glioblastoma
• ProMedica puts Coldwater Regional Hospital up for sale

OHIO

• Columbus docs pioneering cardiovascular advances
• Mercy Health St. Anne Hospital opens cutting-edge hybrid cardiovascular lab
• Nationwide Children’s Hospital seeks Columbus tax break on for-profit subsidiary
• Adena Health System could acquire Ohio hospital with surgery center
• Keeping UTMC a teaching hospital benefits the region
• Ohio pain clinic, owner pay $650K settlement for unnecessary procedures
• Former TriHealth exec hired as CFO of major Greater Cincinnati nonprofit
• Commissioners file claim against Morrow County Hospital board
• Bon Secours Mercy Health forecasts $10B in revenue this year
• Ohio county sues hospital board, wants out of deal with OhioHealth
• ProMedica puts Coldwater Regional Hospital up for sale

WISCONSIN

• Bill would allow Wisconsin hospitals to hire more physician assistants
• Columbus’ Prairie Ridge Health receives top performer awards
• Tom Still: Wisconsin at center of looming federal battle over health records
• Froedtert Health to open hospital at site across from Milwaukee County Zoo
• Ascension pledges $1 million for Racine Community Health Center over 5 years
• GE Healthcare transferring up to 250 jobs from metro Milwaukee to Chicago
• Wisconsin at center of looming federal battle over health records
• Children’s Wisconsin receives $15 million donation for mental health services
• Study says hospitals boost local economy
• Mayo Clinic Health System in Barron expands its birth center
• UW nurses, in reviving union, tell hospital board current system isn’t working
• Froedtert Health plans new campus at former Wisconsin Heart Hospital
• Madison hospitals taking steps to screen for coronavirus
• Atlanta, Milwaukee children’s hospitals get $15M donations
• Wisconsin healthcare professionals taking precautions to contain Wuhan coronavirus

SOUTH/SOUTHEAST

(Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee)

ALABAMA

• • What will UAB-Ascension alliance mean?
  • Encompass Health expanding with another joint venture
  • New CEO named at Encompass Health Rehabilitation Hospital of Shelby County

FLORIDA

• • Orlando surgery center faces federal lawsuit over kidney stone procedures, kickback claims
  • Baptist Health to build $200M Florida hospital
  • Nurses call for Florida Senate to pass bill removing physician supervision
  • South Florida hospitals preparing for potential cases of coronavirus
  • AdventHealth taps Brent Davis as CFO of Central Florida Division-North Region
  • Nation’s top orthopedic hospital opens in West Palm Beach
  • Florida hospital locked down after bomb threat
  • HSS opens 1st Florida hospital, 2nd new facility in 1 week
  • Nurses rally in Tallahassee to expand health care options
  • Florida hospital names Paige Laughlin COO

GEORGIA

• • WellStar opens new health park at Avalon
  • St. Francis Hospital names new CEO, she assumes post next month
  • Georgia health system acquires remaining stake in surgery center
  • Doctors Hospital pursues Columbia County ER
  • St. Francis hires new leader following CEO’s resignation. Here are the details.
  • Grady Health System Taps H.J. Russell, Skanska to Build $151 MM Free-Standing Surgical Center
  • Atlanta, Milwaukee children’s hospitals get $15M donations
  • Doctors Hospital talks about nurse shortage in Georgia

MISSISSIPPI

• • Future of Mississippi’s healthcare remains clouded on the heels of the governor’s first State of the State
  • Tucker joins UMMC as Obstetrics-Gynecology chair
  • New CEO at hospital

NORTH CAROLINA

• • Ocracoke Health Center Up and Running
  • In ‘Year of the Nurse,’ North Carolina has ongoing shortage
  • CaroMont step closer to building Belmont hospital
  • New Hanover hospital sale talk gets attention of state treasurer
  • Atrium breaks ground on $116M Charlotte hospital
  • Independent monitor for hospital merger going public in big way
  • Bacteria-sniffing dog helps keep North Carolina hospital clean
  • North Carolina hospital CEO on medical scare: ‘I’m grateful for the experience from a patient’s side’
  • SECU Comprehensive Cancer Center at CarolinaEast Medical Center is Officially Open
  • Lexington Medical Center to stop delivering babies by the end of June
  • Bill Kirby Jr.: Nagowski to share health care vision for community
  • Atrium Health executive named CBJ’s Women in Business Lifetime Achievement Award winner
  • Novant Health-GoHealth Urgent Care Opens First Center in Mint Hill
  • New heart failure clinic opens Feb. 3
  • UNC Health program rated best in nation
  • Construction underway for new tower at Atrium Health’s Pineville hospital

SOUTH CAROLINA

• • New comprehensive burn center to open at MUSC in Charleston
  • South Carolina hospital hit with lawsuit following malware attack
  • West Ashley Medical Pavilion result of city’s, MUSC’s visions

TENNESSEE

• • Reopening one of Tennessee’s closed hospitals proves difficult for new owner in Clay Co.
  • Saint Thomas Rutherford Hospital names new CFO
  • Payroll problems plague Tennessee hospital
  • Texas hospital challenges $300K penalty caused by typo
  • As HCA beats Q4 expectations, hospital giant points to talent strategy as key ‘competitive advantage’
  • Tennessee physician settles allegations of inflating NP charges
  • HCA’s profit tops $1B in Q4
  • Vanderbilt University Medical CEO: 3 revenue wins for academic medical centers

SOUTH-CENTRAL/SOUTHWEST

(Arkansas, Arizona, Louisiana, New Mexico, Oklahoma, Texas)

ARKANSAS

• • Mercy Hospital Fort Smith welcomes new COO Ryan Geib
  • Arkansas BCBS grants $800K to rural hospitals for participation in medical records exchange
  • $817,000 Awarded To 14 Rural Arkansas Hospitals For Patient Information
  • Judge dismisses legal challenge to Safe Surgery Arkansas effort
  • Rural health partners among award nominees
  • UA Little Rock receives grant for healthcare continuing education

ARIZONA

• • HonorHealth breaks ground on $39M behavioral health hospital
  • Appeals court orders Arizona to pay $1.4 million fine in prison health care lawsuit
  • Some Arizona hospitals are adding screening measures for coronavirus after outbreak spreads
  • Phoenix veteran charged $4,500 he didn’t owe for ER visit
  • HonorHealth names new CFO, chief human resources officer
  • Lyft expanding its reach in healthcare with CommonSpirit Health partnership
  • Grant money promotes mental health support for Arizona first responders
  • More healthcare offices help alleviate the impact of crowded hospitals
  • Northern Arizona Healthcare breast cancer program recognized for outstanding care

LOUISIANA

• • Analysis: Louisiana Medicaid Dispute Lingers Into New Term
  • Appeals challenge scrapping of Louisiana Medicaid contracts
  • Louisiana businessman owes Medicare over $27 million
  • Behavioral health center opens at New Orleans Children’s Hospital
  • Feud reignited between John Bel Edwards, Jeff Landry over controversial health care lawsuit
  • Louisiana Medicaid dispute lingers into new term
  • New use in the works for old University Hospital

NEW MEXICO

• • New bill proposes to cap insulin costs in New Mexico
  • Amid scare, state makes plan for coronavirus
  • New Mexico launches website regarding Novel Coronavirus info
  • PSP donates $5.9 million to TTUHSC for rural health care program

OKLAHOMA

• • Patients sue Oklahoma hospital over potential exposure to HIV, hepatitis
  • How Would State Pay for Medicaid Expansion? No One Knows Yet
  • New Machine Allows Tulsa Doctors To Test For Several Viruses

TEXAS

• • San Antonio hospitals spared from Texas downsizing
  • 6,000 Steward Health Care workers strike labor deal
  • CommonSpirit Health CEO to retire
  • University Health System invests in new mobile app
  • Kindred Healthcare to close 6 Houston, Dallas locations
  • Children’s Medical Center Plano to triple capacity with 7-story tower
  • Children’s Health partners with Amazon to streamline patient package delivery
  • Major Houston health system launches new air ambulance service
  • UT Health East Texas ushers in new leadership
  • 3 San Antonio hospital systems settle nurses’ wage lawsuit
  • Could a Local Company Save Rural Healthcare?
  • What Ride Share Could Mean For North Texas Healthcare
  • Texas hospital challenges $300K penalty caused by typo
  • VA’s Dallas hospital went without a gynecologist for nearly two years
  • Texas Health Fort Worth is the First in the Nation to Earn This Joint Commission Certification
  • Baylor Scott & White Garland and a VA Rebirth
  • Texas Health Fort Worth is the First in the Nation to Earn This Joint Commission Certification
  • Baylor Scott & White Garland and a VA Rebirth

NORTHWEST

(Alaska, Idaho, Montana, Oregon, Washington, Wyoming)

ALASKA

• • Alaska to Remove Psychiatric Patients From Jails, Hospitals
  • 2016 Medicaid reform bill generates huge savings
  • State health officials say Alaska is not among states with patients being monitored for coronavirus

IDAHO

• • Local hospital shutting down residency program this summer
  • Minidoka Memorial offers patients robotic arm assisted joint replacement procedures
  • Idaho Medicaid expansion signups pass 60,000
  • St. Luke’s Health System adds higher ed exec to board
  • Getting health care in rural Idaho areas could become easier
  • Idaho Health and Welfare seeks $3.7 billion overall budget

MONTANA

• • Hospital project gets $600,000 boost
  • Bozeman Health collaborates with Seattle Children’s Hospital ahead of NICU opening
  • CMMC updates to a new system for patients electronic medical records
  • Montana hospitals made an insurer to compete with BCBS. It worked — until hospital leaders wanted out
  • Bozeman health officials monitor coronavirus developments

OREGON

• • Oregon’s most charitable hospitals are not the largest
  • Nursing homes in Freeport, Oregon fined for endangering patients
  • Heatherington Foundation endows public health program
  • Oregon Senate bill aims to reduce numbers at State Hospital

WASHINGTON

• • ‘People don’t have any idea’: Swedish closing two ERs on Monday in advance of strike
  • A Corporate Hospital System Buys A Small Hospital. What Happens Next?
  • Seattle hospital hires tactical security guards ahead of strike
  • Seattle hospital to close 2 EDs during strike
  • UW Medicine is developing coronavirus diagnostic test
  • Northwest Kidney Centers Names Rebecca Cofinas Fox President and CEO
  • Bozeman Health collaborates with Seattle Children’s Hospital ahead of NICU opening
  • Seattle hospital strike begins
  • New Harborview tower could cost $952 million and rise above I-5

WYOMING

• • AHA honors Wyoming hospital with rural health award
  • Wyoming Medical Center exploring Banner Health affiliation
  • Cheyenne Regional Health System Gift of $250,000 Supports UW Nursing

WEST

(California, Colorado, Hawaii, Nevada, Utah)

CALIFORNIA

• • LA hospital back to full service after water line break
  • Dignity Health, PHC say they’re working to reach agreement
  • Health Data Breach Not Reported for Seven Months
  • San Diego’s Arch Health Pays $2.9 Million to Resolve False Claims Act Allegations
  • Some Bay Area hospital buildings pose risk of earthquake collapse
  • Workers at Methodist Hospital of Southern California vote to unionize
  • California health system eyes cuts, layoffs to overcome $57M shortfall
  • California physician group settles false billing case for $2.9M
  • California hospital taps CommonWell, Carequality for EHR data sharing
  • Tenet hospital in California names new CEO

COLORADO

• • Colorado Plains Medical Center named LifePoint Health National Quality Leader
  • The Medical Center of Aurora Names Dr. Philip Stahel Chief Medical Officer
  • Colorado hospital profits are skyrocketing, new state report says
  • CarePoint Health, MRH announce Emergency Medicine Care partnership
  • Colorado birth center pilots Mayo Clinic telemedicine program
  • Denver-based eye-care tech company names new executive suite
  • Colorado health system names new CEO
  • CDC Investigates Possible Case Of Coronavirus At St. Anthony Hospital In Lakewood
  • St. Mary’s cutting imaging costs
  • Lakewood Patient Doesn’t Have Coronavirus, Officials Announce
  • Report says Colorado hospital profits on the rise while patient costs continue to go up
  • Colorado Hospice Uses Telehealth Platform to Improve Palliative Care
  • California nursing home fined $13K+ for firing nurse after maternity leave
  • Colorado Bill Seeks Medicaid Reimbursement for Telehealth in FQHCs
  • 3 finalists named for hospital CEO
  • Hospitals Won’t Sue Colorado, Signals Truce Over Polis Reinsurance Fees
  • Banner opens first mental health unit for older adults in Northern Colorado

HAWAII

• • Coronavirus: West Hawaii hospitals prepared
  • Queen’s opens new Island Urgent Care center in Kakaako
  • Big Isle hospitals take action following China outbreak
  • HMSA appoints Mark Mugiishi as new president, CEO
  • Hawaii Island hospital to open new, $25M emergency room

NEVADA

• • MountainView Hospital breaks ground on free-standing ER facility in northwest Las Vegas
  • New emergency room to break ground in northwest Las Vegas
  • Clark County patient isolated for potential case of coronavirus
  • Carson Tahoe Health helps raise awareness, education for American Heart Month
  • Northern Nevada Medical Center is prepared for Coronavirus

UTAH

• • More than half of Utahns struggle to afford health care
  • St. Mark’s Hospital briefly placed on lockdown
  • Intermountain plans $500M pediatric ‘model health system’
  • Terri Kane, longtime CEO of Dixie Regional Medical Center, ending her 30-year medical career
  • How Intermountain added more time with patients, less in EHR

The post Health Provider News – January 31, 2020 appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.