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- Audience: Hospital and Health Systems
Events
11th Annual ASC and Health Care Management Symposium
Garfunkel Wild's 11th Annual ASC and Health Care Management Virtual Symposium is dedicated to the most important business, legal, clinical, and operational issues facing the ASC and health care management community.
Alerts
NJ Supreme Court Vacates $23.4M Award Against Valley Hospital
On April 16, 2024, the Supreme Court of New Jersey issued its decision in Comprehensive Neurosurgical, P.C. v. The Valley Hospital. In an over 60-page unanimous opinion, the Court vacated a 23.4 million dollar award against Valley Hospital.
Alerts
OIG Allows Patient Assistance Programs Funded by Drug Manufacturers
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-02) permitting a non-profit organization (Non-Profit) to provide financial support to eligible patients with specific rare diseases through assistance programs (Programs) it operates.
Events
Cybersecurity – It’s More Than HIPAA: NY Regulatory Refresher for 2024
Join the health care professionals of Garfunkel Wild and Withum as they dive into the technical, legal, and financial steps you will need to take to come into compliance with the new cybersecurity regulations for New York hospitals.
Alerts
FQHC Look-Alike Application Blackout Period: Changes are Coming
The Health Resources and Services Administration (HRSA) has announced that it will not be accepting Federally Qualified Health Center (FQHC) Look-Alike Initial Designation (LAL-ID) applications for approximately one month starting in late June.
Alerts
CMS Announces Payment Program for Providers Impacted by Change Healthcare Cyberattack
On March 9, 2024, CMS announced it will make available Change Healthcare/Optum Payment Disruption accelerated payments to providers experiencing potentially significant cash-flow problems as a result of the cyberattack on UnitedHealth Group’s subsidiary Change Healthcare/Optum .
Alerts
OIG Issues New Resource for Single Audits
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
Alerts
Hospitals Should Consider Legal Action to Resolve Medicare Advantage 340B Drugs Underpayments
Despite the United States Supreme Court’s finding that the reduction of Medicare reimbursement rates for 340B outpatient drugs was unlawful, Medicare Advantage organizations (“MAOs”) maintain that they have no similar responsibility to make hospitals whole.
Alerts
New York OMIG Updates Self-Disclosure Guidance
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
Alerts
Favorable OIG Advisory Opinion Allows Subsidies for FDA-Approved Clinical Studies
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-11) that allows a medical device manufacturer (Manufacturer) to subsidize Medicare cost-sharing obligations as part of a U.S. Food & Drug Administration (FDA)-approved clinical study involving a Category B Investigational Device Exemption.
Alerts
OIG Approves Creative Approach to Restructuring Medical Practice Partnerships
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-12) that allows a limited liability partnership (the Partnership) consisting of two classes of physician partners to make a one-time, voluntary redemption offer (offer) to individual partners when they reach age 67.
Alerts
OIG Approves Use of Gift Cards for Referrals in Certification-Heavy Advisory Opinion
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-15) permitting a consulting company’s (Consultant) proposal to offer gift cards to its current physician practice customers for referring potential new physician practice customers to Consultant. Notably, OIG determined that the proposed arrangement did not implicate the Anti-Kickback Statute (AKS).
Alerts
OIG’s Newest Strategic Plan Prioritizes Managed Care Oversight
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) recently designated oversight of managed care as a “priority area”, and developed a coordinated strategic plan (the Plan) to better align its audits, evaluations, investigations, and enforcement of managed care.
Alerts
OMIG’s 2024 Work Plan Gives Critical Insights into Program Integrity Initiatives
The New York State Office of the Medicaid Inspector General (OMIG) released its 2024 work plan in furtherance of its mission to coordinate and conduct activities to prevent, detect and investigate medical assistance program fraud, waste and abuse, and to recover improperly expended Medicaid funds.
Alerts
More Provider “Nuggets” From OIG’s Year-End Reporting Blitz
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
Alerts
OIG’s Favorable Advisory Opinions Allow Incentives to Medigap Plan Policyholders
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted two favorable Advisory Opinions (23-09 and 23-10) to allow a licensed offeror of Medicare Supplemental Health Insurance (Medigap Plan) policies and a preferred health organization (PHO) (collectively, “the requestors”) to incentivize Medigap Plan policyholders to seek inpatient care from a hospital within the PHO’s network. Notably, OIG issued these favorable opinions even though the proposed incentives implicated the Anti-Kickback Statute (AKS) and the Beneficiary Inducement Civil Money Penalty (CMP), and there was no applicable exception or safe harbor.
Alerts
DOJ/HHS Jointly Release "Highlight Reel" Report
This week, the United States Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) fulfilled its annual statutory obligation by releasing its jointly-authored Health Care Fraud and Abuse Control Program (HCFAC) Report for Fiscal Year 2022.
Alerts
OIG Provides Roadmap to Hot-Button Issues
The OIG fulfilled its annual statutory obligation by releasing its Top Management and Performance Challenges (TMC) document. Providers should take note because the document provides important insight into the specific areas over which HHS (and the OIG) will remain focused.
Events
FCMA and HCMA Webinar - Website and Online Pitfalls: A Prescription for Physicians and Other Heathcare Providers
Join Garfunkel Wild's Zachary B. Cohen and Taras M. Czebiniak for an informative and eye-opening session that will delve into some of the most common compliance issues physicians must navigate in the digital age.
Alerts
OIG Releases New General Compliance Program Reference Guide
On November 6, 2023, the OIG released its General Compliance Program Guidance, the first in a series of new, non-binding reference guides designed to share information with health care compliance professionals and other health care industry stakeholders
Alerts
CMS Releases Updated Request for Applications for New Making Care Primary Model
On August 14, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a request for applications for the Making Care Primary (MCP) Model, its newest innovation program aimed at improving patient care by supporting the delivery of advanced primary care services
Alerts
Temporary Health Care Staffing Agencies Now Required to Register in New York
In what appears to follow a multi-state trend to protect “temporary” workers, as part of the New York Budget for FY 2023-2024, a new law went into effect that requires any entity that provides temporary staff to health care entities to register with the Department of Health (DOH).
Alerts
Connecticut Signals Increased Scrutiny of Physician Practice Acquisitions
On July 21, 2023, the Executive Director of the Connecticut Office of Health Strategy (“OHS”), sent a letter to Connecticut physicians reminding them of the requirement for certain practice transactions to obtain Certificate of Need (“CON”) approval prior to closing.
Alerts
FQHC Enters Into Agreement To Resolve Disability Discrimination Complaint
On May 10, 2023, MCR Health, Inc. (“MCR” or the “Center”), a federally qualified health center (“FQHC”) based in Florida entered into a voluntary resolution agreement with the Department of Health and Human Services, Office of Civil Rights (“OCR”) to resolve a disability discrimination complaint against the Center.
Events
Florida Telehealth – What Florida and Non-Florida Practitioners Need to Know
Garfunkel Wild’s Susan L. St. John will present the Webinar “Florida Telehealth – What Florida and Non-Florida Practitioners Need to Know” on February 28, 2023 from 12:00 PM - 1:00 PM ET.
Alerts
Payment Error Rate Measurement Program for Florida Medicaid and Chip Providers
On February 17, 2023, Florida Medicaid released a Health Care Alert reminding providers of their obligations under the Centers for Medicare and Medicaid Services (“CMS”) Payment Error Rate Measurement (“PERM”) program.
Alerts
New York Proposes Law To Approve Transactions Involving Physician Practices and MSOs
The New York State Executive Budget for fiscal year 2024 includes a proposed law to review and approve material transactions involving physician practices, Management Services Organizations (MSOs), and other health care entities.
Podcasts
Health Information Technology Podcast - Termination and Transition Periods
Garfunkel Wild's Health Care Information and Technology Practice Group's Podcast Series "Health Information Technology Podcast- Termination and Transition Periods".
Publications
Federal No Surprises Act – 2023 Enforcement Of The Good Faith Estimate For Convening Providers And Facilities
The No Surprises Act requires providers and facilities to provide uninsured or self-pay individuals with a good faith estimate (“GFE”) of expected charges for a scheduled or requested item or service.
Alerts
Cultural Training and EMR Requirements for NJ Hospitals and Laboratories
Beginning January 18, 2023, New Jersey hospitals and clinical laboratories must demonstrate compliance with cultural competency requirements recently issued by the New Jersey Department of Health (“DOH”).
Alerts
Online Tracking Technologies Can Lead to HIPAA Violations
The Department of Health and Human Services, Office of Civil Rights (“OCR”) has published a Bulletin which officially states that incorporating certain tracking technologies into websites and mobile applications may cause HIPAA violations that could result in breach notification obligations as well as penalties. This includes platforms and services provided by companies like Meta (formerly Facebook) and Google.
Events
NY Chapter ACS/Manhattan Council Annual Dinner: Does Your Practice Have Sufficient Protocols and Training with Regard to How Staff Must Accommodate Deaf or Hard of Hearing Patients?
Garfunkel Wild’s Marc A. Sittenreich will present “Does Your Practice Have Sufficient Protocols and Training with Regard to How Staff Must Accommodate Deaf or Hard of Hearing Patients?” at the New York Chapter American College of Surgeons – Manhattan Council Annual Dinner on November 10, 2022.
Events
Garfunkel Wild and Garfunkel Health Advisors Complimentary Webinar – Major Changes to E/M Coding and Documentation Requirements in 2023 – Will You Be Ready?
Garfunkel Health Advisors Alicia Shickle, Simon Chaykler, and Garfunkel Wild’s Robert A. Del Giorno will present the webinar ”Major Changes to E/M Coding and Documentation Requirements in 2023 – Will You Be Ready? on November 8 and 9, 2022.
Events
Health Care Hot Topics: Florida’s New Minimum Wage Requirements For Medicaid Providers
Garfunkel Wild's Susan St. John discusses the things providers need to know about the new minimum wage requirements, and a new civil cause of action for non-compliance.
Alerts
No Sanctions for Financial Relationships Between a Hospital and Federally Qualified Health Center Look-Alike
In Advisory Opinion No. 22-17, posted on September 6, 2022, the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) stated that it would not impose sanctions on a hospital system (Hospital) and a federally qualified health center look-alike (FQHCLA) that were parties to agreements under which the Hospital provided financial support to the FQHCLA.
Alerts
CMS Rescinds COVID-19 Emergency Declaration Blanket Waivers for Medicare Long-Term Care Facilities
On April 7, 2022, the Centers for Medicare & Medicaid Services (“CMS”) released a memorandum, QSO-22-15, announcing the restoration of certain minimum regulatory requirements that had been waived in response to the COVID-19 Public Health Emergency. CMS will end the waivers in two groups, under two time frames.
Alerts
New York Lifts Suspension of Nursing Home Staffing/Minimum Spending Requirements
Governor Kathy Hochul re-instated provisions in the State Public Health Law (Sections 2895-b[3] and 2828[1]). The New York State Department of Health (DOH) later notified nursing home administrators that these two provisions are in “full effect” as of April 1, 2022.
Podcasts
IP Rights & Issues Associated with Non-Fungible Tokens (NFTs)
Garfunkel Wild's Health Care Information and Technology practice groups first Podcast in the series "Topics and Issues related to Health IT" addresses new and cutting edge IT technological developments and issues.
Events
4th Annual CHEMED Medicine & Ethics Conference
Mr. Jeff Adest will present on “Developing Services Delivery and Technology Considerations” and “Emerging Employee Issues: Vaccines, Marijuana and Related Concerns” at the 4th Annual CHEMED Medicine & Ethics Conference, February 17-20, 2022.
Events
Garfunkel Wild Webinar – Federal No Surprises Act – One Month In. What Have We Learned? What Questions Remain?
Garfunkel Wild’s Debra Silverman and John Martin will present the webinar “Federal No Surprises Act – One month in. What have we learned? What questions remain?" on February 1, 2022, from 12:00 pm – 1:00 pm (EST).
Alerts
The Supreme Court Approves CMS Vaccine Mandate, but Halts OSHA Mandate
On January 13, 2022, the U.S. Supreme Court permitted the vaccine mandate for health care workers in facilities regulated by Centers for Medicare and Medicaid Services (CMS). Specifically, the CMS vaccine mandate requires all staff of facilities participating in Medicare/Medicaid to be vaccinated.
Events
Leading Age Annual Meeting
Garfunkel Wild Partner Director Debra Silverman will present at the Leading Age Annual Meeting on October 25, 2021.
Events
Behavioral Health News Webinar “This Will Only Hurt a Little – Stoicism in the Face of EHR Implementations”
Garfunkel Wild Partner Terence Russo will present at Behavioral Health News Webinar “This Will Only Hurt a Little – Stoicism in the Face of EHR Implementations” on October 13, 2021 from 1:00 pm – 2:00 pm EDT.
Alerts
COVID Health Care Worker Mandates: New York, New Jersey and Connecticut
As the Delta variant of COVID-19 continues to spread, New York, New Jersey, and Connecticut have mandated that certain health care workers be vaccinated against COVID-19.
Alerts
New York Hospital/Nursing Home Staffing Legislation Enacted
On June 18, 2021, Governor Cuomo signed into law two bills related to clinical staffing for hospitals and nursing homes. As reported in our prior Alerts, dated May 7, 2021:
Alerts
The NJ Health Care Transparency Act: Time is Running Out
The New Jersey Health Care Transparency Act (the “Act”) becomes effective on July 1, 2021. The Act requires health care professionals to clearly inform patients of their training and qualifications when they are providing in-person care to patients and when advertising their practice.
Alerts
Cuomo Announces End of State of Emergency in New York
On June 23, 2021, Governor Cuomo announced that the State-of-Emergency in New York declared as a result of the COVID-19 pandemic ends June 24, 2021.
Alerts
New York DOH Issues Policy on Submission of False Information in License Applications
On June 11, 2021, the New York Department of Health (DOH) posted a “Dear Applicant Letter” informing applicants for certificates of need (CON), licensure for adult care facilities (ACF) or licensed home care services agencies (LHCSA) or transfer of ownership interest notices of its new policy regarding evaluation of the applicant’s character and competency.
Publications
Salvatore Puccio Co-Authored an Article Published in Outpatient Surgery Magazine
Salvatore Puccio, co-authored the article “Avoiding Pandemic Predicaments: Be ready to navigate the changing landscape brought on by COVID-19,” published in the May 2021 edition of Outpatient Surgery Magazine.
Alerts
Staffing Legislation Impacts New York Hospitals
On May 5, 2021, the New York State legislature approved two bills with differing requirements related to clinical staffing for hospitals and nursing homes. With a goal of improving both patient and staff safety, as well as patient outcomes, the Governor is expected to sign each bill (A07119 and A00108B) into law soon. This Alert addresses the requirements for hospitals.