Robert Nauman

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Ohio Expands Availability of Telehealth

Since the beginning of the COVID-19 pandemic, policymakers at both the federal and state level have worked to expand the availability of telehealth services. Since telehealth , in many cases, is viewed to provide a convenient, accessible and safe alternative to in-person visits with healthcare providers, it has been considered an effective tool to maintain … Continue Reading

Updated: Ohio Hospitals May Soon be Subject to License Requirements

Unlike most other states, Ohio does not currently have a hospital licensure system. While Ohio hospitals are subject to registration and information reporting requirements, as well as licensure requirements for certain discrete hospital services, Ohio does not require hospitals to obtain a state license in order to operate. That may change if certain provisions in … Continue Reading

CMS Publishes Stark Law Final Rules-Updated

In follow up to our post last month, on Wednesday, December 2, The Centers for Medicare and Medicaid Services (CMS) published final rules implementing many of the Stark Law changes first proposed in October 2019 (the Final Rules). These changes have been adopted to address the shift to a value-based and coordinated healthcare environment. The … Continue Reading

CMS Releases Final Rules Implementing Stark Law Changes to Reflect Value-Based Healthcare Delivery and Payment Environment

On Friday, November 20, CMS released final rules implementing many Stark Law changes first proposed in October 2019 (the “Final Rules”). This release comes despite earlier suggestions that these Final Rules may be delayed until sometime in 2021. Developed as part of the Regulatory Sprint to Coordinated Care program, the Final Rules represent CMS’s recognition … Continue Reading

CMS Delays Publication of Final Rule Implementing Stark Law Changes to 2021.

As we reported last October, CMS and the OIG issued proposed rules aimed at updating the Stark Law, Anti-Kickback Statute, and Civil Monetary Penalties Law as part of HHS’ Regulatory Sprint to Coordinated Care. In part, the proposed rules seek to address the current value-based and coordinated healthcare environment. While publication of final rules concerning … Continue Reading

HHS OIG says “Ditto” to HHS Blanket Stark Waivers for Purposes of the Anti-Kickback Statute

On April 3, the Department of Health and Human Services Office of the Inspector General (HHS OIG) released a policy statement to align its enforcement of the federal Anti-Kickback Statute (AKS) with HHS’s recent Blanket Waivers of Stark (Blanket Waivers) during the COVID-19 pandemic. As previously reported, HHS issued the Blanket Waivers to allow for … Continue Reading

Financial Lifelines, Waivers and Other Support for Hospitals and Healthcare Systems Responding to the Coronavirus Pandemic

In just the past week, the federal government has issued a flurry of legislative and regulatory aid packages, programs and rule changes for hospitals and health systems responding to the COVID-19 pandemic. These measures are designed to give emergency financial support and to cut through regulatory roadblocks to delivering care during the crisis. The federal … Continue Reading

UPDATED: CMS Expands Accelerated and Advance Payment Program

On March 28, 2020, the Centers for Medicare & Medicaid Services (CMS) announced an expansion of its Accelerated and Advance Payment Program (the Program). The Program is designed to help providers with “significant cash flow problems resulting from…unusual circumstances of the hospital’s operation.” 42 U.S.C. § 1395g (e)(3). Usually deployed during times of natural disasters, … Continue Reading

CMS Issues Blanket Stark Law Waivers in Connection with COVID-19 Emergency

On March 30, in connection with the national COVID-19 emergency, the Centers for Medicare and Medicaid Services (“CMS”) issued waivers (the “Waivers”) for certain provisions of the federal physician self-referral law, commonly referred to as the “Stark Law.” To ensure there will be sufficient capacity to handle the unique challenges of the COVID-19 pandemic, CMS … Continue Reading

US Department of Labor Publishes Further Guidance Concerning Paid Sick Leave and Paid FMLA Leave under FFCRA; Finally Clarifies Small Business Exemption

Since the Families First Coronavirus Response Act (FFCRA) became law last week, the US Department of Labor (DOL) has been publishing and updating guidance concerning the public health emergency paid sick leave and emergency Family and Medical Leave Act (FMLA) leave required under the law.  See a summary here by Daniel Pasternak in our Employment … Continue Reading

HHS Expands Coverage for Telehealth in Response to COVID-19

On March 17, 2020, in response to the national COVID-19 public health emergency, divisions of the Department of Health and Human Services (HHS) outlined a series of policy changes regarding telehealth services. In an effort meant to expand the capacity of the healthcare system and protect seniors who are the most vulnerable to COVID-19, the … Continue Reading

Coronavirus Resource Center

In December 2019, a new strain of coronavirus emerged in Wuhan, China. The World Health Organization (‘WHO’) has named this strain COVID-19. WHO declared the outbreak a Public Health Emergency of International Concern on 30 January 2020. The Organization for Economic Cooperation and Development said on 3 March 2020 that while the world economy is … Continue Reading

Ohio Revises Definition of Ambulatory Surgical Facilities, Potentially Expanding Application of Licensure Requirements

Ohio recently revised the definition of an Ambulatory Surgical Facility (ASF), as part of the new 2020/2021 general operating budget legislation. The change expanded the ASF definition, potentially triggering ASF licensing requirements for some facilities not previously subject to such requirements. Under the revised definition, an ASF includes (1) all facilities that provide outpatient surgical … Continue Reading

Proposed Changes to the Anti-Kickback Statute, Stark Law and Civil Monetary Penalties Law Address Value-Based Healthcare Environment

On October 9, the Department of Health and Human Services (HHS) released proposed rules (the Proposed Rules) aiming to update the Anti-Kickback Statute (the AKS), Stark Law and Civil Monetary Penalties Law (CMPL) to address today’s value-based and coordinated healthcare environment. The proposals reflect a recognition on HHS’s part that the healthcare landscape of today … Continue Reading

HHS Proposes Changes to the Discount Safe Harbor Framework to Realign Incentives and Put Downward Pressure on Drug Prices

On February 6, 2019, the Department of Health and Human Services (HHS) published a Proposed Rule modifying the Anti-Kickback Statute safe harbor protection with the aim of lowering prescription pharmaceutical product prices and out-of-pocket costs for (primarily Medicare Part D and Medicaid Managed Care Plan) consumers. With the Proposed Rule, HHS hopes to encourage medication … Continue Reading

Federal Court Held HHS Lacks the Authority to Impose Dramatic 340B Reimbursement Rate Reduction

On December 27, 2018, the provider community scored a major victory when the U.S. District Court for the District of Columbia held that the Medicare statute did not authorize the Department of Health and Human Services (“HHS”) to impose a nearly 30% reduction in 340B Reimbursement rates. The legal implications of this decision may be … Continue Reading

CMS “Regulatory Sprint to Coordinate Care” Seeks Input to Lessen the Regulatory Burden of the Stark Law

Late last month, the Centers for Medicare & Medicaid Services (“CMS”) issued a request for information (“RFI”) seeking input regarding the Medicare physician self-referral law and its implementing regulations (“Stark Law”) and how it may prevent or inhibit care coordination amongst healthcare providers. As part of CMS’s broader “Regulatory Sprint to Coordinated Care” initiative, the … Continue Reading

CMS to Review Stark Law in Connection with Payment Reform

CMS has recently signaled its intention to review the Stark Law and its impact on providers. During a January, 2018 American Hospital Association webinar, CMS Administrator Seema Verma announced the development of an inter-agency group to review the Stark Law in light of provider complaints that the law acts as a barrier to their ability to … Continue Reading

CMS to Reduce 340B Drug Payments to Hospitals by $1.6 Billion

On November 13, CMS published the final rule revising the Medicare hospital Outpatient Prospective Payment System for 2018.  Among a number of changes, the final rule dramatically reduces Medicare Part B payments to hospitals for separately payable drugs purchased through the 340B Program.  Currently, Medicare pays hospitals the Average Sales Price (ASP) plus 6% for … Continue Reading

Congress Considering Tax Reform Bills with Major Impacts on Tax-Exempt Organizations

In recent weeks, we’ve highlighted provisions of the House and Senate tax bills that impact tax-exempt bonds.  However, the bills contain other provisions which may have a significant impact on tax-exempt organizations, including hospitals and other tax-exempt health care providers.  Specifically, provisions in the bills regarding charitable giving, tax-favored financing, governance and compensation, political activity, unrelated … Continue Reading

The Senate Gives the House the Byrd and Retains Tax-Exempt Qualified Private Activity Bonds, Tax Credit Bonds, and Tax-Exempt Stadium Financing Bonds. Tax-Exempt Advance Refunding Bonds, However? Not so Much.

Last week, our tax experts summarized certain provisions of the House tax reform bill which would affect the exclusion from gross income of interest on tax-exempt bonds.  This week, we summarize the Senate’s version of the bill which, in contrast, makes no changes to the existing provisions of the Internal Revenue Code that permit the issuance of certain … Continue Reading

So it Begins: First Draft Tax Reform Bill Eliminates 501(c)(3) Bonds and All Other Private Activity Bonds, All Advance Refunding Bonds, All Tax Credit Bonds, and Governmental Bonds for Sports Venues

The House Committee on Ways and Means has released the first draft of the federal tax reform bill.  This bill, if adopted, would profoundly affect the exclusion from gross income of interest on tax-exempt bonds.  Our public finance and tax experts have prepared a detailed summary for our Public Finance Tax blog.  A link to … Continue Reading

2018 Proposed Changes to the Physician Fee Schedule

On July 21, 2017, the Center for Medicare & Medicaid Services (CMS) published a proposed rule that addresses Part B Medicare payments and policies for calendar year (CY) 2018. The major proposed rule is one of several Medicare payment rules for CY 2018 reflecting a broader strategy to relieve regulatory burdens for providers; support the … Continue Reading
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