Duane Morris Health Law

August 12, 2011September 10, 2014 by Duane Morris

IRS Releases Proposed Rules on Health Insurance Premium Tax Credit

On August 12, 2011, the Internal Revenue Service (“IRS”) released proposed regulations regarding the health insurance premium tax credit available to certain individuals who enroll in insurance plans through the state-based Affordable Insurance Exchanges (“Exchanges”). The tax credit is designed to make health insurance purchased through the Exchanges more affordable. The proposed regulations outline eligibility for and calculation of the tax credit, providing several examples for explanation and clarification. The proposed regulations were published in the Federal Register on August 17, 2011. Comments are due October 31, 2011, and a public hearing is scheduled for November 17, 2011.

To read the text of the Proposed Rule, please go to http://www.gpo.gov/fdsys/pkg/FR-2011-08-17/pdf/2011-20728.pdf.

August 3, 2011September 10, 2014 by Duane Morris

Interim Final Rule Released Allowing HRSA to Exempt Religious Employers From Covering Contraception

Interim final regulations released on August 3, 2011 by the Department of Health and Human Services, the Department of the Treasury and the Department of Labor (DOL) give the Health Resources and Services Administration (HRSA) the discretion to exempt religious employers that offer insurance to their employees from the requirement to cover contraception. These regulations amended the previous interim final regulations addressing coverage of preventive services by new insurance plans. The Interim Final Rule sets forth a definition of “religious employer” based on the most commonly used definition in those states that exempt religious employers from state law requirements to cover contraception. HHS is accepting comments on this definition.

To read the Interim Final Rule, please go to: http://www.gpo.gov/fdsys/pkg/FR-2011-08-03/pdf/2011-19684.pdf.

August 1, 2011September 10, 2014 by Duane Morris

New Guidelines Require New Insurance Plans to Provide Preventive Services to Women at No Additional Cost

On August 1, 2011, the U.S. Department of Health and Human Services (HHS) announced guidelines requiring new health insurance plans to provide certain preventive services to women without cost-sharing. The guidelines were developed by the Institute of Medicine. The preventive services that will no longer be subject to any co-payment, co-insurance or deductible include well-woman visits, screening for gestational diabetes, HPV testing for women 30 years of age and older, sexually-transmitted infection counseling, HIV screening and counseling, contraception and contraception counseling, breastfeeding support, and domestic violence screening and counseling. New health insurance plans must comply for plan years starting on or after August 1, 2012.

To read more about this announcement, please go to http://www.hhs.gov/news/press/2011pres/08/20110801b.html.

August 1, 2011September 10, 2014 by Duane Morris

CMS and HHS Release Final Rules Affecting Payment to Inpatient Rehabilitation Facilities and Skilled Nursing Facilities

On August 1, 2011, the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) released a Final Rule updating the prospective payment rates for inpatient rehabilitation facilities (IRFs). The rule also establishes a program that reduces the annual increase factor by 2 percent for failure to report quality data to HHS starting in 2014. The Final Rule implements section 3004 of the Affordable Care Act and will become effective on October 1, 2011.

The Final Rule affecting IRFs was published in the Federal Register on August 5, 2011 and can be found here: http://www.gpo.gov/fdsys/pkg/FR-2011-08-05/pdf/2011-19516.pdf.

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July 29, 2011September 10, 2014 by Duane Morris

CMS Transmittal Clarifies that Critical Access Hospitals are Included in CMS Laboratory Demonstration Project

On July 29, 2011, CMS issued Transmittal 78 clarifying that critical access hospitals (CAH) are included in CMS’ laboratory demonstration project for certain complex diagnostic tests. Under standard rules, payment made for tests provided by a laboratory working under arrangement with a hospital or CAH would ordinarily be in the form of a bundled payment to the hospital or CAH, and not directly to the laboratory. However, the Affordable Care Act requires that CMS conduct a demonstration project that will allow laboratories to receive a separate, direct payment for certain complex tests. The demonstration project begins January 1, 2012 and continues for two years or until the $100 million in funding is exhausted. Transmittal 78 rescinds and replaces Transmittal 74 dated July 15, 2011.

To read Transmittal 78, please go to https://www.cms.gov/transmittals/downloads/R78DEMO.pdf.

July 29, 2011September 10, 2014 by Duane Morris

$71.3 Million in Federal Funding to Expand Nursing Workforce

On July 29, 2011, the U.S. Department of Health and Human Services (HHS) announced that it would provide a total of $71.3 million in grant funding to expand the education and training of nurses and nursing diversity. The monies will be distributed among six types of awards: Nurse Education, Practice, Quality and Retention; Nursing Workforce Diversity; Nurse Faculty Loan Program; Advanced Nursing Education Program; Advanced Education Nursing Traineeships; Nurse Anesthetist Traineeships. Monies from these awards will support all levels of education from entry-level nursing to advanced traineeships, increase opportunities for individuals from disadvantaged backgrounds, and provide partial loan-forgiveness for nursing faculty.

To read more about this announcement and see details of each of the awards, please go to http://www.hhs.gov/news/press/2011pres/07/20110729a.html.

July 11, 2011August 18, 2014 by Patricia S. Hofstra

Some Thoughts on HIPAA

A few thoughts on HIPAA

Real case scenario. A health care provider’s car gets broken into and private health information (“PHI”) is stolen, along with other items. Next steps? Once the provider determines that a breach of unsecured PHI has occurred (an incidental disclosure of PHI does not constitute a breach), the provider should perform a risk assessment to determine whether the event poses a significant risk of financial, reputational or other harm to the patient.

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June 2, 2011August 18, 2014 by Neville M. Bilimoria

Expansion of CMS Never Events: They’re Not Just For Medicare Or Just For Hospitals Anymore

In 2005 when “Never Events” were proposed for hospitals through the Deficit Reduction Act, no one knew what the overall effect would be on hospitals or patient care. CMS later developed these and implemented these Never Events under the authority of the DRA to prevent Medicare payment to hospitals for certain “never events” or hospital acquired conditions (HACs) which were conditions that were high volume, involved higher payment, and which could be easily preventable. Now, hospitals and other health care providers have to worry about Never Events in the Medicaid space.

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May 13, 2011August 18, 2014 by Patricia S. Hofstra

Hospital Employment of Physicians

Those of us who have been in the health care industry for awhile have seen hospital employment of physicians come and go several times. In my early years as a health care attorney, I was an in-house counsel in the hospital industry. I represented hospitals in the rush to jump on the band wagon of physician employment. I am now in the private practice of law and while I continue to represent hospitals, I also represent physicians and physician groups exploring various relationships with hospitals including employment.

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April 12, 2011September 10, 2014 by Duane Morris

New Public-Private Partnership To Focus on Improving Quality, Safety and Affordability of Health Care

On April 12, 2011, The U.S. Department of Health and Human Services (HHS) announced its intentions to form a public-private partnership with stakeholders such as patient advocates, healthcare providers and leaders at major hospitals. Called Partnership for Patients, this national initiative was created to improve quality and safety in health care, while also substantially reducing health care costs. HHS estimated that the partnership could save up to $35 billion in health care costs. Under the authority of the Affordable Care Act, HHS will invest $1 billion dollars towards this endeavor.

The two main goals will be to assist hospital patients by (1) preventing injury and further illness and (2) eliminating or mitigating complications that would adversely affect patient recovery. To learn more about the Partnership for Patients, please visit HealthCare.gov.