Continuing to look for ways to reduce the Medicare administrative law judge (ALJ) appeals backlog, CMS has explored enhancing the role of Qualified Independent Contractors (QICs) to resolve disputed claims earlier in the appeals process. Its main pilot in this area is the Telephone and Reopening Process Demonstration (Demonstration), which affords certain providers the ability to present their case to a representative of the QIC and have a live discussion about the merits of the appeal.
Legal Insights and Perspectives for the Healthcare Industry
The Morgan Lewis Labor & Employment NOW video series provides analysis of the latest legal developments and compliance insight for employers. In this edition, Doug Hart discusses staffing-related trends that arise in collective bargaining in the healthcare industry. Doug offers guidance to hospitals and healthcare facilities to better understand unions’ bargaining positions and determine appropriate employer responses, focusing on in-house registries, float pools, ratios, contract language, and wage and hour concerns.
Starting with an analysis of the hospital and health plan price transparency rules, Health Law Scan celebrated the month that brings us Thanksgiving with several interesting servings.
Further strengthening incentives for organizations to self-report potential FCPA violations, the US Department of Justice continued that trend with additional updates to the FCPA Corporate Enforcement Policy announced on November 20.
The US Department of Health and Human Services (HHS) Office of General Counsel (OGC) offered the healthcare industry the benefit of its legal analysis of the recent US Supreme Court opinion in Azar v. Allina Health Services (Allina) with respect to its impact on Medicare payment rules, sharing its Memorandum to the Principal Deputy Administrator & Director of the Center for Medicare dated October 31, 2019 (OGC Memo) with the public.
In what has become the new “normal” in Washington, DC, these days, hospitals and their associations filed a lawsuit today against the US Secretary of Health and Human Services (Secretary) challenging the recent Final Rule issued by the Centers for Medicare and Medicaid Services (CMS) on November 27, 2019, addressing hospital pricing disclosures.
US government–funded academic medical centers and other research institutions are caught between traditional values of academic freedom, collaboration, and nondiscrimination and their obligations to comply with US law and enforcement authorities.
The government watchdog agencies continue to focus their attention on Medicare oversight of hospice providers, with two recent reports from the US Government Accountability Office (GAO) and the HHS Office of Inspector General (OIG) focused in large part on ways to improve hospice surveys and nursing care oversight deficiencies.
In this LawFlash, our healthcare industry team unpacks the final rule requiring hospitals to make standard charges public and the proposed transparency in coverage rule requiring group health plans and health insurance issuers to disclose negotiated rates with providers and out-of-network estimates for consumers.
Healthcare is the largest labor market in the United States, employing over 18 million workers.