An interesting wrinkle in the development of False Claims Act cases has been the increase in whistleblowers who come from a position of trust. A recent example was an August 19, 2013 $26 million settlement with the Department of Justice by Shands Healthcare, a network of health care providers in Florida for which the complaint was recently unsealed. Continue reading
CMS indicated on its website in early November that it is extending the implementation period for another three months, until March 31, 2014. The website says that, “in general, CMS will not conduct post-payment patient status reviews for claims with dates of admission of October 1, 2013 thru March 31, 2014.” CMS also issued two new guidance documents on its website that describe selecting and reviewing hospital claims for patient status.
Written by: Emily Grey
The Center for Medicare and Medicaid Services (CMS) released what has become known as the “Two Midnight Rule” on August 2, 2013 in the Inpatient Prospective Payment System (IPPS). The Final Rule is available in the August 19, 2013 Federal Register.
Last week, in response to provider concerns and a letter from more than 100 members of Congress asking for postponement of the rule, CMS announced a 90 day implementation period beginning on October 1, 2013. Continue reading
In November, 2012, Louisiana health officials declined to create a state-run exchange, leaving it to the federal government to operate a marketplace for Louisiana residents. Only recently has any real clarity on the structure of the Louisiana Health Insurance Exchange been available for its October 1, 2013 opening date. Continue reading
On Thursday, August 29, in response to the Supreme Court overturning a key portion of the Defense Of Marriage Act (DOMA), a handful of agencies announced they would be extending rights to married same-sex couples. Notably, the Department of Health and Human Services (HHS) is one of them. This development means an extension of Medicare benefits to couples previously denied Medicare benefits because of DOMA. Same-sex married couples will be allowed to file joint federal tax returns, and as a result are able to claim marriage-related exemptions, employee benefits, claiming the earned income tax credit and other credits and deductions even if they live in jurisdictions that don’t recognize same-sex marriage. Continue reading
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