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OIG Puts Muscle Behind Its Alert

Only two days after releasing its latest fraud alert, a deputy director from HHS’s Office of Inspector General announced that the OIG will be hiring additional attorneys to look into taking more administrative actions against physicians in their individual capacity. This announcement emphasizes that the OIG means serious business – not only is the OIG … Continue Reading

Capital Thinking: Health Care Legislative Update

House to Vote on Medical Device Excise Tax and IPAB Repeals In the House of Representatives, Majority Leader Kevin McCarthy (R-CA) has announced that several health care bills will be considered on the floor this week. Two of these bills dismantle portions of the Affordable Care Act (ACA). H.R. 160, the Protect Medical Innovation Act … Continue Reading

Oh, the Places You’ll Go! – International Healthcare Opportunities: Meeting the Need for Senior Care Facilities in China

The World Economic Forum has identified that today’s global infrastructure demand is estimated at approximately US$ 4 trillion in annual expenditures, with a gap – or missed opportunity – of at least US$ 1 trillion every year.  Despite existing supply of private capital, much more is needed to fill this gap.  This demand for infrastructure … Continue Reading

Capital Thinking: Health Care Legislative Update

This Week’s Hearings: Wednesday, June 10: The House Committee on Ways and Means will hold a hearing titled “Obamacare Implementation and the Department of Health and Human Services FY 2016 Budget Request.” Wednesday, June 10: The House Committee on Veterans’ Affairs Subcommittee on Oversight and Investigations will hold a hearing titled “Prescription Mismanagement and the … Continue Reading

Capital Thinking: Health Care Legislative Update

Lawmakers Anticipate King v. Burwell Decision With the Supreme Court expected to issue its opinion in the statutory interpretation case of King v. Burwell this month, lawmakers are considering legislative options to address any potential changes to the Affordable Care Act (ACA). The issue in the case of King v. Burwell is whether the ACA … Continue Reading

Resurrection of the 340B Mega Rule

In November 2014, we provided an update, which noted that the Health Resources and Services Administration (HRSA) had halted publication of the 340B Mega Rule.  HRSA, however, has now resurrected the Mega Rule having recently submitted the “340B Program Omnibus Guidelines” to the Office of Management and Budget, which is pending review. The substantive contents … Continue Reading

Capital Thinking: Health Care Legislative Update

Congressional Committees Consider Veterans’ Health, Chronic Conditions Several hearings this week will focus on veterans’ health topics. Both the House and the Senate will discuss the implementation of the Veterans Choice Program early in the week, with the Senate holding a hearing on Tuesday, May 12, and the House following on Wednesday, May 13. On … Continue Reading

Capital Thinking: Health Care Legislative Update

House and Senate Consider Medical Modernization Capitol Hill focuses on the future of health care this week. The Senate Committee on Health, Education, Labor, and Pensions (HELP) will conduct a discussion on medical advancement and improvement on Tuesday with a hearing titled “Continuing America’s Leadership: The Future of Medical Innovation for Patients.” Dr. Christopher P. … Continue Reading

Capital Thinking: Health Care Legislative Update

Legislative Activity Last Thursday, President Obama signed H.R. 2, the Medicare Access and CHIP Reauthorization Act, into law. Also known as the Sustainable Growth Rate (SGR) package or the “permanent doc fix,” the bill permanently repealed Medicare’s often-criticized physician payment system. The House and Senate each drew support from both sides of the aisle to … Continue Reading

Capital Thinking: Health Care Legislative Update

With both chambers returning from recess this week, attention is focused on Senate consideration of the House-passed bill to permanently repeal Medicare’s physician payment system. While the last “doc fix” expired March 31, the Centers for Medicare and Medicaid Services (CMS) indicated it would hold claims for two weeks to allow Congress to return from … Continue Reading

Capital Thinking: Health Care Legislative Update

Lawmakers Continue Negotiations on Doc Fix Package, Working Framework Announced With the current patch expiring on March 31, lawmakers continued over the weekend to negotiate a legislative package to permanently repeal Medicare’s automatic payment cut to physicians. H.R. 1470 is very similar to the bipartisan legislation that key committees in both chambers approved last year. … Continue Reading

Capital Thinking: Health Care Legislative Update

Congressmen Negotiate SGR Package Lawmakers on the House side of the Capitol continue to negotiate a package that would prevent an anticipated cut to Medicare physician payments and include a permanent repeal of payment system. Bipartisan leaders on the House Committee on Ways and Means and the House Committee on Energy and Commerce released joint … Continue Reading

Capital Thinking: Health Care Legislative Update

All Eyes On The Supreme Court On Wednesday, March 4, the attention of many lawmakers will turn to the Supreme Court, where oral arguments are slated for the statutory interpretation case of King v. Burwell. The issue in this case is whether the Affordable Care Act (ACA) provides tax subsidies to individuals who purchase insurance … Continue Reading

FDA Rethinks Consumer-Directed Print Ads for Drugs

In 2004, the FDA promulgated requirements for drug print advertisements.  FDA, 69 Fed. Reg. 6307 (May 10, 2004).  Those regulations required “the entire risk-related sections of the FDA-approved professional labeling.”  The FDA is now significantly changing its course because of  “recent social science research” indicating that non-material information should be omitted from drug advertisements in print … Continue Reading

IRS Releases Final Regulations for IRS Code Section 501(r)

On December 29th, the IRS released final regulations regarding Internal Revenue Code Section 501(r).  Section 501(r) was added to the Code as part of the Accountable Care Act and imposes certain requirements on charitable hospitals.   In general, the final regulations provide guidance on hospital obligations under Section 501(r), define the types of entities that must … Continue Reading

CMS Issues Post Windsor Guidance Regarding Same-Sex Spouses

The Centers for Medicare and Medicaid (“CMS”) issued a proposed rule broadening the definitions of “representative” and “spouse” in its Medicare and Medicaid conditions of participation and conditions of coverage in response to United States v. Windsor, 570 U.S. 12 (2013) — the U.S. Supreme Court  decision striking down Section 3 of the Defense of … Continue Reading

Capital Thinking: Health Care Legislative Update

Legislative Activity With the end of the year in sight, Congress remains busy in the health policy arena. Partisan talking points are expected to fly on Tuesday, when Chairman Darrell Issa (R-CA) will chair one of his final hearings in the House Committee on Oversight and Government Reform focused on the Affordable Care Act. Economist … Continue Reading

Update: Will Exchanges Treble Your Already Treble Damages?

Squire Patton Boggs attorneys recently published an article that discussed three anti-fraud elements of the Affordable Care Act (ACA) regarding maintaining financial integrity of the health insurance exchanges. Looking at those provisions, some may erroneously conclude that the ACA dramatically increased the damages that may be imposed for false claims made in connection with the … Continue Reading

DOJ Continues Record Recoveries for False Claims

It’s another record haul for the United States Department of Justice! In FY 2014, the DOJ ensured the collection of more than $ 24 billion from civil and criminal actions. The False Claims Act yielded a substantial portion of that total by having its own record setting recovery of $ 5.69 billion. Healthcare fraud recoveries … Continue Reading

This Week’s Legislative Activity and Hearings

Legislative Activity With the midterm elections now over, the attention of the health policy community has shifted to the Affordable Care Act’s open enrollment period, which began on November 15. Due to last year’s bungled rollout, as well as recently disclosed statements made by economist and White House consultant Jonathan Gruber, a renewed focus on … Continue Reading

Legislative Activity

 This Week’s Hearings: Wednesday, November 12: The Senate Committee on Appropriations will hold a hearing titled “The U.S. Government Response to the Ebola Outbreak.” Thursday, November 13: The House Committee on Foreign Affairs will hold a hearing titled “Combating Ebola in West Africa: The International Response.” The House Committee on Veterans’ Affairs will hold a … Continue Reading

The Yellow Brick Road to Medicare Provider Reimbursement Appeal

Over the years, various instruments have narrowed and darkened providers’ appellate rights relating to Medicare underpayment and recoupments. Recent court decisions, however, may put providers’ Medicare appeal rights back on the yellow brick road. On August 6th, the U.S. District Court for the District of Columbia issued three injunctions, each prohibiting HHS, the PRRB and … Continue Reading

Best Practice on Data Privacy

 Most organizations would agree that data privacy must be treated as a priority issue, not least because of the financial and reputational consequences of a data breach.  Squire Patton Boggs has a global team of specialists advising clients on local and global data issues. Two members of our team, Tom Zeno and Lindsay Holmes have written a two … Continue Reading